Background

A thinner cerebral cortex is associated with higher white matter hyperintensity burden and cognitive impairment in community-dwelling and dementia cohorts. It is important to assess these associations in people with ischemic stroke because their cerebrovascular disease profiles are different to these cohorts.

Aims

We aimed to determine whether cortical thickness was related to white matter hyperintensity burden and cognition after ischemic stroke.

Methods

We measured cortical thickness using advanced normalization tools' “KellyKapowski” function in 244 patients with ischemic stroke or transient ischemic attack from the Virtual International Stroke Trials Archive. We measured white matter hyperintensity burden via quantitative volumes and Fazekas score. We extracted data on vascular risk factors at baseline and Mini Mental State Examination scores at one year. We assessed associations between imaging and clinical data using correlation and multiple linear regression.

Results

Pairwise correlation showed that higher white matter hyperintensity Fazekas score was associated with a thinner cortex (rho = −0.284, P < 0.0001). White matter hyperintensities were generally distributed adjacent to and above the lateral ventricles. Voxel-wise analyses showed statistically significant negative associations between cortical thickness and white matter hyperintensities across fronto-temporal and inferior parietal cortical regions. Mean cortical thickness was positively related to Mini Mental State Examination in pair-wise correlation (r = 0.167, P = 0.0088) but there was no independent association after adjustment for age and white matter hyperintensities (beta = 0.016, P = 0.7874).

Conclusions

Cortical thickness was not an independent predictor of cognition after ischemic stroke. Further work is required to understand how white matter hyperintensities are associated with a thinner cortex in temporal regions but less so in more superior regions where white matter hyperintensities are generally found in people with stroke.

中文翻译：

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皮质厚度，白质高信号和中风后的认知

背景

在社区住宅和痴呆人群中，较薄的大脑皮层与较高的白质超负荷负担和认知障碍有关。评估缺血性卒中患者的这些关联非常重要，因为他们的脑血管疾病谱与这些人群不同。

目的

我们的目的是确定皮质厚度是否与缺血性卒中后白质过高负担和认知有关。

方法

我们使用虚拟国际中风试验档案库中的244位缺血性中风或短暂性脑缺血发作患者，使用高级归一化工具的“ KellyKapowski”功能测量了皮质厚度。我们通过定量量和Fazekas评分测量了白质高强度负担。我们提取了基线时的血管危险因素数据和一年时的迷你精神状态检查分数。我们使用相关性和多元线性回归评估了影像学和临床数据之间的关联。

结果

成对相关性表明，较高的白质高信号Fazekas评分与较薄的皮质相关（rho = -0.284，P  <0.0001）。白质高信号通常分布在侧脑室附近和上方。体素分析表明，在额颞叶和顶下皮质区域，皮质厚度与白质高强度之间存在统计学上的显着负相关。平均皮层厚度与迷你精神状态检查成对相关（r = 0.167，P = 0.0088），但在校正年龄和白质高强度后，没有独立的相关性（β= 0.016，P = 0.7874）。

结论

皮质厚度不是缺血性卒中后认知的独立预测因子。需要做进一步的工作来了解白质高信号在颞叶区域与较薄的皮层有何关系，而在中风患者中普遍存在白质高信号的较优越的区域则不那么相关。