Memory after silent stroke

Blum, Sonja; Luchsinger, José A.; Manly, Jennifer J.; Schupf, Nicole; Stern, Yaakov; Brown, Truman R.; DeCarli, Charles; Small, Scott A.; Mayeux, Richard; Brickman, Adam M.

doi:10.1212/wnl.0b013e31823ed0cc

Cited by 89 publications

(68 citation statements)

References 43 publications

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“…23 Subclinical brain infarcts have been associated with lower verbal memory performance in patients without dementia, 3,5 but SBI was not associated with total number of words learned in our study. However, power to detect an association may have been limited given that SBI was analyzed as a binary variable.…”

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confidence: 57%

“…1 While some studies have focused on general memory performance, often with composite or summary scores, [2][3][4][5] few studies have examined the effects of these brain markers on the learning process specifically. We examined the learning component of memory, and its relationship to vascular disease and brain volume measured on imaging studies.…”

mentioning

confidence: 99%

“…Similar to the frontal lobe impairment seen with white matter lesions, 21 subcortical infarctions may disconnect the frontal lobes from other cortical and subcortical regions, resulting in impaired executive function and semantic clustering, 3,22 a strategy often used by participants to remember groups of words. 23 Subclinical brain infarcts have been associated with lower verbal memory performance in patients without dementia, 3,5 but SBI was not associated with total number of words learned in our study.…”

mentioning

confidence: 99%

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Subclinical cerebrovascular disease inversely associates with learning ability

Glazer¹,

Dong²,

Yoshita

et al. 2015

Neurology

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Objective: Memory has been examined in subjects with imaging markers of cerebrovascular disease, but learning has been less well studied. We examined the relationship among subclinical cerebrovascular disease, cerebral volumes, and verbal learning in an ethnically and racially diverse community sample.Methods: A clinically stroke-free subset of Northern Manhattan Study participants underwent cognitive testing and brain MRI with quantification of white matter hyperintensity volume (WMHV) and total cerebral volume (TCV) using semiautomated segmentation. We used generalized linear regression and mixed models to examine the association between imaging findings and verbal learning.Results: There were 1,272 participants (61% women, mean age 70 6 9 years). Participants with greater WMHV and smaller TCV remembered fewer total words on a list-learning task (b 5 20.83 per SD change in WMHV, 95% confidence interval [CI] 5 21.22 to 20.45, p , 0.0001; and b 5 0.48 per SD change in TCV, 95% CI 5 0.05 to 0.90, p 5 0.03, respectively). Subclinical brain infarction (SBI) was not associated with total words learned (b 5 20.04, 95% CI 5 21.08 to 1.00, p 5 0.94). Those with greater WMHV had increased odds of a flatter learning slope. After excluding participants with SBI, the association between total words learned and WMHV remained significant. All measurements were adjusted for age, education, race/ethnicity, medical insurance status, and the presence of SBI.Conclusions: White matter hyperintensities, a marker of cerebral small vessel disease, may have an impact on learning slope. This suggests that verbal learning performance can be incorporated into neuropsychological measures for vascular cognitive impairment and that cerebrovascular disease discovered on imaging affects the ability to learn new information. Neurology ® 2015;84:2362-2367 GLOSSARY CI 5 confidence interval; NOMAS 5 Northern Manhattan Study; OR 5 odds ratio; SBI 5 subclinical brain infarction; TCV 5 total cerebral volume; WMHV 5 white matter hyperintensity volume.White matter hyperintensities and "involutional changes" due to aging, vascular, or neurodegenerative causes are frequently found on the MRI scans of asymptomatic individuals. The contribution of such damage to changes in cognitive function is not completely understood.Memory is made up of multiple processes, including registration, consolidation, storage, and retrieval, each of which may be differentially affected by various brain abnormalities, including executive dysfunction despite an intact temporal lobe.1 While some studies have focused on general memory performance, often with composite or summary scores, 2-5 few studies have examined the effects of these brain markers on the learning process specifically. We examined the learning component of memory, and its relationship to vascular disease and brain volume measured on imaging studies.

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mentioning

confidence: 99%

mentioning

confidence: 99%

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Subclinical cerebrovascular disease inversely associates with learning ability

Glazer¹,

Dong²,

Yoshita

et al. 2015

Neurology

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“…However, the use of animal models, such as the photothrombosis model, allows for improved understanding of stroke pathophysiology and the exploration of new therapeutic approaches to provide neuroprotection following a stroke. Small cortical strokes and microinfarctions produced by the photothrombotic model are clinically relevant to subclinical or "silent" stroke [13][14][15] , which has a high prevalence and affects approximately 4 percent of the United States population (about 11 million people ) each year 16 . Silent stroke does not have the classic stroke symptoms present in a larger stroke, such as paralysis, sensory loss and difficulty speaking such as seen in the middle cerebral artery (MCA) occlusion or transient ischemic attack (TIA) 17 .…”

Section: Discussionmentioning

confidence: 99%

Rose Bengal Photothrombosis by Confocal Optical Imaging <em>In Vivo</em>: A Model of Single Vessel Stroke

Watts

Zheng

Garling

et al. 2015

JoVE

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In vivo imaging techniques have increased in utilization due to recent advances in imaging dyes and optical technologies, allowing for the ability to image cellular events in an intact animal. Additionally, the ability to induce physiological disease states such as stroke in vivo increases its utility. The technique described herein allows for physiological assessment of cellular responses within the CNS following a stroke and can be adapted for other pathological conditions being studied. The technique presented uses laser excitation of the photosensitive dye Rose Bengal in vivo to induce a focal ischemic event in a single blood vessel.The video protocol demonstrates the preparation of a thin-skulled cranial window over the somatosensory cortex in a mouse for the induction of a Rose Bengal photothrombotic event keeping injury to the underlying dura matter and brain at a minimum. Surgical preparation is initially performed under a dissecting microscope with a custom-made surgical/imaging platform, which is then transferred to a confocal microscope equipped with an inverted objective adaptor. Representative images acquired utilizing this protocol are presented as well as time-lapse sequences of stroke induction. This technique is powerful in that the same area can be imaged repeatedly on subsequent days facilitating longitudinal in vivo studies of pathological processes following stroke. Video LinkThe video component of this article can be found at

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“…1 Because SBI is frequently accompanied by white matter hyperintensities 2,3 and associated with an increased risk of cognitive decline [4][5][6] and clinical stroke, 7 timely identification and optimal implementation of strategies to mitigate future stroke and vascular cognitive impairment could be of great use to physicians.…”

Section: S Ilent Brain Infarction (Sbi)mentioning

confidence: 99%