open access

Vol 22, No 4 (2018)
Original paper
Published online: 2018-11-22
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Evaluation of the coexistence of cognitive disorders, leukoaraiosis and other risk factors in patients with stroke

Dawid Mamak1, Maciej Horyniecki2, Mateusz Rajchel1, Kaja Skowronek1, Aleksandra Lupa1, Justyna Szałajko1, Monika Adamczyk-Sowa2
·
Arterial Hypertension 2018;22(4):185-192.
Affiliations
  1. Students Scientific Group affiliated to Department of Neurology in Zabrze, Medical University of Silesia in Katowice with the Division of Dentistry in Zabrze
  2. Department of Neurology in Zabrze, Medical University of Silesia in Katowice with the Division of Dentistry in Zabrze

open access

Vol 22, No 4 (2018)
ORIGINAL PAPERS
Published online: 2018-11-22

Abstract

Background. Stroke is a common cause of mortality and disability. There are many risk factors for stroke among
which leukoaraiosis (LA) is mentioned. Historically, LA was a radiological term, however, today it is classified as
Cerebral Small Vessel Disease (CSVD) which clinical presentation depends on the affected brain area. Higher prevalence
of LA is found not only in stroke patients, but also in patients with hypertension and other cerebrovascular risk
factors. Therefore, the aim of the study was to evaluate the relationship between the present LA, selected laboratory
tests, the carotid ultrasound markers and cognitive tests results in patients with stroke.

Material and methods. The study included 102 patients (W: 56, M: 46) at the age of 70.9 ± 11.5 hospitalized due
to stroke in the Stroke Unit of the Department of Neurology. The clinical assessment included NIHSS score, MMSE
testing, laboratory blood tests, carotid duplex USG and CT scan of the brain. Patients were dichotomized based on
the presence of LA in the CT scan.

Results. LA was present in 25 (24.5%) patients. It was more frequently found in older patients (> 72 years old;
p < 0.001). In the LA group, higher levels of LDL cholesterol (p = 0.002), lower hemoglobin concentration
(p = 0.03) and higher platelets count (p = 0.04) were observed. The carotid ultrasound showed higher intimamedia
complexes in the LA group (p = 0.02). The functional test showed lower scores on the clock test in patients
with LA (p = 0.04). The presence of LA was three times less likely to be present in patients administered with
beta1-adrenolytics (p = 0.03).

Conclusions. The occurrence of leukoaraiosis in patients with acute stroke is associated with clustering of other
vascular risk factors cognitive impairment, and may be related to ongoing cardiovascular therapy.

Abstract

Background. Stroke is a common cause of mortality and disability. There are many risk factors for stroke among
which leukoaraiosis (LA) is mentioned. Historically, LA was a radiological term, however, today it is classified as
Cerebral Small Vessel Disease (CSVD) which clinical presentation depends on the affected brain area. Higher prevalence
of LA is found not only in stroke patients, but also in patients with hypertension and other cerebrovascular risk
factors. Therefore, the aim of the study was to evaluate the relationship between the present LA, selected laboratory
tests, the carotid ultrasound markers and cognitive tests results in patients with stroke.

Material and methods. The study included 102 patients (W: 56, M: 46) at the age of 70.9 ± 11.5 hospitalized due
to stroke in the Stroke Unit of the Department of Neurology. The clinical assessment included NIHSS score, MMSE
testing, laboratory blood tests, carotid duplex USG and CT scan of the brain. Patients were dichotomized based on
the presence of LA in the CT scan.

Results. LA was present in 25 (24.5%) patients. It was more frequently found in older patients (> 72 years old;
p < 0.001). In the LA group, higher levels of LDL cholesterol (p = 0.002), lower hemoglobin concentration
(p = 0.03) and higher platelets count (p = 0.04) were observed. The carotid ultrasound showed higher intimamedia
complexes in the LA group (p = 0.02). The functional test showed lower scores on the clock test in patients
with LA (p = 0.04). The presence of LA was three times less likely to be present in patients administered with
beta1-adrenolytics (p = 0.03).

Conclusions. The occurrence of leukoaraiosis in patients with acute stroke is associated with clustering of other
vascular risk factors cognitive impairment, and may be related to ongoing cardiovascular therapy.

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Keywords

stroke; leukoaraiosis; Doppler ultrasound; beta1-adrenolytics; clock test

About this article
Title

Evaluation of the coexistence of cognitive disorders, leukoaraiosis and other risk factors in patients with stroke

Journal

Arterial Hypertension

Issue

Vol 22, No 4 (2018)

Article type

Original paper

Pages

185-192

Published online

2018-11-22

Page views

1028

Article views/downloads

852

DOI

10.5603/AH.a2018.0019

Bibliographic record

Arterial Hypertension 2018;22(4):185-192.

