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Title: Dynamic Regional Brain Atrophy Rates in the First Year After Ischemic Stroke.
Austin Authors: Brodtmann, Amy ;Khlif, Mohamed Salah;Egorova, Natalia;Veldsman, Michele;Bird, Laura J;Werden, Emilio 
Affiliation: The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Australia
Melbourne Dementia Research Centre, Florey Institute, University of Melbourne, Australia
Melbourne School of Psychological Sciences, University of Melbourne, Australia
Eastern Cognitive Disorders Clinic, Eastern Health, Monash University, Australia
Issue Date: Sep-2020 2020
Publication information: Stroke 2020; 51(9): e183-e192
Abstract: Brain atrophy can be regarded as an end-organ effect of cumulative cardiovascular risk factors. Accelerated brain atrophy is described following ischemic stroke, but it is not known whether atrophy rates vary over the poststroke period. Examining rates of brain atrophy allows the identification of potential therapeutic windows for interventions to prevent poststroke brain atrophy. We charted total and regional brain volume and cortical thickness trajectories, comparing atrophy rates over 2 time periods in the first year after ischemic stroke: within 3 months (early period) and between 3 and 12 months (later period). Patients with first-ever or recurrent ischemic stroke were recruited from 3 Melbourne hospitals at 1 of 2 poststroke time points: within 6 weeks (baseline) or 3 months. Whole-brain 3T magnetic resonance imaging was performed at 3 time points: baseline, 3 months, and 12 months. Eighty-six stroke participants completed testing at baseline; 125 at 3 months (76 baseline follow-up plus 49 delayed recruitment); and 113 participants at 12 months. Their data were compared with 40 healthy control participants with identical testing. We examined 5 brain measures: hippocampal volume, thalamic volume, total brain and hemispheric brain volume, and cortical thickness. We tested whether brain atrophy rates differed between time points and groups. A linear mixed-effect model was used to compare brain structural changes, including age, sex, years of education, a composite cerebrovascular risk factor score, and total intracranial volume as covariates. Atrophy rates were greater in stroke than control participants. Ipsilesional hemispheric, hippocampal, and thalamic atrophy rates were 2 to 4 times greater in the early versus later period. Regional atrophy rates vary over the first year after stroke. Rapid brain volume loss in the first 3 months after stroke may represent a potential window for intervention. Registration: URL: Unique identifier: NCT02205424.
DOI: 10.1161/STROKEAHA.120.030256
PubMed URL: 32772680
Type: Journal Article
Subjects: atrophy
magnetic resonance imaging
risk factors
Appears in Collections:Journal articles

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