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Infarct location and cognitive change in patients after acute ischemic stroke: The ICONS study

  • Chen Zhang
    Affiliations
    National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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  • Author Footnotes
    1 These authors contributed equally to this work.
    Yue Wang
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
    Search for articles by this author
  • Author Footnotes
    1 These authors contributed equally to this work.
    Shiping Li
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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  • Yuesong Pan
    Affiliations
    National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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  • Mengxing Wang
    Affiliations
    National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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  • Xiaoling Liao
    Affiliations
    National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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  • Jiong Shi
    Correspondence
    Corresponding authors at: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119, South Fourth Ring West Road, Fengtai District, Beijing 100070, China.
    Affiliations
    National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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  • Yongjun Wang
    Correspondence
    Corresponding authors at: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119, South Fourth Ring West Road, Fengtai District, Beijing 100070, China.
    Affiliations
    National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
    Search for articles by this author
  • Author Footnotes
    1 These authors contributed equally to this work.

      Highlights

      • Thalamic infarction is associated with cognitive deterioration in patients with minor ischemic stroke at 12 months.
      • Stroke etiology is not correlated with worse cognitive performance in patients with minor ischemic stroke at 12 months.
      • Thalamus may be a critical structure in preserving cognition after stroke.

      Abstract

      Background and purpose

      Post stroke cognitive impairment is closely related to the quality of life. We aimed to evaluate the association between infarct location and cognitive change over time after acute ischemic stroke (AIS).

      Methods

      Patients were selected from the Impairment of Cognition and Sleep after AIS or transient ischemic attack in Chinese patients (ICONS) study. Infarct location was assessed by brain magnetic resonance imaging. Cognition was screened at two weeks and 12 months by the Montreal Cognitive Assessment (MoCA). The primary outcome was the cognitive change at 12 months compared to two weeks. We tested the associations with cognitive change using logistic regression analysis.

      Results

      A total of 865 patients were enrolled. The mean age of the study participants was 59.67 ± 10.92 years, and the median National Institutes of Health Stroke Scale was 3 (1–5). In a fully adjusted model, thalamic infarction was significantly associated with cognitive decline after 12 months following an AIS (odds ratio [OR] 4.873, 95% confidence interval [CI] 1.634–14.534; p = 0.005), independent of stroke etiology (p > 0.05).

      Conclusions

      Thalamic infarction increased the risk of worse cognitive performance, as screened by MoCA in relatively young patients with minor ischemic stroke at 12 months, suggesting the thalamus may be a critical structure in preserving cognition after stroke.

      Keywords

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