Keywords

stroke
leukoaraiosis
Doppler ultrasound
beta1-adrenolytics
clock test

Authors

Dawid Mamak
Maciej Horyniecki
Mateusz Rajchel
Kaja Skowronek
Aleksandra Lupa
Justyna Szałajko
Monika Adamczyk-Sowa

References (25)
  1. Lindsay P, Furie KL, Davis SM, et al. World Stroke Organization global stroke services guidelines and action plan. Int J Stroke. 2014; 9 Suppl A100: 4–13.
  2. Ryglewicz D. Choroby naczyń mózgowych w Polsce: diagnoza i rekomendacje. In: Strzelecki Z, Szymborski J. ed. Zachorowalność i umieralność na choroby układu krążenia a sytuacja demograficzna Polski. Rządowa Rada Ludnościowa, Warszawa 2015: 140–147.
  3. Clarke DJ, Forster A. Improving post-stroke recovery: the role of the multidisciplinary health care team. J Multidiscip Healthc. 2015; 8: 433–442.
  4. Fride Y, Adamit T, Maeir A, et al. What are the correlates of cognition and participation to return to work after first ever mild stroke? Top Stroke Rehabil. 2015; 22(5): 317–325.
  5. Kwolek A. Rehabilitacja w udarze mózgu. Wydawnictwo Uniwersytetu Rzeszowskiego, Rzeszów 2009: 33–36.
  6. Renna R, Pilato F, Profice P, et al. Risk factor and etiology analysis of ischemic stroke in young adult patients. J Stroke Cerebrovasc Dis. 2014; 23(3): e221–e227.
  7. Lin Q, Huan WQ, Ma QL, et al. Incidence and risk factors of leukoaraiosis from 4683 hospitalized patients. Medicine (Baltimore). 2017; 96(39): e7682.
  8. Huo D, Fenh HL. New progress in the research of leukoaraiosis. Med Recapitulate. 2015: 269–271.
  9. Smith EE. Leukoaraiosis and stroke. Stroke. 2010; 41(10 Suppl): S139–S143.
  10. Srikanth V, Beare R, Blizzard L, et al. Cerebral white matter lesions, gait, and the risk of incident falls: a prospective population-based study. Stroke. 2009; 40(1): 175–180.
  11. Zagrajek MM, Pokryszko-Dragan A. The characteristic and clinical signs of leukoaraiosis. Udar Mózgu. 2005; 7(2): 56–60.
  12. Kissela B, Lindsell CJ, Kleindorfer D, et al. Clinical prediction of functional outcome after ischemic stroke: the surprising importance of periventricular white matter disease and race. Stroke. 2009; 40(2): 530–536.
  13. Debette S, Beiser A, DeCarli C, et al. Association of MRI markers of vascular brain injury with incident stroke, mild cognitive impairment, dementia, and mortality: the Framingham Offspring Study. Stroke. 2010; 41(4): 600–606.
  14. Shi J, Hao K, Qi P, et al. Confirmation of the abnormal lipid metabolism as a risk factor for the disease of leukoaraiosis. Saudi J Biol Sci. 2017; 24(3): 508–513.
  15. Kanaan RA, Chaddock C, Allin M, et al. Gender influence on white matter microstructure: a tract-based spatial statistics analysis. PLoS One. 2014; 9(3): e91109.
  16. Seo SK, Jung I, Lee SM, et al. Relationship between leukoaraiosis and menopause in healthy middle-aged women. Fertil Steril. 2013; 100(2): 500–504.
  17. Smith JA, Turner ST, Sun YV, et al. Complexity in the genetic architecture of leukoaraiosis in hypertensive sibships from the GENOA Study. BMC Med Genomics. 2009; 2: 16.
  18. Zamboni V, Cesari M, Zuccalà G, et al. Anemia and cognitive performance in hospitalized older patients: results from the GIFA study. Int J Geriatr Psychiatry. 2006; 21(6): 529–534.
  19. Kang SJ, Park BJ, Shim JY, et al. Mean platelet volume (MPV) is associated with leukoaraiosis in the apparently healthy elderly. Arch Gerontol Geriatr. 2012; 54(2): e118–e121.
  20. Tanaka T, Shimizu T, Fukuhara T. The relationship between leukoaraiosis volume and parameters of carotid artery duplex ultrasonographic scanning in asymptomatic diabetic patients. Comput Med Imaging Graph. 2009; 33(6): 489–493.
  21. Rodríguez Hernández SA, Kroon AA, van Boxtel MPJ, et al. Is there a side predilection for cerebrovascular disease? Hypertension. 2003; 42(1): 56–60.
  22. Godin O, Tzourio C, Maillard P, et al. Antihypertensive treatment and change in blood pressure are associated with the progression of white matter lesion volumes: the Three-City (3C)-Dijon Magnetic Resonance Imaging Study. Circulation. 2011; 123(3): 266–273.
  23. Vernooij MW, Ikram MA, Vrooman HA, et al. White matter microstructural integrity and cognitive function in a general elderly population. Arch Gen Psychiatry. 2009; 66(5): 545–553.
  24. Nitkunan A, Barrick TR, Charlton RA, et al. Multimodal MRI in cerebral small vessel disease: its relationship with cognition and sensitivity to change over time. Stroke. 2008; 39(7): 1999–2005.
  25. Zhong G, Zhang R, Jiaerken Y, et al. Better Correlation of Cognitive Function to White Matter Integrity than to Blood Supply in Subjects with Leukoaraiosis. Front Aging Neurosci. 2017; 9: 185.

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