Influence of seizures on stroke outcomes A large multicenter study

被引:107
作者
Huang, Chin-Wei [1 ,2 ]
Saposnik, Gustavo [3 ,4 ]
Fang, Jimming [4 ]
Steven, David A. [1 ]
Burneo, Jorge G. [1 ]
机构
[1] Univ Western Ontario, Dept Clin Neurol Sci, Epilepsy Program, London, ON, Canada
[2] Natl Cheng Kung Univ, Dept Neurol, Natl Cheng Kung Univ Hosp, Sch Med, Tainan 70101, Taiwan
[3] Univ Toronto, St Michaels Hosp, Toronto, ON M5S 1A1, Canada
[4] Inst Clin Evaluat Sci, Toronto, ON, Canada
关键词
TISSUE-PLASMINOGEN ACTIVATOR; CANADIAN NEUROLOGICAL SCALE; ACUTE ISCHEMIC-STROKE; PERIINFARCT DEPOLARIZATIONS; CEREBRAL-ISCHEMIA; SEX-DIFFERENCES; RELIABILITY; VALIDATION; MORTALITY; EPILEPSY;
D O I
10.1212/WNL.0000000000000166
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective: To investigate the associations among beta-amyloid (A beta), cortical thickness, and episodic memory in a cohort of cognitively normal to mildly impaired individuals at increased risk of vascular disease. Methods: In 67 subjects specifically recruited to span a continuum of cognitive function and vascular risk, we measured brain A beta deposition using [C-11] Pittsburgh compound B-PET imaging and cortical thickness using MRI. Episodic memory was tested using a standardized composite score of verbal memory, and vascular risk was quantified using the Framingham Coronary Risk Profile index. Results: Increased A beta was associated with cortical thinning, notably in frontoparietal regions. This relationship was strongest in persons with high A beta deposition. Increased A beta was also associated with lower episodic memory performance. Cortical thickness was found to mediate the relationship between A beta and memory performance. While age had a marginal effect on these associations, the relationship between A beta and cortical thickness was eliminated after controlling for vascular risk except when examined in only Pittsburgh compound B-positive subjects, in whom A beta remained associated with thinner cortex in precuneus and occipital lobe. In addition, only the precuneus was found to mediate the relationship between A beta and memory after controlling for vascular risk. Conclusion: These results suggest strong links among A beta, cortical thickness, and memory. They highlight that, in individuals without dementia, vascular risk also contributes to cortical thickness and influences the relationships among A beta, cortical thickness, and memory.
引用
收藏
页码:768 / 776
页数:9
相关论文
共 35 条
  • [1] Alberti A, 2008, VASC HEALTH RISK MAN, V4, P715
  • [2] Acute seizures in acute ischemic stroke: does thrombolysis have a role to play?
    Alvarez, Vincent
    Rossetti, Andrea O.
    Papavasileiou, Vasileios
    Michel, Patrik
    [J]. JOURNAL OF NEUROLOGY, 2013, 260 (01) : 55 - 61
  • [3] Andrews Peter J D, 2004, Curr Opin Crit Care, V10, P110, DOI 10.1097/00075198-200404000-00006
  • [4] CLASSIFICATION AND NATURAL-HISTORY OF CLINICALLY IDENTIFIABLE SUBTYPES OF CEREBRAL INFARCTION
    BAMFORD, J
    SANDERCOCK, P
    DENNIS, M
    BURN, J
    WARLOW, C
    [J]. LANCET, 1991, 337 (8756) : 1521 - 1526
  • [5] BURN JPS, 1992, STROKE, V23, P438, DOI 10.1161/str.23.3.438b
  • [6] Impact of seizures on morbidity and mortality after stroke: a Canadian multi-centre cohort study
    Burneo, J. G.
    Fang, J.
    Saposnik, G.
    [J]. EUROPEAN JOURNAL OF NEUROLOGY, 2010, 17 (01) : 52 - 58
  • [7] Retrospective assessment of initial stroke severity - Comparison of the NIH Stroke Scale and the Canadian Neurological Scale
    Bushnell, CD
    Johnston, DCC
    Goldstein, LB
    [J]. STROKE, 2001, 32 (03) : 656 - 660
  • [8] Seizures and epilepsy after ischemic stroke
    Camilo, O
    Goldstein, LB
    [J]. STROKE, 2004, 35 (07) : 1769 - 1775
  • [9] THE CANADIAN NEUROLOGICAL SCALE - VALIDATION AND RELIABILITY ASSESSMENT
    COTE, R
    BATTISTA, RN
    WOLFSON, C
    BOUCHER, J
    ADAM, J
    HACHINSKI, V
    [J]. NEUROLOGY, 1989, 39 (05) : 638 - 643
  • [10] Antidepressant use and risk of adverse outcomes in older people: population based cohort study
    Coupland, Carol
    Dhiman, Paula
    Morriss, Richard
    Arthur, Antony
    Barton, Garry
    Hippisley-Cox, Julia
    [J]. BMJ-BRITISH MEDICAL JOURNAL, 2011, 343