Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/25131
Title: Microstructural degeneration and cerebrovascular risk burden underlying executive dysfunction after stroke.
Austin Authors: Veldsman, Michele;Werden, Emilio ;Egorova, Natalia;Khlif, Mohamed Salah;Brodtmann, Amy 
Affiliation: Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
Austin Health
Eastern Clinical Research Unit, Box Hill Hospital, Melbourne, VIC, Australia
The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
Department of Experimental Psychology, University of Oxford, New Radcliffe House, Radcliffe Observatory Quarter, Oxford, OX2 6GG, UK
Issue Date: 21-Oct-2020
metadata.dc.date: 2020-10-21
Publication information: Scientific Reports 2020; 10(1): 17911
Abstract: Executive dysfunction affects 40% of stroke patients, but is poorly predicted by characteristics of the stroke itself. Stroke typically occurs on a background of cerebrovascular burden, which impacts cognition and brain network structural integrity. We used structural equation modelling to investigate whether measures of white matter microstructural integrity (fractional anisotropy and mean diffusivity) and cerebrovascular risk factors better explain executive dysfunction than markers of stroke severity. 126 stroke patients (mean age 68.4 years) were scanned three months post-stroke and compared to 40 age- and sex-matched control participants on neuropsychological measures of executive function. Executive function was below what would be expected for age and education level in stroke patients as measured by the organizational components of the Rey Complex Figure Test, F(3,155) = 17, R2 = 0.25, p < 0.001 (group significant predictor at p < 0.001) and the Trail-Making Test (B), F(3,157) = 3.70, R2 = 0.07, p < 0.01 (group significant predictor at p < 0.001). A multivariate structural equation model illustrated the complex relationship between executive function, white matter integrity, stroke characteristics and cerebrovascular risk (root mean square error of approximation = 0.02). Pearson's correlations confirmed a stronger relationship between executive dysfunction and white matter integrity (r = - 0.74, p < 0.001), than executive dysfunction and stroke severity (r = 0.22, p < 0.01). The relationship between executive function and white matter integrity is mediated by cerebrovascular burden. White matter microstructural degeneration of the superior longitudinal fasciculus in the executive control network better explains executive dysfunction than markers of stroke severity. Executive dysfunction and incident stroke can be both considered manifestations of cerebrovascular risk factors.
URI: https://ahro.austin.org.au/austinjspui/handle/1/25131
DOI: 10.1038/s41598-020-75074-w
PubMed URL: 33087782
Type: Journal Article
Appears in Collections:Journal articles

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