Type 2 Diabetes Mellitus and Impaired Renal Function Are Associated With Brain Alterations and Poststroke Cognitive Decline

• Published in: Stroke (1970) 2017-09, Vol.48 (9), p.2368-2374
• Main Authors: Ben Assayag, Einor, Eldor, Roy, Korczyn, Amos D, Kliper, Efrat, Shenhar-Tsarfaty, Shani, Tene, Oren, Molad, Jeremy, Shapira, Itzhak, Berliner, Shlomo, Volfson, Viki, Shopin, Ludmila, Strauss, Yehuda, Hallevi, Hen, Bornstein, Natan M, Auriel, Eitan
• Format: Article
• Language: English
• Subjects: Aged; Brain - diagnostic imaging; Brain - pathology; Cerebral Cortex - diagnostic imaging; Cerebral Cortex - pathology; Cognitive Dysfunction - diagnostic imaging; Cognitive Dysfunction - epidemiology; Cognitive Dysfunction - etiology; Cognitive Dysfunction - psychology; Cohort Studies; Comorbidity; Dementia - diagnostic imaging; Dementia - epidemiology; Dementia - etiology; Dementia - psychology; Diabetes Mellitus, Type 2 - epidemiology; Executive Function; Female; Hippocampus - diagnostic imaging; Hippocampus - pathology; Humans; Israel - epidemiology; Magnetic Resonance Imaging; Male; Middle Aged; Motor Skills; Neuropsychological Tests; Organ Size; Prospective Studies; Renal Insufficiency, Chronic - epidemiology; Risk Factors; Stroke - complications; Stroke - diagnostic imaging; Stroke - epidemiology; Stroke - psychology; White Matter - diagnostic imaging; White Matter - pathology
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/STROKEAHA.117.017709

BACKGROUND AND PURPOSE—Type 2 diabetes mellitus (T2DM) is associated with diseases of the brain, kidney, and vasculature. However, the relationship between T2DM, chronic kidney disease, brain alterations, and cognitive function after stroke is unknown. We aimed to evaluate the inter-relationship between T2DM, impaired renal function, brain pathology on imaging, and cognitive decline in a longitudinal poststroke cohort. METHODS—The TABASCO (Tel Aviv brain acute stroke cohort) is a prospective cohort of stroke/transient ischemic attack survivors. The volume and white matter integrity, ischemic lesions, and brain and hippocampal volumes were measured at baseline using 3-T MRI. Cognitive tests were performed on 507 patients, who were diagnosed as having mild cognitive impairment, dementia, or being cognitively intact after 24 months. RESULTS—At baseline, T2DM and impaired renal function (estimated creatinine clearance [eCCl]