Survivors don't give a shit about determinants of Poststroke Cognitive Performance. They want concrete protocols that bring back their cognitive performance. Are you that fucking stupid you have NO understanding of survivor wants and needs? Send your doctor after these people to see their cognitive performance on stroke problems to be solved.
The GRECogVASC Study
Originally published4 Oct 2018Stroke. 2018;49:2666–2673
Abstract
Background and Purpose—
We
aimed to define the neuroimaging determinants of poststroke cognitive
performance and their relative contributions among a spectrum of
magnetic resonance imaging markers, including lesion burden and
strategic locations.
Methods—
We
prospectively included patients with stroke from the GRECogVASC study
(Groupe de Réflexion pour l’Évaluation Cognitive Vasculaire) who
underwent 3-T magnetic resonance imaging and a comprehensive
standardized battery of neuropsychological tests 6 months after the
index event. An optimized global cognitive score and neuroimaging
markers, including stroke characteristics, cerebral atrophy markers, and
small vessel diseases markers, were assessed. Location of strategic
strokes was determined using a specifically designed method taking into
account stroke size and cerebral atrophy. A stepwise multivariable
linear regression model was used to identify magnetic resonance imaging
determinants of cognitive performance.
Results—
Data
were available for 356 patients (mean age: 63.67±10.6 years; 326
[91.6%] of the patients had experienced an ischemic stroke). Six months
poststroke, 50.8% of patients presented with a neurocognitive disorder.
Strategic strokes (right corticospinal tract, left antero-middle
thalamus, left arcuate fasciculus, left middle frontal gyrus, and left
postero-inferior cerebellum; R2=0.225; P=0.0001), medial temporal lobe atrophy (R2=0.077; P=0.0001), total brain tissue volume (R2=0.028; P=0.004), and stroke volume (R2=0.013; P=0.005)
were independent determinants of cognitive performance. Strategic
strokes accounted for the largest proportion of the variance in the
cognitive score (22.5%). The white matter hyperintensity burden, brain
microbleeds, and dilated perivascular spaces were not independent
determinants.
Conclusions—
Optimized
global cognitive score and combined approach of both quantitative
measures related to structure loss and qualitative measures related to
the presence of strategic lesion are required to improve the
determination of structure-function relationship of cognitive
performance after stroke.
Footnotes
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