Is the female sex associated with an increased risk for long-term cognitive decline after the first-ever lacunar stroke? Prospective study on small vessel disease cohort

Pavlović, Aleksandra M.; Gazibara, Tatjana; Mijajlović, Milija; Tomić, Gordana; Trajković, Jasna Zidverc

doi:10.3389/fneur.2022.1052401

Cited by 4 publications

(3 citation statements)

References 75 publications

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“…Considering stroke patients and the view that depression leads to cognitive impairment, post-stroke depression has been associated with worse performance in cognitive functions, including inhibition/switching errors [46], memory [56,57], reduced psychomotor/cognitive speed [57,58], nonverbal problem solving, and attention [57]. Considering the impact of gender, women who have experienced lacunar strokes have been found to have cognitive impairment more frequently than men, and this association has been shown to be dependent on the occurrence of depression and severity of white matter hyperintensities in women but not in men [59]. In line with that, with regard to specificity, our results suggest that, after stroke, there may be a correlation between changes over time in depressive symptom severity and changes in phonemic verbal fluency in women, but not in men.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Post-Stroke Depressive Symptoms on Cognitive Performance in Women and in Men: A 4 Month Prospective Study

Sobreiro

Terroni

Mattos

et al. 2023

Life

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Background: Depressive symptoms have been associated with cognitive impairment after stroke, and women may be specifically affected. Objective: The aim of this study was to investigate gender-specific characteristics in the relationship between changes in depression severity and changes in cognitive performance after stroke. Methods: We prospectively evaluated 73 patients without a previous history of depression in the first and fourth months after a first ischemic stroke. The severity of depressive symptoms was assessed using the 31-item version of the Hamilton Rating Scale for Depression, and executive function, attention, working memory, and verbal fluency were assessed using a neuropsychological battery. Results: We included 46 (63.0%) men and 27 (36.9%) women, with mean ages of 55.2 (SD ± 15.1) and 46.8 (SD ± 14.7) years, respectively. We found significant improvement in the digit span forward and Stroop dots from month 1 to month 4 post stroke for both men and women. Women, but not men, presented a correlation between changes in phonemic verbal fluency and changes in the 31-item version of the Hamilton Rating Scale for Depression scores. Improvement in depression was correlated with improvement in verbal fluency, and worsening in depression was correlated with worsening in verbal fluency. Conclusions: Our results suggest that women might be more vulnerable to the relationship between depressive symptoms and cognitive performance, and improvement of depression may be necessary for women’s improvement in phonemic verbal fluency from the first to the fourth month after a stroke. We did not adjust the results for multiple comparisons. Thus, our findings might be considered preliminary, and confirmatory studies, also focusing on specific characteristics of women that could explain these differences, are warranted.

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Section: Discussionmentioning

confidence: 99%

The Impact of Post-Stroke Depressive Symptoms on Cognitive Performance in Women and in Men: A 4 Month Prospective Study

Sobreiro

Terroni

Mattos

et al. 2023

Life

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“…There is emerging evidence suggesting that there may be sex differences in the susceptibility to and outcomes of cerebral ischemia. Several preclinical studies have reported differences in brain damage, neuroinflammation, and neuroprotective responses between male and female animals exposed to ischemic insult [112,113]. Investigating these sex differences may lead to the development of sex-specific therapeutic strategies for the prevention and treatment of global cerebral ischemia.…”

Section: Challenges and Future Directions For In Vivo Models Of Cereb...mentioning

confidence: 99%

In Vivo Experimental Models of Cerebral Ischemia: Analysis, Translational Potential and Clinical Relevance

2024

Cardiol Res Cardiovasc Med

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Despite all current efforts in the field of cerebrovascular disease prevention, stroke remains the leading cause of disability and death worldwide. Animal models are essential tools in stroke research to mitigate its devastating effects. The novelty of this review is the comprehensiveness of the approach and the detailed analysis of progress in the field, translational potential and clinical relevance. Recent research aimed to refine and enhance animal models to better mimic clinical scenario and improve reproducibility. This review provides extensive overview of its classification, underlining their key features, advantages, limitations, and advancements. Additionally, characterization and validation of ischemia models are discussed. Therapeutic strategies such as hypothermia, pharmacological interventions, genetic and molecular approaches, and cell-based therapies are highlighted. This review analyse the challenges and future directions, as well as translational potential and clinical relevance of ischemia models. Incorporating patient-derived cells and genetic modifications in animal models can provide a more personalized and clinically relevant approach. Bridging the gap is challenging and requires careful consideration of multiple factors, including appropriate dose translation, understanding species differences, and aligning protocols. Future studies should focus on optimizing the translational process and conducting well-designed clinical trials to assess the safety and efficacy of promising interventions.

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“…1 Females have been reported to be more susceptible than males to CSVD and its effect on cognition. 1,2 Sex-specific variations in how several vascular risk factors such as hypertension affect CSVD have also been reported. Hypertension, which increases with age, is an established risk factor for cerebrovascular conditions, which are prominent causes of morbidity and mortality.…”

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confidence: 99%

Sex Differences in the Association of Age at Hypertension Diagnosis With Brain Structure

Kaur,

Angarita Fonseca,

Lissaman

et al. 2024

Hypertension

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BACKGROUND: Sex differences exist in the likelihood of cognitive decline. The age at hypertension diagnosis is a unique contributor to brain structural changes associated with cerebral small vessel disease. However, whether this relationship differs between sexes remains unclear. Therefore, our objective was to evaluate sex differences in the association between the age at hypertension diagnosis and cerebral small vessel disease–related brain structural changes. METHODS: We used data from the UK Biobank to select participants with a known age at hypertension diagnosis and brain magnetic resonance imaging (n=9430) and stratified them by sex and age at hypertension diagnosis. Control participants with magnetic resonance imaging scans but no hypertension were chosen at random matched by using propensity score matching. For morphological brain structural changes, generalized linear models were used while adjusting for other vascular risk factors. For the assessment of white matter microstructure, principal component analysis led to a reduction in the number of fractional anisotropy variables, followed by regression analysis with major principal components as outcomes. RESULTS: Males but not females with a younger age at hypertension diagnosis exhibited lower brain gray and white matter volume compared with normotensive controls. The volume of white matter hyperintensities was greater in both males and females with hypertension than normotensive controls, significantly higher in older females with hypertension. Compared with normotensive controls, white matter microstructural integrity was lower in individuals with hypertension, which became more prominent with increasing age. CONCLUSIONS: Our study demonstrates that the effect of hypertension on cerebral small vessel disease–related brain structure differs by sex and by age at hypertension diagnosis.

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Is the female sex associated with an increased risk for long-term cognitive decline after the first-ever lacunar stroke? Prospective study on small vessel disease cohort

Cited by 4 publications

References 75 publications

The Impact of Post-Stroke Depressive Symptoms on Cognitive Performance in Women and in Men: A 4 Month Prospective Study

The Impact of Post-Stroke Depressive Symptoms on Cognitive Performance in Women and in Men: A 4 Month Prospective Study

In Vivo Experimental Models of Cerebral Ischemia: Analysis, Translational Potential and Clinical Relevance

Sex Differences in the Association of Age at Hypertension Diagnosis With Brain Structure

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