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Hippocampal size and dementia in stroke patients: the Sydney stroke study.

Abstract

BACKGROUND

Hippocampal atrophy is an early feature of Alzheimer's disease (AD) but it has also been reported in vascular dementia (VaD). It is uncertain whether hippocampal size can help differentiate the two disorders.

METHODS

We assessed 90 stroke/TIA patients 3-6 months after the event, and 75 control subjects, with neuropsychological tests, medical and psychiatric examination and brain MRI scans. A diagnosis of VaD, vascular mild cognitive impairment (VaMCI) or no cognitive impairment (NCI) was reached by consensus on agreed criteria. T1-weighted MRI was used to obtain total intracranial volume (TICV), gray and white matter volume, CSF volume, hippocampus and amygdala volumes, and T2-weighted scans for white matter hyperintensity (WMH) ratings.

RESULTS

Stroke/TIA patients had more white matter hyperintensities (WMHs), larger ventricle-to-brain ratios and smaller amygdalae than controls, but hippocampus size and gray and white matter volumes were not different. WMHs and amygdala but not hippocampal volume distinguished stroke/TIA patients with VaD and VaMCI and without NCI and amygdala volumes. Right hippocampus volume significantly correlated with new visual learning.

CONCLUSIONS

Stroke/TIA patients and patients with post-stroke VaMCI or mild VaD do not have hippocampal atrophy. The amygdala is smaller in stroke/TIA patients, especially in those with cognitive impairment, and this may be accounted for by white matter lesions. The hippocampus volume relates to episodic memory, especially right hippocampus and new visual learning. A longitudinal study of these subjects will determine whether hippocampal atrophy is a late development in VaD.

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  • Authors+Show Affiliations

    ,

    School of Psychiatry, University of New South Wales, Sydney, Australia; Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney, Australia. p.sachdev@unsw.edu.au

    , , , ,

    Source

    Journal of the neurological sciences 260:1-2 2007 Sep 15 pg 71-7

    MeSH

    Aged
    Alzheimer Disease
    Amygdala
    Atrophy
    Dementia, Vascular
    Diagnosis, Differential
    Diffusion Magnetic Resonance Imaging
    Female
    Hippocampus
    Humans
    Lateral Ventricles
    Magnetic Resonance Imaging
    Male
    Memory Disorders
    Nerve Fibers, Myelinated
    Neuropsychological Tests
    New South Wales
    Predictive Value of Tests
    Stroke

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    17482210

    Citation

    Sachdev, P S., et al. "Hippocampal Size and Dementia in Stroke Patients: the Sydney Stroke Study." Journal of the Neurological Sciences, vol. 260, no. 1-2, 2007, pp. 71-7.
    Sachdev PS, Chen X, Joscelyne A, et al. Hippocampal size and dementia in stroke patients: the Sydney stroke study. J Neurol Sci. 2007;260(1-2):71-7.
    Sachdev, P. S., Chen, X., Joscelyne, A., Wen, W., Altendorf, A., & Brodaty, H. (2007). Hippocampal size and dementia in stroke patients: the Sydney stroke study. Journal of the Neurological Sciences, 260(1-2), pp. 71-7.
    Sachdev PS, et al. Hippocampal Size and Dementia in Stroke Patients: the Sydney Stroke Study. J Neurol Sci. 2007 Sep 15;260(1-2):71-7. PubMed PMID: 17482210.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Hippocampal size and dementia in stroke patients: the Sydney stroke study. AU - Sachdev,P S, AU - Chen,X, AU - Joscelyne,A, AU - Wen,W, AU - Altendorf,A, AU - Brodaty,H, Y1 - 2007/05/04/ PY - 2007/01/24/received PY - 2007/04/03/accepted PY - 2007/5/8/pubmed PY - 2007/12/7/medline PY - 2007/5/8/entrez SP - 71 EP - 7 JF - Journal of the neurological sciences JO - J. Neurol. Sci. VL - 260 IS - 1-2 N2 - BACKGROUND: Hippocampal atrophy is an early feature of Alzheimer's disease (AD) but it has also been reported in vascular dementia (VaD). It is uncertain whether hippocampal size can help differentiate the two disorders. METHODS: We assessed 90 stroke/TIA patients 3-6 months after the event, and 75 control subjects, with neuropsychological tests, medical and psychiatric examination and brain MRI scans. A diagnosis of VaD, vascular mild cognitive impairment (VaMCI) or no cognitive impairment (NCI) was reached by consensus on agreed criteria. T1-weighted MRI was used to obtain total intracranial volume (TICV), gray and white matter volume, CSF volume, hippocampus and amygdala volumes, and T2-weighted scans for white matter hyperintensity (WMH) ratings. RESULTS: Stroke/TIA patients had more white matter hyperintensities (WMHs), larger ventricle-to-brain ratios and smaller amygdalae than controls, but hippocampus size and gray and white matter volumes were not different. WMHs and amygdala but not hippocampal volume distinguished stroke/TIA patients with VaD and VaMCI and without NCI and amygdala volumes. Right hippocampus volume significantly correlated with new visual learning. CONCLUSIONS: Stroke/TIA patients and patients with post-stroke VaMCI or mild VaD do not have hippocampal atrophy. The amygdala is smaller in stroke/TIA patients, especially in those with cognitive impairment, and this may be accounted for by white matter lesions. The hippocampus volume relates to episodic memory, especially right hippocampus and new visual learning. A longitudinal study of these subjects will determine whether hippocampal atrophy is a late development in VaD. SN - 0022-510X UR - https://www.unboundmedicine.com/medline/citation/17482210/Hippocampal_size_and_dementia_in_stroke_patients:_the_Sydney_stroke_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-510X(07)00275-4 DB - PRIME DP - Unbound Medicine ER -