Only White Matter Hyperintensities Predicts Post-Stroke Cognitive Performances Among Cerebral Small Vessel Disease Markers: Results from the TABASCO Study

Article type: Research Article

Authors: Molad, Jeremy^{a; 1} | Kliper, Efrat^{a; b; c; 1} | Korczyn, Amos D.^{a; b} | Ben Assayag, Einor^{a; b} | Ben Bashat, Dafna^{b; c; d} | Shenhar-Tsarfaty, Shani^a | Aizenstein, Orna^e | Shopin, Ludmila^a | Bornstein, Natan M.^{a; b} | Auriel, Eitan^{a; b; *}

Affiliations: [a] Department of Neurology, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel | [b] Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel | [c] Functional Brain Center, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel | [d] Sagol School of Neurosciense, Tel Aviv University, Tel-Aviv, Israel | Department of Radiology, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel

Correspondence: [*] Correspondence to: Eitan Auriel, MD, Department of Neurology, Tel-Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv 6423906, Israel. Tel.: +972 58 4448182; Fax: +972 3 6973146; E-mail: eitanman1@gmail.com.

Note: [1] These authors contributed equally to this work.

Abstract: Background: White matter hyperintensities (WMH) were shown to predict cognitive decline following stroke or transient ischemic attack (TIA). However, WMH are only one among other radiological markers of cerebral small vessel disease (SVD). Objective: The aim of this study was to determine whether adding other SVD markers to WMH improves prediction of post-stroke cognitive performances. Methods: Consecutive first-ever stroke or TIA patients (n = 266) from the Tel Aviv Acute Brain Stroke Cohort (TABASCO) study were enrolled. MRI scans were performed within seven days of stroke onset. We evaluated the relationship between cognitive performances one year following stroke, and previously suggested total SVD burden score including WMH, lacunes, cerebral microbleeds (CMB), and perivascular spaces (PVS). Results: Significant negative associations were found between WMH and cognition (p < 0.05). Adding other SVD markers (lacunes, CMB, PVS) to WMH did not improve predication of post-stroke cognitive performances. Negative correlations between SVD burden score and cognitive scores were observed for global cognitive, memory, and visual spatial scores (all p < 0.05). However, following an adjustment for confounders, no associations remained significant. Conclusion: WMH score was associated with poor post-stroke cognitive performance. Adding other SVD markers or SVD burden score, however, did not improve prediction.

Keywords: Cognition, stroke, small vessel disease burden, TABASCO, white matter hyperintensities

DOI: 10.3233/JAD-160939

Journal: Journal of Alzheimer's Disease, vol. 56, no. 4, pp. 1293-1299, 2017