scholarly journals Vascular Cognitive Impairment (VCI) after non-embolic ischemic stroke during a 12-month follow-up in Brazil

2012 ◽  
Vol 6 (3) ◽  
pp. 164-169 ◽  
Author(s):  
Sonia Maria Dozzi Brucki ◽  
Michel Ferreira Machado ◽  
Maria Sheila Guimarães Rocha
Keyword(s):  
Ischemic Stroke ◽  
Cognitive Impairment ◽  
Vascular Cognitive Impairment ◽  
Subclinical Disease ◽  
Cognitive Evaluation ◽  
Diagnosis Of Dementia ◽  
One Year ◽  
Associated Risk Factors ◽  
Cognitive Impairment No Dementia

ABSTRACT VCI represents a spectrum of cognitive impairments associated with stroke, vascular brain injury, or subclinical disease ranging from the least to most severe manifestations. Few studies are available on the prevalence of post-stroke VCI and none have been conducted in Brazil. Objective: To determine the prevalence rates of VCI and associated risk factors in a sample of ischemic stroke patients. Methods: We evaluated 172 patients with ischemic stroke for cognitive impairment one year after ictus. Results: Patients comprised 81 women (47.1%) and had a mean age of 67.77 (7.86) years, schooling of 3.52 (2.99) years, and MMSE score of 24.94 (3.59) points. After cognitive evaluation, 4.6% were diagnosed as CIND (cognitive impairment no dementia) and 12.2% had a diagnosis of dementia (probable vascular dementia in 20 patients and one subject with cerebrovascular disease and Alzheimer's disease). Conclusion: The prevalence of dementia was lower than previous reports but our sample had a lower age than others, while a 12 month-period of follow-up prevented interference from associated neurodegenerative disorders.

Clinical analysis of first-ever acute ischemic stroke involving the territory of paramedian mesencephalic arteries

Open Medicine ◽  
2007 ◽  
Vol 2 (1) ◽  
pp. 37-46 ◽  
Author(s):  
Peterus Thajeb ◽  
Teguh Thajeb ◽  
Dao-Fu Dai
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Age Of Onset ◽  
Clinical Analysis ◽  
Clinical Triad ◽  
One Year ◽  
Associated Risk Factors ◽  
A Prospective Study ◽  
Bilateral Lesions

AbstractTo determine one-year clinical outcome of patients with first-ever acute ischemic stroke involving the territory of paramedian mesencephalic arteries (PMAS), we conducted a prospective study evaluating the cognitive functions of 28 patients with PMAS. Neuropsychological tests were performed during the first month of stroke onset and at the 12th month of follow-up. There were 12 women and 16 men. Mean age of onset for women and men was 70 years and 65 years, respectively. Progressing strokes occurred in 62% of patients and 96% developed a full-blown picture of the clinical triad of akinetic mutism, hypersomnolence, and bilateral blepharoptosis and ophthalmoparesis. Involuntary movements occurred in 6, and focal myoclonus in 4 patients. The top four associated risk factors were hypertension (68%), hyperlipidemia (57%), diabetes mellitus (46%), and atrial fibrillation (36%). Unilateral midbrain infarctions occurred in 12 patients and bilateral lesions in 16. Thalamic infarctions were unilateral in 10 and bilateral in 13 cases. Three of the 28 (11%) patients died of recurrent cerebral infarctions within 1 year of the onset of PMAS. The recurrent infarctions involved the basilar artery territory in two cases and the carotid system in another. One patient died of acute myocardial infarction. Of the 24 patients who had survived the stroke by 1 year, 20 (71%) developed dementia. We conclude that first-ever ischemic stroke with PMAS is not a benign syndrome. Most patients developed dementia by 1 year after the stroke.

TMS follow-up study in patients with vascular cognitive impairment-no dementia

2013 ◽  
Vol 534 ◽  
pp. 155-159 ◽  
Author(s):  
Rita Bella ◽  
Raffaele Ferri ◽  
Giuseppe Lanza ◽  
Mariagiovanna Cantone ◽  
Manuela Pennisi ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Vascular Cognitive Impairment ◽  
Follow Up Study ◽  
Cognitive Impairment No Dementia

White matter hyperintensities predict dementia in poststroke patients with cognitive impairment no dementia (CIND)

2011 ◽  
Vol 26 (S2) ◽  
pp. 490-490
Author(s):  
Y.K. Chen ◽  
E. Lee ◽  
J.Y. Lu ◽  
W.C.W. Chu ◽  
V.C.T. Mok ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cognitive Impairment ◽  
White Matter ◽  
White Matter Hyperintensities ◽  
Hippocampal Volume ◽  
Cognitive Domain ◽  
Nihss Score ◽  
One Year ◽  
Cognitive Impairment No Dementia

