Enlarged perivascular spaces are associated with health‐related quality of life in patients with acute ischemic stroke

Liang, Yan; Deng, Min; Chen, Yang Kun; Mok, Vincent; Wang, De Feng; Ungvári, Gábor S.; Chu, Winnie C.W.; Berge, Eivind; Tang, Wai Kwong

doi:10.1111/cns.12766

Cited by 11 publications

(12 citation statements)

References 30 publications

(73 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This finding suggested the necessity of combining SVD markers. 21 However, our study replicated the finding of the TABASCO study by showing that the effects of WMHs on cognitive status were larger than that of SVD burden. This finding was possibly related to the imperfect constructing method of SVD burden.…”

Section: Discussionsupporting

confidence: 84%

“…The total volume was then generated by multiplying the total area by the sum of the slice thickness and gap. 21…”

Section: Methodsmentioning

confidence: 99%

“…The total volume was then generated by multiplying the total area by the sum of the slice thickness and gap. 21 Inter-rater reliability. Thirty MRI scans were randomly selected for separate assessment by Y.L.…”

Section: Magnetic Resonance Imaging Analysismentioning

confidence: 99%

See 2 more Smart Citations

Cerebral Small Vessel Disease Burden Is Associated With Accelerated Poststroke Cognitive Decline: A 1-Year Follow-Up Study

Liang

Chen

Liu

et al. 2019

J Geriatr Psychiatry Neurol

Self Cite

View full text Add to dashboard Cite

Objective: This study investigated the association between small vessel disease (SVD) burden, a combination of multiple SVD markers and cognitive dysfunction after stroke. Methods: The study sample comprised 451 patients with first-ever acute ischemic stroke. Cognitive functions were assessed with the Mini-Mental State Examination (MMSE) at 3, 9, and 15 months after the index stroke. Cognitive impairment was defined as an MMSE score of ≤26. A total SVD score, indicating SVD burden, was constructed by summing the scores of the 4 SVD markers (white matter hyperintensities [WMHs], lacunes, cerebral microbleeds, and perivascular spaces) ascertained by magnetic resonance imaging (range: 0-4). The association between SVD burden and cognitive dysfunction was assessed with linear mixed models or generalized estimating equation models, as appropriate. Results: The majority of patients had mild-to-moderate stroke and at least one identifiable SVD marker. Cognitive impairment was found in about one-third of patients. After adjusting for confounding factors, the SVD burden was associated with MMSE scores (β = −0.37, P = .003) and cognitive impairment (odds ratio [OR] = 1.20, 95% confidence interval [CI] = 1.02-1.42). SVD burden was specifically associated with the performance of MMSE subscores including orientation to place and time, calculation, and word recall. Of the SVD markers, WMHs was the most robust predictor of decrease in MMSE scores (β = −0.25, P = .01) and cognitive impairment (OR = 1.14, 95% CI = 1.01-1.29). Conclusion: Cerebral SVD burden is associated with decreased MMSE scores, suggesting cognitive dysfunction during the first year after mild-to-moderate acute ischemic stroke.

show abstract

Section: Discussionsupporting

confidence: 84%

“…The total volume was then generated by multiplying the total area by the sum of the slice thickness and gap. 21…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Cerebral Small Vessel Disease Burden Is Associated With Accelerated Poststroke Cognitive Decline: A 1-Year Follow-Up Study

Liang

Chen

Liu

et al. 2019

J Geriatr Psychiatry Neurol

Self Cite

View full text Add to dashboard Cite

show abstract

“…At 3 months after index stroke, the following assessments were performed in a research clinic. The details of assessments are provided by our prior publications ( 4 , 10 ).…”

Section: Methodsmentioning

confidence: 99%

Association Between Behavioral Dysexecutive Syndrome and the Health-Related Quality of Life Among Stroke Survivors

