Hippocampal atrophy and cognitive function in transient ischemic attack and minor stroke patients over three years

Philip Barber; Sean M Nestor; Meng Wang; Pauline Wu; Jake Ursenbach; Amlish Munir; Rani Gupta; Sah Sana Tariq; Eric Smith; Richard Frayne; Sandra E Black; Tolupe Sajobi; Shelagh Coutts; Alzheimer s Disease Neuroimaging Initiative

doi:10.1016/j.cccb.2021.100019

Hippocampal atrophy and cognitive function in transient ischemic attack and minor stroke patients over three years

Cereb Circ Cogn Behav. 2021 Jun 25:2:100019. doi: 10.1016/j.cccb.2021.100019. eCollection 2021.

Authors

Philip Barber^{1

2

3}, Sean M Nestor^{4

5}, Meng Wang³, Pauline Wu¹, Jake Ursenbach^{1

6

2}, Amlish Munir^{1

6

2}, Rani Gupta^{1

6

2}, Sah Sana Tariq^{1

2}, Eric Smith^{1

2}, Richard Frayne^{6

2

7

8}, Sandra E Black⁴, Tolupe Sajobi^{1

3}, Shelagh Coutts^{1

2}; Alzheimer s Disease Neuroimaging Initiative

Affiliations

¹ Calgary Stroke Program, Department of Clinical Neurosciences, Foothills Medical Centre, 1403 29th Street NW, Calgary AB, Canada.
² Cumming School of Medicine, Hotchkiss Brain Institute, 3330 Hospital Drive NW, Calgary AB, Canada.
³ Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, Canada.
⁴ Hurvitz Brain Sciences Program, Sunnybrook Health Science Centre, University of Toronto, ON, Canada.
⁵ Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
⁶ Seaman Family MR Center, Foothills Medical Centre, 1403 29th Street NW, Calgary AB, Canada.
⁷ Department of Clinical Neurosciences, University of Calgary, 1403 29th Street NW, Calgary, Canada.
⁸ Department of Radiology, University of Calgary, 1403 29th Street NW, Calgary, Canada.

Abstract

Introduction: Transient ischemic attack (TIA) and minor ischemic stroke (IS) is associated with a increased risk of late life dementia. In this study we aim to study the extent to which the rates of hippocampal atrophy in TIA/IS differ from healthy controls, and how they are correlated to neuropsychological measurements.

Methods: TIA or minor stroke patients were tested with a neuropsychological battery including tests of executive function, and verbal and non-verbal memory at three time points out to 3 years. Annualized rates of hippocampal atrophy in TIA/IS patients were compared to controls. A linear-mixed regression model was used to assess the difference in rates of hippocampal atrophy after adjusting for time and demographic characteristics.

Results: TIA/IS patients demonstrated a higher hippocampal atrophy rate than healthy controls over a 3-year interval: the annual percentage change of the left hippocampal volume was 2.5% (78 mm³ per year (SD 60)) for TIA/IS patients compared to 0.9% (29 mm³ per year (SD 32)) for controls (p < 0.01); and the annual percentage change of the right hippocampal volume was 2.5% (80 mm³ per year (SD 46)) for TIA/IS patients compared to 0.5% (17 mm³ per year (SD 33)) for controls (P < 0.01). Patients with higher annual hippocampal atrophy were more likely to report higher TMT B times, but lower ROC total score, lower California Verbal Learning Test-II total recall, and lower ROC Figure recall scores longitudinally.

Conclusion: TIA/IS patients experience a higher rate of hippocampal atrophy independent of TIA/IS recurrence that are associated with changes in episodic memory and executive function over 3 years.

Keywords: Atrophy; Cognition; Hippocampus; MRI; Stroke.

Grants and funding

U01 AG024904/AG/NIA NIH HHS/United States