Back to Search
Start Over
Prestroke statins, progression of white matter hyperintensities, and cognitive decline in stroke patients with confluent white matter hyperintensities.
- Source :
-
Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics [Neurotherapeutics] 2014 Jul; Vol. 11 (3), pp. 606-11. - Publication Year :
- 2014
-
Abstract
- Cerebral white matter hyperintensities (WMH) are a consequence of cerebral small vessel disease. Statins have been shown to reduce recurrent stroke among patients with various stroke subtypes, including lacunar stroke, which also arises from small vessel disease. In this study, we investigated the hypothesis that prestroke statin use would reduce the progression of WMH and/or cognitive decline among stroke patients with confluent WMH. Patients (n = 100) were participants of the VITAmins To Prevent Stroke magnetic resonance imaging substudy. All patients had confluent WMH on magnetic resonance imaging at baseline. Eighty-one patients completed the 2-year follow-up. We assessed general cognition and executive function using the mini-mental state examination and Mattis dementia rating scale-initiation/perseveration subscale, respectively. We compared the change in volume of WMH and cognition between prestroke statin use and prestroke nonstatin use groups. We also evaluated the effects of prestroke statin use on incident lacunes and microbleeds. The prestroke statin use group (n = 51) had less WMH volume progression (1.54 ± 4.52 cm(3) vs 5.01 ± 6.00 cm(3), p = 0.02) compared with the prestroke nonstatin use group (n = 30). Multivariate linear regression modeling identified prestroke statin use as an independent predictor of WMH progression (β = -0.31, p = 0.008). Prestroke statin use was also associated with less decline (Mattis dementia rating scale-initiation/perseveration subscale; β = 0.47, p = 0.001). No association was observed with changes in mini-mental state examination scores. There were no between group differences on incident lacunes or incident microbleeds. Prestroke statin use may reduce WMH progression and decline in executive function in stroke patients with confluent WMH.
- Subjects :
- Aged
Cerebral Cortex blood supply
Cerebral Small Vessel Diseases complications
Cerebral Small Vessel Diseases drug therapy
Cognition Disorders drug therapy
Cognition Disorders etiology
Female
Folic Acid therapeutic use
Humans
Magnetic Resonance Imaging
Male
Vitamin B 12 therapeutic use
Vitamin B 6 therapeutic use
Cerebral Cortex pathology
Cerebral Small Vessel Diseases pathology
Disease Progression
Stroke complications
White Matter pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1878-7479
- Volume :
- 11
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics
- Publication Type :
- Academic Journal
- Accession number :
- 24692001
- Full Text :
- https://doi.org/10.1007/s13311-014-0270-5