Association between intracranial vessel calcifications, structural brain damage, and cognitive impairment after minor strokes: a prospective study
BackgroundVascular calcifications are a hallmark of atherosclerosis, and in the coronary arteries are routinely used as a prognostic marker. Calcifications of intracranial vessels (ICC) are frequently observed on non-contrast CT (NCCT) and their effect on post-stroke cognitive impairment (PSCI) rema...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1218077/full |
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| author | Estelle Emanuelle Seyman Estelle Emanuelle Seyman Udi Sadeh-Gonik Phillip Berman Itay Blum Genady Shendler Bornstein Nathan Bornstein Nathan Ofer Rothschild Jeremy Molad Einor Ben Assayag Einor Ben Assayag Einor Ben Assayag Hen Hallevi Hen Hallevi Hen Hallevi the TABASCO prospective cohort study group |
| author_facet | Estelle Emanuelle Seyman Estelle Emanuelle Seyman Udi Sadeh-Gonik Phillip Berman Itay Blum Genady Shendler Bornstein Nathan Bornstein Nathan Ofer Rothschild Jeremy Molad Einor Ben Assayag Einor Ben Assayag Einor Ben Assayag Hen Hallevi Hen Hallevi Hen Hallevi the TABASCO prospective cohort study group |
| author_sort | Estelle Emanuelle Seyman |
| collection | DOAJ |
| description | BackgroundVascular calcifications are a hallmark of atherosclerosis, and in the coronary arteries are routinely used as a prognostic marker. Calcifications of intracranial vessels (ICC) are frequently observed on non-contrast CT (NCCT) and their effect on post-stroke cognitive impairment (PSCI) remains unclear. Our aim was to explore the association of ICC with prospective long-term cognitive function and advanced MRI-measures in a large prospective cohort of cognitively intact mild stroke survivors.MethodsData from the Tel-Aviv brain acute stroke cohort (TABASCO) study [ClinicalTrials.gov #NCT01926691] were analyzed. This prospective cohort study (n = 575) aimed to identify predictors of PSCI, in cognitively intact mild stroke survivors. A quantitative assessment of the intracranial calcium content – The ICC score (ICCS) was calculated semi-automatically on NCCT using a validated calcium quantification application. Participants underwent a 3 T-MRI and prospective comprehensive cognitive clinical and laboratory assessments at enrollment, 6, 12, and 24-months.ResultsData were available for 531 participants (67.4 years, 59.5% males). The incidence of PSCI at two-years doubled in the high ICCS group (26% vs. 13.7%, p < 0.001). The high ICCS group had significantly greater small-vessel-disease (SVD) tissue changes and reduced microstructural-integrity assessed by Diffusion-Tensor-Imaging (DTI) maps (p < 0.05 for all). In multivariate analysis, a higher ICCS was independently associated with brain atrophy manifested by lower normalized white and gray matter, hippocampal and thalamic volumes (β = −0.178, β = −0.2, β = −0.137, β = −0.157; p < 0.05) and independently predicted PSCI (OR 1.83, 95%CI 1.01–3.35).ConclusionOur findings suggest that the ICCS, which is a simple and readily available imaging marker on NCCT, is associated with brain atrophy, microstructural damage, the extent of SVD, and may predict PSCI. This finding has implications for identifying individuals at risk for PSCI and implementing targeted interventions to mitigate this risk. |
| first_indexed | 2024-03-12T23:07:06Z |
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| id | doaj.art-e6e314865e874822bf8ede51a29da3fe |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-12T23:07:06Z |
| publishDate | 2023-07-01 |
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| series | Frontiers in Neurology |
| spelling | doaj.art-e6e314865e874822bf8ede51a29da3fe2023-07-18T16:14:21ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-07-011410.3389/fneur.2023.12180771218077Association between intracranial vessel calcifications, structural brain damage, and cognitive impairment after minor strokes: a prospective studyEstelle Emanuelle Seyman0Estelle Emanuelle Seyman1Udi Sadeh-Gonik2Phillip Berman3Itay Blum4Genady Shendler5Bornstein Nathan6Bornstein Nathan7Ofer Rothschild8Jeremy Molad9Einor Ben Assayag10Einor Ben Assayag11Einor Ben Assayag12Hen Hallevi13Hen Hallevi14Hen Hallevi15the TABASCO prospective cohort study groupStroke Department Division of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDepartment of Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, IsraelDepartment of Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, IsraelDepartment of Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, IsraelDepartment of Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelBrain