TY - JOUR
T1 - Cognitive decline after stroke
T2 - Relation to inflammatory biomarkers and hippocampal volume
AU - Kliper, Efrat
AU - Bashat, Dafna Ben
AU - Bornstein, Natan M.
AU - Shenhar-Tsarfaty, Shani
AU - Hallevi, Hen
AU - Auriel, Eitan
AU - Shopin, Ludmila
AU - Bloch, Sivan
AU - Berliner, Shlomo
AU - Giladi, Nir
AU - Goldbourt, Uri
AU - Shapira, Itzhak
AU - Korczyn, Amos D.
AU - Assayag, Einor Ben
PY - 2013/5
Y1 - 2013/5
N2 - BACKGROUND AND PURPOSE-: Inflammation may contribute to cognitive impairment after stroke. Inflammatory markers are associated with hippocampal atrophy. We tested whether markers of inflammation, erythrocyte sedimentation rate (ESR), and serum levels of C-reactive protein are associated with reduced hippocampal volume and poor cognitive performance among stroke survivors. METHODS-: We analyzed 368 consecutive cases from our prospective study of first-ever mild-moderate stroke patients. MRI, cognitive tests, and inflammatory markers were determined. Patients were reevaluated 6 and 12 months after the event. RESULTS-: ESR remained unchanged in follow-up examinations, suggesting a chronic inflammation background in some patients. Higher levels of C-reactive protein and ESR were associated with worse performance in cognitive tests, particularly memory scores. This association was maintained for ESR (but not C-reactive protein) after adjustment for confounders (P=0.002). Patients with smaller hippocampi had inferior cognitive results. Moreover, in a multivariate regression model, higher ESR values (but not C-reactive protein) were related to reduced hippocampal volume (P=0.049). CONCLUSIONS-: This report shows a strong relationship between ESR and hippocampal volume, as well as with cognitive performance among poststroke patients. This could plausibly relate to incipient cognitive decline via hippocampal pathways.
AB - BACKGROUND AND PURPOSE-: Inflammation may contribute to cognitive impairment after stroke. Inflammatory markers are associated with hippocampal atrophy. We tested whether markers of inflammation, erythrocyte sedimentation rate (ESR), and serum levels of C-reactive protein are associated with reduced hippocampal volume and poor cognitive performance among stroke survivors. METHODS-: We analyzed 368 consecutive cases from our prospective study of first-ever mild-moderate stroke patients. MRI, cognitive tests, and inflammatory markers were determined. Patients were reevaluated 6 and 12 months after the event. RESULTS-: ESR remained unchanged in follow-up examinations, suggesting a chronic inflammation background in some patients. Higher levels of C-reactive protein and ESR were associated with worse performance in cognitive tests, particularly memory scores. This association was maintained for ESR (but not C-reactive protein) after adjustment for confounders (P=0.002). Patients with smaller hippocampi had inferior cognitive results. Moreover, in a multivariate regression model, higher ESR values (but not C-reactive protein) were related to reduced hippocampal volume (P=0.049). CONCLUSIONS-: This report shows a strong relationship between ESR and hippocampal volume, as well as with cognitive performance among poststroke patients. This could plausibly relate to incipient cognitive decline via hippocampal pathways.
KW - erythrocyte sedimentation rate
KW - hippocampus
KW - inflammation
KW - poststroke cognitive performance
UR - http://www.scopus.com/inward/record.url?scp=84876871720&partnerID=8YFLogxK
U2 - 10.1161/STROKEAHA.111.000536
DO - 10.1161/STROKEAHA.111.000536
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C2 - 23444307
AN - SCOPUS:84876871720
VL - 44
SP - 1433
EP - 1435
JO - Stroke
JF - Stroke
SN - 0039-2499
IS - 5
ER -