White Matter Hyperintensity Volume and Poststroke Cognition: An Individual Patient Data Pooled Analysis of 9 Ischemic Stroke Cohort Studies-Reference-Cited by-同舟云学术

White Matter Hyperintensity Volume and Poststroke Cognition: An Individual Patient Data Pooled Analysis of 9 Ischemic Stroke Cohort Studies

Published:2023-12 Issue:12 Volume:54 Page:3021-3029
ISSN:0039-2499
Container-title:Stroke
language:en
Short-container-title:Stroke

Author:

de Kort Floor A.S.¹^ORCID,Coenen Mirthe¹^ORCID,Weaver Nick A.¹^ORCID,Kuijf Hugo J.²^ORCID,Aben Hugo P.³^ORCID,Bae Hee-Joon⁴^ORCID,Bordet Régis⁵^ORCID,Cammà Guido¹^ORCID,Chen Christopher P.L.H.⁶⁷^ORCID,Dewenter Anna⁸^ORCID,Duering Marco⁸⁹^ORCID,Fang Rong⁸^ORCID,van der Giessen Ruben S.¹⁰^ORCID,Hamilton Olivia K.L.¹¹¹²¹³^ORCID,Hilal Saima⁶⁷¹⁴^ORCID,Huenges Wajer Irene M.C.¹¹⁵,Kan Cheuk Ni⁶⁷,Kim Jonguk⁴^ORCID,Kim Beom Joon⁴^ORCID,Köhler Sebastian¹⁶^ORCID,de Kort Paul L.M.³^ORCID,Koudstaal Peter J.¹⁰^ORCID,Lim Jae-Sung¹⁷^ORCID,Lopes Renaud⁵^ORCID,Mok Vincent C.T.¹⁸¹⁹,Staals Julie²⁰^ORCID,Venketasubramanian Narayanaswamy²¹^ORCID,Verhagen Charlotte M.¹,Verhey Frans R.J.¹⁶^ORCID,Wardlaw Joanna M.¹¹¹²^ORCID,Xu Xin⁶⁷^ORCID,Yu Kyung-Ho²²^ORCID,Biesbroek J. Matthijs¹²³^ORCID,Biessels Geert Jan¹^ORCID

Affiliation:

1. Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, the Netherlands (F.A.S.d.K., M.C., N.A.W., G.C., I.M.C.H.W., C.M.V., J.M.B., G.J.B.).

2. Image Sciences Institute, University Medical Center Utrecht, the Netherlands (H.J.K.).

3. Department of Neurology, Elisabeth Tweesteden Hospital, Tilburg, the Netherlands (H.P.A., P.L.M.d.K.).

4. Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea (H.-J.B., J.K., B.J.K.).

5. Lille Neuroscience & Cognition (LilNCog) U1172, Université Lille, Inserm, CHU Lille, France (R.B., R.L.).

6. Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore (C.P.L.H.C., S.H., C.N.K., X.X.).

7. Memory, Aging and Cognition Center, National University Health System, Singapore (C.P.L.H.C., S.H., C.N.K., X.X.).

8. Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Germany (A.D., M.D., R.F.).

9. Medical Image Analysis Center (MIAC) and Department of Biomedical Engineering, University of Basel, Switzerland (M.D.).

10. Department of Neurology, Erasmus Medical Center, Rotterdam, the Netherlands (R.S.v.d.G., P.J.K.).

11. Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, United Kingdom (O.K.L.H., J.M.W.).

12. UK Dementia Research Institute at the University of Edinburgh, United Kingdom (O.K.L.H., J.M.W.).

13. MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, United Kingdom (O.K.L.H.).

14. Saw Swee Hock School of Public Health, National University of Singapore and National University Health System (S.H.).

15. Experimental Psychology, Helmholtz Institute, Utrecht University, the Netherlands (I.M.C.H.W.).

16. Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, the Netherlands (S.K., F.R.J.V.).

17. Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea (J.-S.L.).

18. Division of Neurology, Department of Medicine and Therapeutics (V.C.T.M.), The Chinese University of Hong Kong.

19. Lau Tat-Chuen Research Centre of Brain Degenerative Diseases in Chinese, Li Ka Shing Institute of Health Sciences, Gerald Choa Neuroscience Institute, Lui Chi Woo Institute of Innovative Medicine (V.C.T.M.), The Chinese University of Hong Kong.

20. Department of Neurology, Maastricht University Medical Center, the Netherlands (J.S.).

21. Raffles Neuroscience Centre, Raffles Hospital, Singapore (N.V.).

22. Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea (K.-H.Y.).

23. Department of Neurology, Diakonessenhuis Hospital, Utrecht, the Netherlands (J.M.B.).

Abstract

BACKGROUND: White matter hyperintensities (WMH) are associated with cognitive dysfunction after ischemic stroke. Yet, uncertainty remains about affected domains, the role of other preexisting brain injury, and infarct types in the relation between WMH burden and poststroke cognition. We aimed to disentangle these factors in a large sample of patients with ischemic stroke from different cohorts. METHODS: We pooled and harmonized individual patient data (n=1568) from 9 cohorts, through the Meta VCI Map consortium ( www.metavcimap.org ). Included cohorts comprised patients with available magnetic resonance imaging and multidomain cognitive assessment <15 months poststroke. In this individual patient data meta-analysis, linear mixed models were used to determine the association between WMH volume and domain-specific cognitive functioning ( Z scores; attention and executive functioning, processing speed, language and verbal memory) for the total sample and stratified by infarct type. Preexisting brain injury was accounted for in the multivariable models and all analyses were corrected for the study site as a random effect. RESULTS: In the total sample (67 years [SD, 11.5], 40% female), we found a dose-dependent inverse relationship between WMH volume and poststroke cognitive functioning across all 4 cognitive domains (coefficients ranging from −0.09 [SE, 0.04, P =0.01] for verbal memory to −0.19 [SE, 0.03, P <0.001] for attention and executive functioning). This relation was independent of acute infarct volume and the presence of lacunes and old infarcts. In stratified analyses, the relation between WMH volume and domain-specific functioning was also largely independent of infarct type. CONCLUSIONS: In patients with ischemic stroke, increasing WMH volume is independently associated with worse cognitive functioning across all major domains, regardless of old ischemic lesions and infarct type.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Advanced and Specialized Nursing,Cardiology and Cardiovascular Medicine,Neurology (clinical)

Reference39 articles.

1. Profile of and risk factors for poststroke cognitive impairment in diverse ethnoregional groups

2. Poststroke Cognitive Impairment Negatively Impacts Activity and Participation Outcomes

3. Systematic review and meta-analysis of the prevalence of cognitive impairment no dementia in the first year post-stroke

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