PURPOSE The aim of this study was to investigate the association between preexisting cerebral abnormalities in patients with acute ischemic stroke upon their functional outcomes. METHODS We recruited 272 patients with first-ever acute ischemic stroke. Cerebral abnormalities on magnetic resonance imaging included infarction, silent brain infarcts (SBI), enlarged perivascular spaces, white matter lesions (WMLs), global brain atrophy, and medial temporal lobe atrophy (MTLA). Functional outcomes were assessed using the instrumental activities of daily living (IADL) scale and basic activities of daily living (BADL) scale, at 3 and 6 months after the index stroke. RESULTS Two hundred and fifty patients completed the 3-month follow-up and 246 patients completed the 6-month follow-up. Univariate analyses showed that patients with poor IADL and BADL were older, more likely to be men, had higher National Institutes of Health Stroke Scale (NIHSS) score on admission, more frequent atrial fibrillation, and large artery atherosclerosis subtypes. They also had more frequent cortical infarcts, subcortical infarcts, infratentorial infarcts, larger infarct volume, more frequent presence of SBI, severe WMLs, and MTLA. In multiple regression analyses, NIHSS on admission, subcortical region infarct and MTLA were significant predictors of poor IADL at 3 months. National Institutes of Health Stroke Scale on admission, SBI and MTLA were significant predictors of poor IADL at 6 months. National Institutes of Health Stroke Scale on admission and MTLA were significant predictors of poor BADL at 3 months. National Institutes of Health Stroke Scale on admission and SBI were significant predictors of poor BADL at 6 months. CONCLUSIONS In patients with acute ischemic stroke, the presence of SBI, and severe MTLA represent significant predictors of poorer functional outcomes, thus highlighting the importance of preexisting cerebral abnormalities.

中文翻译：

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急性缺血性中风后已有的脑异常和功能预后。

目的这项研究的目的是研究急性缺血性中风患者预后的脑部异常与其功能结局之间的关系。方法我们招募了272例首例急性缺血性中风患者。磁共振成像中的脑部异常包括梗死，静默性脑梗塞（SBI），血管周围间隙扩大，白质病变（WML），整体性脑萎缩和内侧颞叶萎缩（MTLA）。在指数卒中后3个月和6个月，使用日常生活工具活动量（IADL）量表和日常生活基础活动量（BADL）量表评估功能结局。结果250例患者完成了3个月的随访，246例患者完成了6个月的随访。单因素分析表明，IADL和BADL较差的患者年龄较大，更有可能是男性，入院时的美国国立卫生研究院卒中量表（NIHSS）评分较高，房颤更为频繁，大动脉粥样硬化亚型。他们还具有更频繁的皮质梗塞，皮质下梗塞，下腔内梗塞，更大的梗塞体积，SBI，更严重的WML和MTLA出现率更高。在多元回归分析中，入院时的NIHSS，皮质下梗死和MTLA是3个月时IADL差的重要预测指标。美国国立卫生研究院卒中量表，SBI和MTLA是6个月IADL差的重要预测指标。美国国立卫生研究院卒中量表和MTLA是3个月BADL差的重要预测指标。美国国立卫生研究院卒中量表和SBI量表是6个月BADL差的重要预测指标。结论在急性缺血性中风患者中，SBI的存在和严重的MTLA代表了功能预后较差的重要预测因素，因此突出了预先存在的脑部异常的重要性。