Hippocampal subfield volumes are associated with verbal memory after first‐ever ischemic stroke

Khlif, Mohamed Salah; Bird, Laura; Restrepo, Carolina; Khan, Wasim; Werden, Emilio; Egorova-Brumley, Natalia; Brodtmann, Amy

doi:10.1002/dad2.12195

Cited by 11 publications

(9 citation statements)

References 43 publications

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“…( Pendlebury and Rothwell, 2019 ) Multiple cognitive functions may become impaired, though slower information processing and executive dysfunction tend to be predominant features of vascular cognitive impairment. ( Al-Qazzaz, 2014 , Cumming et al, 2013 ) Imaging markers including hippocampal atrophy ( Khlif, 2021 ) and brain parenchymal volume loss ( Bu, 2021 ) have been associated with cognitive/functional outcomes following ischaemic stroke. We reported lower total brain volume 3 years post-stroke in survivors who were cognitively impaired (CI) at 3 months.…”

Section: Introductionmentioning

confidence: 99%

Cortical thinning 3 years after ischaemic stroke is associated with cognitive impairment and APOE ε4

Khlif

Egorova-Brumley

Bird

et al. 2022

NeuroImage: Clinical

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Section: Introductionmentioning

confidence: 99%

Cortical thinning 3 years after ischaemic stroke is associated with cognitive impairment and APOE ε4

Khlif

Egorova-Brumley

Bird

et al. 2022

NeuroImage: Clinical

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“…Thalamic dysfunction has been implicated in the clinical impairments seen after stroke, with ipsi-and contralesional thalamic atrophy over the first year reported (12). In addition, we have previously reported that hippocampal subfield atrophy correlated better with verbal memory impairment in this cohort, suggesting that whole hippocampal atrophy may not be the metric of choice in post-stroke cognitive impairment (55). The observed reduction in TBV in stroke survivors and the strong association with greater TBV loss in those who were cognitively impaired at 3 months are novel.…”

Section: Discussionmentioning

confidence: 81%

Neurodegeneration Over 3 Years Following Ischaemic Stroke: Findings From the Cognition and Neocortical Volume After Stroke Study

et al. 2021

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Background: Stroke survivors are at high risk of dementia, associated with increasing age and vascular burden and with pre-existing cognitive impairment, older age. Brain atrophy patterns are recognised as signatures of neurodegenerative conditions, but the natural history of brain atrophy after stroke remains poorly described. We sought to determine whether stroke survivors who were cognitively normal at time of stroke had greater total brain (TBV) and hippocampal volume (HV) loss over 3 years than controls. We examined whether stroke survivors who were cognitively impaired (CI) at 3 months following their stroke had greater brain volume loss than cognitively normal (CN) stroke participants over the next 3 years.Methods: Cognition And Neocortical Volume After Stroke (CANVAS) study is a multi-centre cohort study of first-ever or recurrent adult ischaemic stroke participants compared to age- and sex-matched community controls. Participants were followed with MRI and cognitive assessments over 3 years and were free of a history of cognitive impairment or decline at inclusion. Our primary outcome measure was TBV change between 3 months and 3 years; secondary outcomes were TBV and HV change comparing CI and CN participants. We investigated associations between group status and brain volume change using a baseline-volume adjusted linear regression model with robust standard error.Results: Ninety-three stroke (26 women, 66.7 ± 12 years) and 39 control participants (15 women, 68.7 ± 7 years) were available at 3 years. TBV loss in stroke patients was greater than controls: stroke mean (M) = 20.3 cm3 ± SD 14.8 cm3; controls M = 14.2 cm3 ± SD 13.2 cm3; [adjusted mean difference 7.88 95%CI (2.84, 12.91) p-value = 0.002]. TBV decline was greater in those stroke participants who were cognitively impaired (M = 30.7 cm3; SD = 14.2 cm3) at 3 months (M = 19.6 cm3; SD = 13.8 cm3); [adjusted mean difference 10.42; 95%CI (3.04, 17.80), p-value = 0.006]. No statistically significant differences in HV change were observed.Conclusions: Ischaemic stroke survivors exhibit greater neurodegeneration compared to stroke-free controls. Brain atrophy is greater in stroke participants who were cognitively impaired early after their stroke. Early cognitive impairment was associated greater subsequent atrophy, reflecting the combined impacts of stroke and vascular brain burden. Atrophy rates could serve as a useful biomarker for trials testing interventions to reduce post-stroke secondary neurodegeneration.Clinical Trail Registration:http://www.clinicaltrials.gov, identifier: NCT02205424.

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“…Microstructural alterations in the ipsilateral hippocampus also occur after young onset stroke, 48 when concomitant degenerative changes are less likely to be a factor. Hippocampal subfield volumes correlate with verbal memory performance after stroke 49 and pathology studies reveal neuronal volume loss, which correlates with memory scores during life, consistent with secondary injury. 50 Given its role in cross-network integration, secondary changes in the thalamus could propagate across multiple networks and cognitive domains.…”

Section: Secondary Injury and Degenerationmentioning

confidence: 77%

Cognitive Recovery After Stroke: Memory

O’Sullivan

Galligan

et al. 2023

Stroke

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Memory impairment occurs in over a third of patients after symptomatic stroke. Memory deficits rarely occur in isolation but are an important component of the poststroke cognitive syndrome because of the strong relationship with the risk of poststroke dementia. In this review, we summarize available data on impairment of episodic memory, with a particular emphasis on the natural history of memory impairment after stroke and the factors influencing trajectory informed by an updated systematic review. We next discuss the pathophysiology of memory impairment and mechanisms of both decline and recovery of function. We then turn to the practical issue of measurement of memory deficits after stroke, emerging biomarkers, and therapeutic approaches. Our review identifies critical gaps, particularly in studies of the natural history that properly map the long-term trajectory of memory and the associations with factors that modulate prognosis. Few studies have used advanced neuroimaging and this, in conjunction with other biomarker approaches, has the potential to provide a much richer understanding of the mechanisms at play and promising therapeutic avenues.

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Hippocampal subfield volumes are associated with verbal memory after first‐ever ischemic stroke

Cited by 11 publications

References 43 publications

Cortical thinning 3 years after ischaemic stroke is associated with cognitive impairment and APOE ε4

Cortical thinning 3 years after ischaemic stroke is associated with cognitive impairment and APOE ε4

Neurodegeneration Over 3 Years Following Ischaemic Stroke: Findings From the Cognition and Neocortical Volume After Stroke Study

Cognitive Recovery After Stroke: Memory

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