IntroductionLongitudinal studies of predicting dementia conversion of poststroke cognitive impairment no dementia (CIND) are limited.ObjectiveTo investigate the clinical and imaging predictors of dementia conversion in poststroke patients with CIND.AimTo understand dementia conversion of CIND.Methods143 patients with CIND (defined as impairment in at least one cognitive domain without meeting the criteria of dementia) at three months after stroke were recruited and followed up for one year. Dementia was diagnosed using the criteria of Diagnostic and Statistical Manual of Mental Disorders (4th edition, DSM-IV). MRI measurements including infarction, microbleeds, white matter hyperintensities (WMHs) and hippocampal volume were conducted. Logistic regression was performed to find the predictors of dementia at follow-up.Results16 (11.2%) out of the 143 patients developed dementia 15 months after stroke. In univariate comparisons, subjects with dementia at follow-up had older age (78.0 ± 5.3 vs.71.5 ± 8.5 years, p = 0.003) and higher NIHSS score (7.1 ± 3.5 vs.4.7 ± 3.3, p = 0.005) on admission. They also had higher frequency of old infarcts in the thalamus (31.3% vs. 11.0%, p = 0.025), larger volume of old infarcts (4.2 ± 11.2 vs. 0.7 ± 2.6 cm3, p < 0.001) and WMHs volume (33.2 ± 34.0 vs. 14.2 ± 14.1 cm3, p = 0.016). In logistic regression, age (odds ratio [OR] =1.203, 95%C.I.=1.054-1.373, p = 0.006), NIHSS score on admission (OR = 1.324, 95%C.I.=1.082-1.619, p = 0.006) and WMHs volume (OR = 1.045, 95%C.I.=1.007-1.084, p = 0.019) were significant predictors of dementia at follow-up.ConclusionsWMHs volume predicts dementia in poststroke patients with CIND, suggesting subcortical ischemic vascular disease was an important origin of poststroke delayed dementia.

Remission of poststroke cognitive impairment no dementia: Clinical and imaging correlates

2011 ◽  
Vol 26 (S2) ◽  
pp. 1179-1179
Author(s):  
Y.K. Chen ◽  
E. Lee ◽  
G.S. Ungvari ◽  
J.Y. Lu ◽  
W.C.W. Chu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cognitive Impairment ◽  
Hippocampal Volume ◽  
Cognitive Status ◽  
Cerebral Microbleeds ◽  
Younger Age ◽  
One Year ◽  
Cognitively Intact ◽  
Cognitive Impairment No Dementia

IntroductionCerebral microbleeds (CMBs) may contribute to cognitive deficits in stroke. Cognitive impairment that does not meet the criteria for dementia (cognitive impairment no dementia [CIND]) is common in stroke, and patients with such impairment can revert to normal cognition.ObjectiveTo investigate the association of CMBs and remission of poststroke CIND.AimTo understand the evolution of poststroke cognitive impairment no dementia (CIND) is bi-directional.Methods143 patients with CIND at three months after stroke were recruited and followed up for one year. Remission of CIND was defined as a conversion of cognitive status from CIND to cognitively intact at follow-up. MRI variables in terms of infarction, cerebral microbleeds (CMBs), and white matter hyperintensities (WMHs) and hippocampal volume were analyzed. Logistic regression was performed to find the predictors of the remission of poststroke CIND.Results30 (21.0%) out of the 143 patients converted to cognitive intact at follow-up. In univariate comparisons, subjects with remission of CIND had younger age (67.1 ± 9.5 vs.73.6 ± 7.6 years, p < 0.001) and higher education years (5.1 ± 4.0 vs.3.6 ± 4.0, p = 0.039). They also had lower WMHs volume (8.2 ± 8.2 vs. 18.6 ± 19.7 cm3, p < 0.001), lower frequency of CMBs (10.0% vs. 31.0%, p = 0.021) and lower volume of the lateral ventricle (33.3 ± 16.5 vs.42.6 ± 19.4 cm3, p = 0.017). In logistic regression, age (odds ratio [OR] = 0.913, 95%C.I. = 0.866–0.962, p = 0.001) and absence of CMBs (OR = 4.292, 95%C.I. = 1.174–15.625, p = 0.028) were significant predictors of remission of CIND.ConclusionsYounger age and absence of CMBs predict the remission of poststroke CIND.

scholarly journals HUBUNGAN NILAI P300 DENGAN MOCA-INA PADA PASIEN DENGAN GANGGUAN KOGNITIF VASKULAR PASCASTROKE ISKEMIK

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Susilo Susilo ◽  
Yudy Goysal ◽  
Abdul Muis ◽  
Muhammad Akbar ◽  
Andi Kurnia Bintang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cognitive Impairment ◽  
Human Life ◽  
Strong Predictor ◽  
Vascular Cognitive Impairment ◽  
P300 Amplitude ◽  
P300 Latency ◽  
Cross Sectional ◽  
Neurology Clinic ◽  
Cross Sectional Design