et al. 2020

Self Cite

View full text Add to dashboard Cite

Aim Behavioral dysexecutive syndrome (BDES) is one common neuropsychiatric comorbidity after stroke. Despite evidences suggesting the adverse effect of BDES on the survivors’ outcome, little is known about the association between BDES and the health-related quality of life (HRQoL) among stroke survivors and how BDES impacts the HRQoL. This study aimed to address these questions. Methods This study included 219 patients with acute ischemic stroke consecutively admitted to a regional hospital in Hong Kong. BDES was defined as a Chinese version of the Dysexecutive Questionnaire (DEX) score of ≥20 assessed at three months after stroke. The HRQoL was assessed with the Chinese version of the Stroke-Specific Quality of Life (SSQoL) questionnaire encompassing 12 domains. Multivariate linear regression models were employed to examine the association between BDES symptoms and the SSQoL total and domain scores. Structural equation model (SEM) was further constructed to delineate the linking pathways linking BDES and the HRQoL. Results The study sample compromised mainly older patients with mild to moderate ischemic stroke. Compared with patients without BDES, those with BDES exhibited poorer performances regarding with the summarized SSQoL (226.2 ± 18.8 vs. 200.3 ± 29.8, p < 0.001) and almost all domains. The BDES symptoms were independently contributed to the whole HRQoL (SSQoL total score) (β = −0.20, p = 0.002), specifically to the domains in personality (β = −0.34, p < 0.001), language (β = −0.22, p = 0.01), and work/productivity (β = −0.32, p < 0.001), after adjusting demographic and clinical characteristics in linear models. The impacts of the BDES symptoms on the HRQoL were mainly explained by the indirect path mediated by depression and anxiety (path coefficient = −0.27, p < 0.05) rather than physical disability, while the resting was elucidated by the path directly linking BDES to the HRQoL (path coefficient = −0.17, p < 0.05). Conclusion The present study preliminarily demonstrated a potential association between BDES and a lower level of the HRQoL, predominantly in domains of personality, language, and work/productivityafter acute ischemic stroke. This study also offered insights into the underlying mechanisms linking BDES and the HRQoL, implicating that integrative psychological therapies were urged to achieve better HRQoL after stroke.

show abstract

“…[ 69 ] In addition, EPVS (either in centrum semi-ovale or basal ganglia) are associated with lower health-related quality of life in patients with mild to moderate acute ischemic stroke. [ 70 ] The association of CSO-EPVS with PSD was also found at 3 months after mild to moderate acute ischemic stroke, after adjusting for demographic, clinical, and imaging characteristics (including the number or presence of acute infarcts). [ 71 ] Moreover, a high number of BG-PVS was associated with increased risk of recurrent stroke (ischemic) in patients with ischemic stroke or TIA and incident stroke (ischemic or ICH) in community-dwelling individuals, while these associations were not reproduced for CS-PVS [ 72 , 73 ] Furthermore, EPVS may also contribute to cognitive decline in Parkinson's disease (PD) patients (BG-EPVS in particular) [ 74 ] and sleep disorders.…”

Section: Clinical Relevance Of Mri Features Of Csvdmentioning

confidence: 99%

Magnetic resonance imaging manifestations of cerebral small vessel disease: automated quantification and clinical application

Zhao

Lee

Fan

et al. 2020

Chinese Medical Journal

View full text Add to dashboard Cite

The common cerebral small vessel disease (CSVD) neuroimaging features visible on conventional structural magnetic resonance imaging include recent small subcortical infarcts, lacunes, white matter hyperintensities, perivascular spaces, microbleeds, and brain atrophy. The CSVD neuroimaging features have shared and distinct clinical consequences, and the automatic quantification methods for these features are increasingly used in research and clinical settings. This review article explores the recent progress in CSVD neuroimaging feature quantification and provides an overview of the clinical consequences of these CSVD features as well as the possibilities of using these features as endpoints in clinical trials. The added value of CSVD neuroimaging quantification is also discussed for researches focused on the mechanism of CSVD and the prognosis in subjects with CSVD.

show abstract

Enlarged perivascular spaces are associated with health‐related quality of life in patients with acute ischemic stroke

Abstract: EPVS are associated with lower HRQoL in patients with mild to moderate acute ischemic stroke. Early identification and intervention of EPVS may improve HRQoL in stroke survivors.

Cited by 11 publications

References 30 publications

Cerebral Small Vessel Disease Burden Is Associated With Accelerated Poststroke Cognitive Decline: A 1-Year Follow-Up Study

Cerebral Small Vessel Disease Burden Is Associated With Accelerated Poststroke Cognitive Decline: A 1-Year Follow-Up Study

Association Between Behavioral Dysexecutive Syndrome and the Health-Related Quality of Life Among Stroke Survivors

Magnetic resonance imaging manifestations of cerebral small vessel disease: automated quantification and clinical application

Contact Info

Product

Resources

About