Center, Shaare Zedek Medical Center, Jerusalem, IsraelStroke Department Division of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, IsraelStroke Department Division of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, IsraelStroke Department Division of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelSagol School of Neuroscience, Tel Aviv University, Tel Aviv, IsraelStroke Department Division of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelSagol School of Neuroscience, Tel Aviv University, Tel Aviv, IsraelBackgroundVascular calcifications are a hallmark of atherosclerosis, and in the coronary arteries are routinely used as a prognostic marker. Calcifications of intracranial vessels (ICC) are frequently observed on non-contrast CT (NCCT) and their effect on post-stroke cognitive impairment (PSCI) remains unclear. Our aim was to explore the association of ICC with prospective long-term cognitive function and advanced MRI-measures in a large prospective cohort of cognitively intact mild stroke survivors.MethodsData from the Tel-Aviv brain acute stroke cohort (TABASCO) study [ClinicalTrials.gov #NCT01926691] were analyzed. This prospective cohort study (n = 575) aimed to identify predictors of PSCI, in cognitively intact mild stroke survivors. A quantitative assessment of the intracranial calcium content – The ICC score (ICCS) was calculated semi-automatically on NCCT using a validated calcium quantification application. Participants underwent a 3 T-MRI and prospective comprehensive cognitive clinical and laboratory assessments at enrollment, 6, 12, and 24-months.ResultsData were available for 531 participants (67.4 years, 59.5% males). The incidence of PSCI at two-years doubled in the high ICCS group (26% vs. 13.7%, p < 0.001). The high ICCS group had significantly greater small-vessel-disease (SVD) tissue changes and reduced microstructural-integrity assessed by Diffusion-Tensor-Imaging (DTI) maps (p < 0.05 for all). In multivariate analysis, a higher ICCS was independently associated with brain atrophy manifested by lower normalized white and gray matter, hippocampal and thalamic volumes (β = −0.178, β = −0.2, β = −0.137, β = −0.157; p < 0.05) and independently predicted PSCI (OR 1.83, 95%CI 1.01–3.35).ConclusionOur findings suggest that the ICCS, which is a simple and readily available imaging marker on NCCT, is associated with brain atrophy, microstructural damage, the extent of SVD, and may predict PSCI. This finding has implications for identifying individuals at risk for PSCI and implementing targeted interventions to mitigate this risk.https://www.frontiersin.org/articles/10.3389/fneur.2023.1218077/fullischemic strokecerebral small vessel diseasepost stroke dementiavascular calcificationsintracranial calcium score |
| spellingShingle | Estelle Emanuelle Seyman Estelle Emanuelle Seyman Udi Sadeh-Gonik Phillip Berman Itay Blum Genady Shendler Bornstein Nathan Bornstein Nathan Ofer Rothschild Jeremy Molad Einor Ben Assayag Einor Ben Assayag Einor Ben Assayag Hen Hallevi Hen Hallevi Hen Hallevi the TABASCO prospective cohort study group Association between intracranial vessel calcifications, structural brain damage, and cognitive impairment after minor strokes: a prospective study Frontiers in Neurology ischemic stroke cerebral small vessel disease post stroke dementia vascular calcifications intracranial calcium score |
| title | Association between intracranial vessel calcifications, structural brain damage, and cognitive impairment after minor strokes: a prospective study |
| title_full | Association between intracranial vessel calcifications, structural brain damage, and cognitive impairment after minor strokes: a prospective study |
| title_fullStr | Association between intracranial vessel calcifications, structural brain damage, and cognitive impairment after minor strokes: a prospective study |
| title_full_unstemmed | Association between intracranial vessel calcifications, structural brain damage, and cognitive impairment after minor strokes: a prospective study |
| title_short | Association between intracranial vessel calcifications, structural brain damage, and cognitive impairment after minor strokes: a prospective study |
| title_sort | association between intracranial vessel calcifications structural brain damage and cognitive impairment after minor strokes a prospective study |
| topic | ischemic stroke cerebral small vessel disease post stroke dementia vascular calcifications intracranial calcium score |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1218077/full |
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