RT Journal Article
SR Electronic
T1 Memory after silent stroke
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 38
OP 46
DO 10.1212/WNL.0b013e31823ed0cc
VO 78
IS 1
A1 S. Blum
A1 J.A. Luchsinger
A1 J.J. Manly
A1 N. Schupf
A1 Y. Stern
A1 T.R. Brown
A1 C. DeCarli
A1 S.A. Small
A1 R. Mayeux
A1 A.M. Brickman
YR 2012
UL http://n.neurology.org/content/78/1/38.abstract
AB Objective: Memory decline commonly occurs among elderly individuals. This observation is often attributed to early neurodegenerative changes in the hippocampus and related brain regions. However, the contribution of vascular lesions, such as brain infarcts, to hippocampal integrity and age-associated memory decline remains unclear. Methods: We studied 658 elderly participants without dementia from a prospective, community-based study on aging and dementia who received high-resolution structural MRI. Cortical and subcortical infarcts were identified, and hippocampal and relative brain volumes were calculated following standard protocols. Summary scores reflecting performance on tasks of memory, language, processing speed, and visuospatial function were derived from a comprehensive neuropsychological battery. We used multiple regression analyses to relate cortical and subcortical infarcts, hippocampal and relative brain volume, to measures of cognitive performance in domains of memory, language, processing speed, and visuospatial ability. Results: Presence of brain infarcts was associated with a smaller hippocampus. Smaller hippocampus volume was associated with poorer memory specifically. Brain infarcts were associated with poorer memory and cognitive performance in all other domains, which was independent of hippocampus volume. Conclusions: Both hippocampal volume and brain infarcts independently contribute to memory performance in elderly individuals without dementia. Given that age-associated neurodegenerative conditions, such as Alzheimer disease, are defined primarily by impairment in memory, these findings have clinical implications for prevention and for identification of pathogenic factors associated with disease symptomatology. AD=Alzheimer disease; FLAIR=fluid-attenuated inversion recovery; FOV=field of view; MCI=mild cognitive impairment; PCA=posterior cerebral artery; SRT=Selective Reminding Test; TE=echo time; TI=inversion time; TR=repetition time