Poststroke Cognitive Decline is Independent of Longitudinal Changes in Cerebral Hemodynamics Parameters

作者：Suministrado Ma Serrie Platero; Shuang Esther Wan Yee; Xu Jing; Teoh Hock Luen; Chan Bernard Poon Lap; Venketasubramanian Narayanaswamy; Seet Raymond Chee Seong; Chen Christopher Li Hsian; Wong Boon Seng; Sharma Vijay Kumar; Dong YanHong

来源：Journal of Neuroimaging, 2017, 27(3): 326-332.

DOI：10.1111/jon.12395

• Cerebral hemodynamics
• cognitive decline
• transcranial Doppler

BACKGROUNDPoststroke vascular cognitive impairment is highly prevalent with significant functional consequences. However, reliable biomarkers for early prediction of cognitive decline after acute ischemic stroke (AIS) are not well established. Although parenchymal imaging in patients with AIS and transient ischemic attack (TIA) may predict the resultant cognitive impairment, it may not explain the progressive deterioration after the index event. We postulated that longitudinal changes in cerebral hemodynamic parameters may influence the cognitive performance after a cerebrovascular event.
METHODSOne-hundred consecutive AIS/TIA patients were recruited within 2 weeks following a cerebrovascular event. At 3-6 months, 69 patients were followed up with transcranial Doppler (TCD) and brief cognitive tests (Mini-Mental State Examination [MMSE]/Montreal Cognitive Assessment [MoCA]). Basic demographics, vascular risk factors, clinical, cognitive, and neurological status were recorded.
RESULTSConsiderable proportion (12%) of patients showed cognitive decline and changes in the hemodynamic parameters over 3-6 months after the index event. We showed that right middle cerebral artery (MCA) stenosis and right internal carotid artery/MCA tandem lesions at 3-6 months are associated with the change in the MMSE scores. Additionally, there was a trend toward association between increased pulsatility index of the right MCA and a decline in the MMSE score. However, we did not observe any association between cognitive decline and longitudinal changes in hemodynamic parameters.
CONCLUSIONAlthough hemodynamic parameters deteriorate in a considerable proportion of patients during first 3-6 months after a cerebrovascular event, cognitive decline appears to be an independent phenomenon.

• 出版日期2017-6