Do Silent Brain Infarctions Predict the Development of Dementia After First Ischemic Stroke?

Authors

  • Ivan Barbov University Clinic of Neurology, Cerebrovascular Disorders, Faculty of Medicine, Ss Cyril and Methodius University of Skopje
  • Slavica Arsova University Clinic for Psychiatry, Faculty of Medicine, Ss Cyril and Methodius University of Skopje
  • Arben Taravari University Clinic of Neurology, Cerebrovascular Disorders, Faculty of Medicine, Ss Cyril and Methodius University of Skopje
  • Vera Petrova University Clinic of Neurology, Cerebrovascular Disorders, Faculty of Medicine, Ss Cyril and Methodius University of Skopje

DOI:

https://doi.org/10.3889/oamjms.2013.013

Keywords:

silent infarcts, dementia, ischemic stroke, vascular risk factors, cognitive decline.

Abstract

Background: Silent brain infarctions (SBI) are common findings in advanced age, but their relationship to dementia is still uncertain.

Aim: The present study was designed to evaluate whether SBI predict the development of dementia after first clinical ischemic stroke.

Methods: We blindly studied admission CT scans of 102 consecutive nondemented patients presenting with ischemic stroke that clinically was their first stroke episode. SBI were defined as CT evidence of infarcts not compatible with the acute event. The patients were subsequently followed for their mental state for 2 years. Survival analysis, wherein onset of dementia was the end point, was performed on the total sample population and conducted separately on those with and without SBI at admission.

Results: Dementia developed in 33 patients (32.3%), including 17 of the 37 (45.9%) with SBI and 16 of the 65 (24.6%) without SBI. Thus, dementia was strong related to SBI.

Conclusion: Elderly people with silent brain infarcts and stroke have an increased risk of dementia and a steeper decline in cognitive function than those without such lesions.

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References

Desmond DW, Moroney JT, Paik MC, et al. Frequency and clinical determinants of dementia after ischemic stroke. Neurology. 2000;54:1124-31. DOI: https://doi.org/10.1212/WNL.54.5.1124

Yannick B, Corine AE, Jerome D, et al. Prevalence of Early Dementia After First-Ever Stroke: A 24-Year Population-Based Study Stroke. 2011;42:607-612. DOI: https://doi.org/10.1161/STROKEAHA.110.595553

Sarah EV, Niels DP, Tom den H, et al. Silent Brain Infarcts and the Risk of Dementia and Cognitive Decline. N Engl J Med. 2003; 348:1215-22. DOI: https://doi.org/10.1056/NEJMoa022066

Henon H, Durieu I, Guerouaou D, et al. Poststroke dementia: incidence and relationship to prestroke cognitive decline. Neurology. 2001;57:1216-22. DOI: https://doi.org/10.1212/WNL.57.7.1216

Caplan LR. Silent brain infarcts. Cerebrovasc Dis. 1994;4(Suppl 1):32-39. DOI: https://doi.org/10.1159/000108559

Folstein M, Folstein S, McHugh PR. Mini-Mental State: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189-192. DOI: https://doi.org/10.1016/0022-3956(75)90026-6

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Washington, DC: American Psychiatric Association, 1994:143-147.

Boon A, Lodder J, Heuts-van Raak L, Kessels F. Silent brain infarcts in 755 consecutive patients with a first-ever supratentorial ischemic stroke. Stroke. 1994:25:2384-90. DOI: https://doi.org/10.1161/01.STR.25.12.2384

Fukuda H, Kobayashi S, Okada K, Tsunematsu T. Frontal white matter lesions and dementia in lacunar infarction. Stroke. 1990;21:1143-49. DOI: https://doi.org/10.1161/01.STR.21.8.1143

Stephen DJM, Sarah T, Martin SD, et al. Cognitive impairment after lacunar stroke: systematic review and meta-analysis of incidence, prevalence and comparison with other stroke subtypes J Neurol Neurosurg Psychiatry. 2013;84:893-900. DOI: https://doi.org/10.1136/jnnp-2012-303645

de Groot JC, de Leeuw FE, Oudkerk M, et al. Periventricular cerebral white matter lesions predict rate of cognitive decline. Ann Neurol. 2002;52:335-41. DOI: https://doi.org/10.1002/ana.10294

Neuropathology Group of the Medical Research Council Cognitive Function and Ageing Study (MRC CFAS). Pathological correlates of late-onset dementia in a multicentre, community-based population in England and Wales. Lancet. 2001;357:169-75. DOI: https://doi.org/10.1016/S0140-6736(00)03589-3

Vermeer SE, Koudstaal PJ, Oudkerk M, et al. Prevalence and risk factors of silent brain infarcts in the population-based Rotterdam Scan Study. Stroke. 2002;33:21-25. DOI: https://doi.org/10.1161/hs0102.101629

Bernick C, Kuller L, Dulberg C, et al. Silent MRI infarcts and the risk of future stroke: the Cardiovascular Health Study. Neurology. 2001;57:1222-29. DOI: https://doi.org/10.1212/WNL.57.7.1222

Salka SS, Wiesje MF, Elisabeth CS, et al. Neurological Signs in Relation to Type of Cerebrovascular Disease in Vascular Dementia Stroke. 2008;39:317-322. DOI: https://doi.org/10.1161/STROKEAHA.107.493353

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Published

2013-12-15

How to Cite

1.
Barbov I, Arsova S, Taravari A, Petrova V. Do Silent Brain Infarctions Predict the Development of Dementia After First Ischemic Stroke?. Open Access Maced J Med Sci [Internet]. 2013 Dec. 15 [cited 2024 Apr. 18];1(1):66-9. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2013.013

Issue

Section

B - Clinical Sciences

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