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dc.contributor.authorSchellhorn, Till
dc.contributor.authorZucknick, Manuela
dc.contributor.authorAskim, Torunn
dc.contributor.authorMunthe-Kaas, Ragnhild
dc.contributor.authorIhle-Hansen, Hege
dc.contributor.authorSeljeseth, Yngve Müller
dc.contributor.authorKnapskog, Anne Brita
dc.contributor.authorNæss, Halvor
dc.contributor.authorEllekjær, Hanne
dc.contributor.authorThingstad, Pernille
dc.contributor.authorWyller, Torgeir Bruun
dc.contributor.authorSaltvedt, Ingvild
dc.contributor.authorBeyer, Mona Kristiansen
dc.coverage.spatialNorwayen_US
dc.date.accessioned2021-09-28T14:57:18Z
dc.date.available2021-09-28T14:57:18Z
dc.date.created2021-07-05T14:34:34Z
dc.date.issued2021-06-14
dc.identifier.issn1471-2318
dc.identifier.urihttps://hdl.handle.net/11250/2784196
dc.description.abstractBackground: Chronic brain pathology and pre-stroke cognitive impairment (PCI) is predictive of post-stroke dementia. The aim of the current study was to measure pre-stroke neurodegenerative and vascular disease burden found on brain MRI and to assess the association between pre-stroke imaging pathology and PCI, whilst also looking for potential sex differences. Methods: This prospective brain MRI cohort is part of the multicentre Norwegian cognitive impairment after stroke (Nor-COAST) study. Patients hospitalized with acute ischemic or hemorrhagic stroke were included from five participating stroke units. Visual rating scales were used to categorize baseline MRIs (N = 410) as vascular, neurodegenerative, mixed, or normal, based on the presence of pathological imaging findings. Pre-stroke cognition was assessed by interviews of patients or caregivers using the Global Deterioration Scale (GDS). Stroke severity was assessed with the National Institute of Health Stroke Scale (NIHSS). Univariate and multiple logistic regression analyses were performed to investigate the association between imaging markers, PCI, and sex. Results: Patients’ (N = 410) mean (SD) age was 73.6 (±11) years; 182 (44%) participants were female, the mean (SD) NIHSS at admittance was 4.1 (±5). In 68% of the participants, at least one pathological imaging marker was found. Medial temporal lobe atrophy (MTA) was present in 30% of patients, white matter hyperintensities (WMH) in 38% of patients and lacunes in 35% of patients. PCI was found in 30% of the patients. PCI was associated with cerebrovascular pathology (OR 2.5; CI = 1.4 to 4.5, p = 0.001) and mixed pathology (OR 3.4; CI = 1.9 to 6.1, p = 0.001) but was not associated with neurodegeneration (OR 1.0; CI = 0.5 to 2.2; p = 0.973). Pathological MRI markers, including MTA and lacunes, were more prevalent among men, as was a history of clinical stroke prior to the index stroke. The OR of PCI for women was not significantly increased (OR 1.2; CI = 0.8 to 1.9; p = 0.3). Conclusions: Pre-stroke chronic brain pathology is common in stroke patients, with a higher prevalence in men. Vascular pathology and mixed pathology are associated with PCI. There were no significant sex differences for the risk of PCI.en_US
dc.description.sponsorshipThis paper was generously funded by a grant from Southeastern Norway Regional Health Authority (Grant No. 2016002). The Nor-COAST study is funded by the National Health Association and the Norwegian University of Science and Technology (NTNU).en_US
dc.language.isoengen_US
dc.publisherBMCen_US
dc.relation.ispartofseriesBMC Geriatrics;21, Article number: 362 (2021)
dc.rightsNavngivelse 4.0 Internasjonal*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/deed.no*
dc.subjectStroke imagingen_US
dc.subjectCognitive impairmentsen_US
dc.subjectPre-stroke cognitive impairmentsen_US
dc.subjectWhite matter lesionsen_US
dc.subjectMedial temporal lobe atrophyen_US
dc.subjectSex differencesen_US
dc.titlePre-stroke cognitive impairment is associated with vascular imaging pathology: a prospective observational studyen_US
dc.typePeer revieweden_US
dc.typeJournal articleen_US
dc.description.versionpublishedVersionen_US
dc.rights.holder© The Author(s). 2021en_US
dc.source.articlenumber362en_US
cristin.ispublishedtrue
cristin.fulltextoriginal
cristin.qualitycode1
dc.identifier.doihttps://doi.org/10.1186/s12877-021-02327-2
dc.identifier.cristin1920330
dc.source.journalBMC Geriatricsen_US
dc.source.volume21en_US
dc.source.pagenumber1-10en_US
dc.relation.projectHelse Sørøst: 2016002en_US


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