1. White matter integrity and functional connectivity of the default mode network in acute stroke are associated with cognitive outcome three months post-stroke.
- Author
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Fruhwirth V, Berger L, Gattringer T, Fandler-Höfler S, Kneihsl M, Eppinger S, Ropele S, Fink A, Deutschmann H, Reishofer G, Enzinger C, and Pinter D
- Subjects
- Humans, Female, Male, Middle Aged, Aged, Aged, 80 and over, Adult, Longitudinal Studies, Neuropsychological Tests, Cognitive Dysfunction etiology, Cognitive Dysfunction diagnostic imaging, Cognitive Dysfunction physiopathology, Young Adult, Adolescent, Brain diagnostic imaging, Brain physiopathology, Brain pathology, Neural Pathways diagnostic imaging, Neural Pathways physiopathology, White Matter diagnostic imaging, White Matter pathology, Stroke diagnostic imaging, Stroke complications, Stroke physiopathology, Magnetic Resonance Imaging, Default Mode Network diagnostic imaging, Default Mode Network physiopathology
- Abstract
Background: Knowledge about factors that are associated with post-stroke cognitive outcome is important to identify patients with high risk for impairment. We therefore investigated the associations of white matter integrity and functional connectivity (FC) within the brain's default-mode network (DMN) in acute stroke patients with cognitive outcome three months post-stroke., Methods: Patients aged between 18 and 85 years with an acute symptomatic MRI-proven unilateral ischemic middle cerebral artery infarction, who had received reperfusion therapy, were invited to participate in this longitudinal study. All patients underwent brain MRI within 24-72 h after symptom onset, and participated in a neuropsychological assessment three months post-stroke. We performed hierarchical regression analyses to explore the incremental value of baseline white matter integrity and FC beyond demographic, clinical, and macrostructural information for cognitive outcome., Results: The study cohort comprised 34 patients (mean age: 64 ± 12 years, 35% female). The initial median National Institutes of Health Stroke Scale (NIHSS) score was 10, and significantly improved three months post-stroke to a median NIHSS = 1 (p < .001). Nonetheless, 50% of patients showed cognitive impairment three months post-stroke. FC of the non-lesioned anterior cingulate cortex of the affected hemisphere explained 15% of incremental variance for processing speed (p = .007), and fractional anisotropy of the non-lesioned cingulum of the affected hemisphere explained 13% of incremental variance for cognitive flexibility (p = .033)., Conclusions: White matter integrity and functional MRI markers of the DMN in acute stroke explain incremental variance for post-stroke cognitive outcome beyond demographic, clinical, and macrostructural information., Competing Interests: Declaration of competing interest The authors declare no financial or other conflicts of interest that relate to the research covered in this article., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
- Published
- 2024
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