- Title
- Transient ischemic attack results in delayed brain atrophy and cognitive decline
- Creator
- Bivard, Andrew; Lillicrap, Thomas; Maréchal, Bénédicte; Garcia-Esperon, Carlos; Holliday, Elizabeth; Krishnamurthy, Venkatesh; Levi, Christopher R.; Parsons, Mark
- Relation
- NHMRC.1078300 http://purl.org/au-research/grants/nhmrc/1078300
- Relation
- Stroke Vol. 49, Issue 2, p. 384-390
- Publisher Link
- http://dx.doi.org/10.1161/strokeaha.117.019276
- Publisher
- Lippincott Williams & Wilkins
- Resource Type
- journal article
- Date
- 2018
- Description
- Background and Purpose: Transient ischemic attack (TIA) initiates an ischemic cascade without resulting in frank infarction and, as such, represents a novel model to study the effects of this ischemic cascade and secondary neurodegeneration in humans. Methods: Patients with suspected TIA underwent acute brain perfusion imaging, and those with acute ischemia were enrolled into a prospective observational study. We collected baseline and 90-day magnetic resonance imaging, including MP-RAGE (high-resolution T1 sequence) and cognitive assessment with the Montreal Cognitive Assessment. Brain morphometry and within patient statistical analysis were performed to identify changes between baseline and 90-day imaging and clinical assessments. Results: Fifty patients with TIA with acute perfusion lesions were studied. All patients experienced a decrease in global cortical gray matter (P=0.005). Patients with anterior circulation TIA (n=31) also had a significant reduction in the volume of the pons (P<0.001), ipsilesional parietal lobe (P<0.001), occipital lobe (P=0.002), frontal lobe (P<0.001), temporal lobe (P=0.003), and thalamus (P=0.016). Patients with an anterior perfusion lesion on acute imaging also had a significant decrease in Montreal Cognitive Assessment between baseline and day 90 (P=0.027), which may be related to the volume of thalamic atrophy (R²=0.28; P=0.009). Conclusions: In a prospective observational study, patients with TIA confirmed by acute perfusion imaging experienced a significant reduction in global gray matter and focal structural atrophy related to the area of acute ischemia. The atrophy also resulted in a proportional decreased cognitive performance on the Montreal Cognitive Assessment. Further studies are required to identify the mechanisms of this atrophy.
- Subject
- atrophy; cognition; gray matter; ischemic attack, transient; perfusion imaging
- Identifier
- http://hdl.handle.net/1959.13/1394576
- Identifier
- uon:33724
- Identifier
- ISSN:0039-2499
- Language
- eng
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