J Clin Neurol.  2012 Mar;8(1):43-50. 10.3988/jcn.2012.8.1.43.

Medial Temporal Atrophy and Memory Dysfunction in Poststroke Cognitive Impairment-No Dementia

• Kim BJ
• Oh MY
• Jang MS
• Han MK
• Lee J
• Lee J
• Kang Y
• Yu KH
• Lee BC
• Kim S
• Yoon BW
• Bae HJ

• KMID: 2287616
• DOI: http://doi.org/10.3988/jcn.2012.8.1.43

Abstract

BACKGROUND AND PURPOSE
It was recently reported that the prevalence of poststroke memory dysfunction might be higher than previously thought. Stroke may exist concomitantly with underlying Alzheimer's disease (AD), and so we determined whether post-stroke memory dysfunction indicates manifestation of underlying subclinical AD.
METHODS
Of 1201 patients in a prospective cognitive assessment database, we enrolled subjects with poststroke amnestic vascular cognitive impairment-no dementia (aVCIND; n=48), poststroke nonamnestic vascular cognitive impairment-no dementia (naVCIND; n=50), and nonstroke amnestic mild cognitive impairment (aMCI; n=65). All subjects had cognitive deficits, but did not meet the criteria for dementia. A standardized neuropsychological test battery and magnetic resonance imaging were performed at least 90 days after the index stroke (mean, 473 days). Visual assessment of medial temporal atrophy (MTA) was used as a measure of underlying AD pathology.
RESULTS
The MTA score was significantly lower in the naVCIND group (0.64+/-0.85, mean+/-SD) than in the aVCIND (1.10+/-1.08) and aMCI (1.45+/-1.13; p<0.01) groups. Multivariable ordinal logistic regression analysis revealed that compared with naVCIND, aVCIND [odds ratio (OR)=2.69; 95% confidence interval (CI)=1.21-5.99] and aMCI (OR=5.20; 95% CI=2.41-11.23) were significantly associated with increasing severity of MTA.
CONCLUSIONS
Our findings show that compared with poststroke naVCIND, the odds of having more-severe MTA were increased for poststroke aVCIND and nonstroke aMCI.

Keyword

vascular cognitive impairment; memory dysfunction; stroke; poststroke dementia

MeSH Terms

Alzheimer Disease
Atrophy
Dementia
Glutamates
Guanine
Humans
Logistic Models
Magnetic Resonance Imaging
Memory
Mild Cognitive Impairment
Neuropsychological Tests
Prevalence
Prospective Studies
Pemetrexed
Stroke
Glutamates
Guanine

Figure

• 

  Fig. 1 Recruitment of the study population. Gray boxes denote the enrolled subjects who were included in the final analyses. aVCIND: amnestic vascular cognitive impairment-no dementia, na-VCIND: nonamnestic vascular cognitive impairment-no dementia, aMCI: amnestic mild cognitive impairment.

• 

  Fig. 2 Comparison of Z-scores among the three vascular cognitive impairment and no dementia (CIND) groups. aMCI: amnestic mild cognitive impairment, aVCIND: amnestic vascular cognitive impairment-no dementia, naVCIND: nonamnestic vascular cognitive impairment-no dementia.

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