      ASSOCIATION OF P300 VALUE WITH MOCA-INA IN VASCULAR COGNITIVE IMPAIRMENT POST-ISCHEMIC STROKE PATIENTSABSTRACTIntroduction: Stroke is a major threat in human life because it can cause disability and mortality. Cognitive impairment in early stroke is strong predictor for long term vascular cognitive impairment while neuropsychology method is superior than conventional method to diagnose cognitive impairment, especially P300.Aim: To identify the association between P300 values and MoCA-Ina in vascular cognitive impairment post ischemic stroke patients.Methods: It is a cross sectional design study for ischemic stroke patients who suffered from vascular cognitive impairment during April to June 2018 in Neurology Clinic of Dr. Wahidin Sudirohusodo Hospital, Makassar. The statistical analysis was performed by Pearson’s correlation test.Result: There were 20 samples, male (60%) and female (40%). The average MoCA-Ina score was 19.35±6.06; the average P300 latency in Fz, Cz, and Pz were 370.22±49.01ms, 360.78±38.27ms, and 361.02±44.45ms, respectively; the average P300 in Fz, Cz, and Pz amplitude were 6.09±3.10µV, 5.67±3.49µV, and 6.10±2.77µV, respectively. The Pearson’s showed that P300 latency had significantly correlation  with MoCA-Ina score while no correlation between the P300 amplitude and MoCA-Ina.Discussion: There was correlation between P300 latency with MoCA-Ina in vascular cognitive impairment post ischemic stroke patients.Keywords: Ischemic stroke, MoCA-Ina, P300 value, vascular cognitive impairment.ABSTRAKPendahuluan: Stroke merupakan suatu ancaman terbesar di kehidupan manusia karena dapat menimbulkan kecacatan dan kematian. Gangguan kognitif pada awal stroke merupakan prediktor kuat untuk gangguan kognitif vaskular jangka panjang dan metode neuropsikologi lebih unggul daripada metode konvensional untuk mendiagnosis gangguan kognitif, terutama P300.Tujuan: Untuk mengetahui hubungan nilai P300 dengan MoCA-Ina pada pasien gangguan kognitif vaskular pascastroke iskemik.Metode: Desain studi potong lintang terhadap pasien stroke iskemik yang mengalami gangguan kognitif vaskular selama bulan April sampai Juni 2018 di Poliklinik Saraf RSUP Dr. Wahidin Sudirohusodo, Makassar. Data diolah menggunakan uji korelasi Pearson’s.Hasil: Didapatkan 20 orang sampel laki-laki (60%) dan perempuan (40%). Nilai MoCA-Ina rata-rata 19,35±6,06; hasil rata-rata latensi gelombang P300 di Fz, Cz, dan Pz   masing-masing adalah 370,22±49,01, 360,78±38,27, dan 361,02±44,45; rata-rata tinggi amplitudo P300 di Fz masing-masing adalah 6,09±3,10, 5,67±3,49, dan 6,10±2,77. Hasil uji korelasi Pearson’s menunjukkan latensi P300 berkorelasi signifikan terhadap MoCA-Ina, sedangkan amplitudo P300 tidak.Pembahasan: Ada hubungan antara latensi gelombang P300 dengan MoCA-Ina pada pasien gangguan kognitif vaskular pascastroke iskemik.Kata kunci: Gangguan kognitif vaskular, MoCA-Ina, nilai P300, stroke iskemik  

scholarly journals Anticholinergics and Benzodiazepines on Cognitive Impairment among Elderly with Alzheimer’s Disease: a One year Follow-Up Study

2019 ◽  
Author(s):  
Rewadee Jenraumjit ◽  
Surarong Chinwong ◽  
Dujrudee Chinwong ◽  
Tipaporn Kanjanarach ◽  
Thanat Kshetradat ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Psychological Symptoms ◽  
Esterase Inhibitors ◽  
One Year ◽  
State Examination ◽  
Harmful Effects

Abstract Objective Age-associated decline in central cholinergic activity makes older adults susceptible to harmful effects of anticholinergics (ACs). Evidence exists of an association between effects of AC medications on cognition. This retrospective cohort study examines how ACs affect cognition among older adults with Alzheimer’s disease (AD) who received acetylcholine esterase inhibitors (AChEIs) over the course of 12 months. Results A total of 133 (80% women, mean age 78.38 years, SD 7.4) were recruited. No difference in sex, age and comorbid diseases was observed between participants who took ACs, Benzodiazepines (BZDs) and AChEIs. The most common prescribed ACs was quetiapine, being used for behavioral and psychological symptoms (BPSD). Multilevel analysis showed that the change of mental state examination scores were significantly predicted in the group using ACs (t (169), -2.52, p = .020) but not with the groups using BZD (t (162), 0.84, p = .440). Evidence showed that older adults with Alzheimer’s disease and exposed to ACs exhibited lower global cognitive scores than those without AC exposure. Using ACs could be a trade-off between controlling BPSD and aggravating cognitive impairment. Highlighting the awareness of the potential anticholinergic effect is important and may be the best policy.

Sign in / Sign up

Export Citation Format

Share Document