Cortical thickness, white matter hyperintensities, and cognition after stroke

Dickie, D. A. , Gardner, K., Wagener, A., Wyss, A., Arba, F., Wardlaw, J. M. and Dawson, J. (2020) Cortical thickness, white matter hyperintensities, and cognition after stroke. International Journal of Stroke, 15(1), pp. 46-54. (doi: 10.1177/1747493019851291) (PMID:31088224)

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Abstract

Background: A thinner cerebral cortex is associated with higher white matter hyperintensity burden and cognitive impairment in community-dwelling and dementia cohorts. It is important to assess these associations in people with ischemic stroke because their cerebrovascular disease profiles are different to these cohorts. Aims: We aimed to determine whether cortical thickness was related to white matter hyperintensity burden and cognition after ischemic stroke. Methods: We measured cortical thickness using advanced normalization tools' “KellyKapowski” function in 244 patients with ischemic stroke or transient ischemic attack from the Virtual International Stroke Trials Archive. We measured white matter hyperintensity burden via quantitative volumes and Fazekas score. We extracted data on vascular risk factors at baseline and Mini Mental State Examination scores at one year. We assessed associations between imaging and clinical data using correlation and multiple linear regression. Results: Pairwise correlation showed that higher white matter hyperintensity Fazekas score was associated with a thinner cortex (rho = −0.284, P < 0.0001). White matter hyperintensities were generally distributed adjacent to and above the lateral ventricles. Voxel-wise analyses showed statistically significant negative associations between cortical thickness and white matter hyperintensities across fronto-temporal and inferior parietal cortical regions. Mean cortical thickness was positively related to Mini Mental State Examination in pair-wise correlation (r = 0.167, P = 0.0088) but there was no independent association after adjustment for age and white matter hyperintensities (beta = 0.016, P = 0.7874). Conclusions: Cortical thickness was not an independent predictor of cognition after ischemic stroke. Further work is required to understand how white matter hyperintensities are associated with a thinner cortex in temporal regions but less so in more superior regions where white matter hyperintensities are generally found in people with stroke.

Item Type:Articles
Additional Information:We would like to sincerely thank the Stroke Association UK for funding David Alexander Dickie through a postdoctoral fellowship (TSAPDF2017/01) and Medical Research Scotland for funding Kirstyn Gardner through a vacation scholarship (Vac-1245-2018).
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Arba, Dr Francesco and Wyss, Ms Annick and Dawson, Professor Jesse and Dickie, Dr David Alexander
Authors: Dickie, D. A., Gardner, K., Wagener, A., Wyss, A., Arba, F., Wardlaw, J. M., and Dawson, J.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:International Journal of Stroke
Publisher:SAGE Publications
ISSN:1747-4930
ISSN (Online):1747-4949
Published Online:14 May 2019
Copyright Holders:Copyright © 2019 World Stroke Organization
First Published:First published in International Journal of Stroke 15(1): 46-54
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
3046420Development of an automated holistic brain MRI damage metric in strokeDavid Alexander DickieMedical Research Scotland (MEDRESSC)Vac-1245-2018CAMS - Cardiovascular Science