NeuroImage. Clinical · 2025
Lesion locations are associated with cognitive impairment after ischemic stroke in young adults.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Schellekens Mijntje M I, Li Hao, Wijnands Maartje, Papounidou Anastasia, Boot Esther M, Verhoeven Jamie I, Ekker Merel S, van Alebeek Mayte E, Brouwers Paul J A M, Arntz Renate M, van Dijk Gert W, Gons Rob A R, van Uden Inge W M, Heijer Tom den, van Tuijl Julia H, de Laat Karlijn F, van Norden Anouk G W, Vermeer Sarah E, van Zagten Marian S G, van Oostenbrugge Robert J, Wermer Marieke J H, Nederkoorn Paul J, van Rooij Frank G, van den Wijngaard Ido R, de Kort Paul L M, Piai Vitória, de Leeuw Frank-Erik, Kessels Roy P C, Tuladhar Anil M
Аннотация
INTRODUCTION: Stroke location is an important determinant of post-stroke cognitive impairment (PSCI). In young adults, a comprehensive map of lesion patterns and their relations to PSCI is lacking. This study aims to identify lesion locations associated with poorer cognitive performance in patients with stroke at a young age.
METHODS: We conducted a multicenter prospective cohort study between 2013 and 2021, enrolling patients aged 18-49 years with first-ever ischemic stroke and a visible stroke lesion on MRI. Cognitive assessments were performed within six months post-stroke, covering seven domains. We categorized patients as having no/mild or major vascular cognitive disorder (VCD), defined as a Z-score < -2.0 in one or more domains. We assessed aphasia by the NIHSS language subscale. We performed multivariate lesion-symptom mapping to identify lesion locations associated with major VCD, poorer cognitive performance in each domain, and aphasia.
RESULTS: Among 522 patients (median age 44.3 years [IQR 37.7-41.5]; 257 [49.2 %] women), 168 (32.2 %) had major VCD. Lesions in both hemispheres and cerebellar regions were associated with presence of a major VCD, and lower performance in episodic memory, processing speed, executive functioning, language, and attention and working memory. Aphasia had the strongest relationship with left fronto-temporo-parietal regions, while the left angular gyrus was the region most associated with major VCD.
DISCUSSION: We show that lesion locations associated with poorer cognitive performance in young stroke patients are widely distributed, including cerebellar regions. This study showcases the complexity in the relationships between affected brain regions and cognitive symptoms, explaining the variability in post-stroke cognitive outcome.
METHODS: We conducted a multicenter prospective cohort study between 2013 and 2021, enrolling patients aged 18-49 years with first-ever ischemic stroke and a visible stroke lesion on MRI. Cognitive assessments were performed within six months post-stroke, covering seven domains. We categorized patients as having no/mild or major vascular cognitive disorder (VCD), defined as a Z-score < -2.0 in one or more domains. We assessed aphasia by the NIHSS language subscale. We performed multivariate lesion-symptom mapping to identify lesion locations associated with major VCD, poorer cognitive performance in each domain, and aphasia.
RESULTS: Among 522 patients (median age 44.3 years [IQR 37.7-41.5]; 257 [49.2 %] women), 168 (32.2 %) had major VCD. Lesions in both hemispheres and cerebellar regions were associated with presence of a major VCD, and lower performance in episodic memory, processing speed, executive functioning, language, and attention and working memory. Aphasia had the strongest relationship with left fronto-temporo-parietal regions, while the left angular gyrus was the region most associated with major VCD.
DISCUSSION: We show that lesion locations associated with poorer cognitive performance in young stroke patients are widely distributed, including cerebellar regions. This study showcases the complexity in the relationships between affected brain regions and cognitive symptoms, explaining the variability in post-stroke cognitive outcome.