Hyperintensities and fronto-subcortical atrophy on MRI are substrates of mild cognitive deficits after stroke

Aim: The current study determines the MRI correlations of the early neuropsychological post-stroke cognitive deficits. Method. Detailed neuropsychological assessments (attention and working memory) were undertaken in 50 stroke survivors >75 years of age [38 with ageing-associated cognitive decline (AACD)] and 15 age-matched controls. A 1.5-tesla General Electric MRI scanner was used. Standardized visual ratings were undertaken of white matter hyperintensities (WMH). Grey matter volumes were assessed using voxel-based morphometery. Results: Associations were identified between processing speed and executive function and the severity of WMH in key areas. In addition, atrophy in the fronto-subcortical circuits was associated with AACD. Conclusion: Attentional and executive impairments are underpinned by WMH in fronto-striato-thalamo-frontal circuits. Frontal atrophy is identified as a novel substrate of cognitive decline in stroke patients. Copyright (C) 2003 S. Karger AG, Basel.