White matter hyperintensities are an independent predictor of cognitive decline 3 years following first-ever stroke—results from the PROSCIS-B study

Background White matter hyperintensities (WMH) are the result of cerebral small vessel disease and may increase the risk of cognitive impairment (CI), recurrent stroke, and depression. We aimed to explore the association between selected cerebrovascular risk factors (CVRF) and WMH load as well as th...

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Bibliographic Details
Published in:Journal of neurology 2023-03, Vol.270 (3), p.1637-1646
Main Authors: Ali, Huma Fatima, Fast, Lea, Khalil, Ahmed, Siebert, Eberhard, Liman, Thomas, Endres, Matthias, Villringer, Kersten, Kufner, Anna
Format: Article
Language:English
Subjects:
Age
Blood pressure
Cerebral infarction
Cognition
Cognitive ability
Cognitive Dysfunction - complications
Cognitive Dysfunction - etiology
Diabetes mellitus
Humans
Hyperlipoproteinemia
Ischemia
Kidney diseases
Magnetic Resonance Imaging
Medicine
Medicine & Public Health
Myocardial infarction
Neurology
Neuroradiology
Neurosciences
Original Communication
Prospective Studies
Risk factors
Stroke
Stroke - complications
Stroke - diagnostic imaging
Stroke - epidemiology
Substantia alba
Survival analysis
Vascular diseases
White Matter - diagnostic imaging
White Matter - pathology
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Summary:Background White matter hyperintensities (WMH) are the result of cerebral small vessel disease and may increase the risk of cognitive impairment (CI), recurrent stroke, and depression. We aimed to explore the association between selected cerebrovascular risk factors (CVRF) and WMH load as well as the effect of increased WMH burden on recurrent vascular events, CI, and depression in first-ever ischemic stroke patients. Methods 431 from the PROSpective Cohort with Incident Stroke (PROSCIS) were included; Age-Related White Matter Changes (ARWMC) score was used to assess WMH burden on FLAIR. The presence of CVRF (defined via blood pressure, body-mass-index, and serological markers of kidney dysfunction, diabetes mellitus, and hyperlipoproteinemia) was categorized into normal, borderline, and pathological profiles based on commonly used clinical definitions. The primary outcomes included recurrent vascular events (combined endpoint of recurrent stroke, myocardial infarction and/or death), CI 3 years post-stroke, and depression 1-year post-stroke. Results There was no clear association between CVRF profiles and WMH burden. High WMH lesion load (ARWMC score ≥ 10) was found to be associated with CI (adjusted OR 1.05 [95% CI 1.00–1.11]; p  
ISSN:0340-5354
1432-1459
DOI:10.1007/s00415-022-11481-5