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dc.contributor.authorSaczynski, Jane S
dc.contributor.authorSigurdsson, Sigurdur
dc.contributor.authorJonsdottir, Maria K
dc.contributor.authorEiriksdottir, Gudny
dc.contributor.authorJonsson, Palmi V
dc.contributor.authorGarcia, Melissa E
dc.contributor.authorKjartansson, Olafur
dc.contributor.authorLopez, Oscar
dc.contributor.authorvan Buchem, Mark A
dc.contributor.authorGudnason, Vilmunder
dc.contributor.authorLauner, Lenore J
dc.date.accessioned2010-10-11T15:16:05Z
dc.date.available2010-10-11T15:16:05Z
dc.date.issued2009-03-01
dc.date.submitted2010-10-11
dc.identifier.citationStroke 2009, 40(3):677-82en
dc.identifier.pmid19131654
dc.identifier.doi10.1161/STROKEAHA.108.530212
dc.identifier.urihttp://hdl.handle.net/2336/112772
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractBACKGROUND AND PURPOSE: Cerebral infarcts increase the risk for cognitive impairment. The relevance of location and number of infarcts with respect to cognitive function is less clear. METHODS: We studied the cross-sectional association between number and location of infarcts and cognitive performance in 4030 nondemented participants of the Age Gene/Environment Susceptibility-Reykjavik Study. Composite scores for memory, processing speed, and executive function were created from a neuropsychological battery. Subcortical, cortical, and cerebellar infarcts were identified on brain MRI. We performed linear regression analyses adjusted for demographic and vascular risk factors, depression, white matter lesions, and atrophy. RESULTS: Compared to participants with no infarcts, those with infarcts in multiple locations (n=287, 7%) had slower processing speed (beta=-0.19; P<0.001) and poorer memory (beta=-0.16; P<0.001) and executive function (beta=-0.12; P=0.003). Compared to no infarcts, the presence of either subcortical infarcts only (n=275; beta=-0.12; P=0.016) or cortical infarcts only (n=215; beta=-0.17; P=0.001) was associated with poorer memory performance. Compared to no infarcts, a combination of cortical and subcortical infarcts (n=45) was associated with slower processing speed (beta=-0.38; P<0.001) and poorer executive function (beta=-0.22; P=0.02), whereas a combination of cerebellar and subcortical infarcts (n=89) was associated with slower processing speed (beta=-0.15; P=0.04). Infarcts in all 3 locations was associated with slower processing speed (beta=-0.33; P=0.002). CONCLUSIONS: Having infarcts in >1 location is associated with poor performance in memory, processing speed, and executive function, independent of cardiovascular comorbidities, white matter lesions, and brain atrophy, suggesting that both the number and the distribution of infarcts jointly contribute to cognitive impairment.
dc.language.isoenen
dc.publisherLippincott Williams & Wilkinsen
dc.relation.urlhttp://dx.doi.org/10.1161/STROKEAHA.108.530212en
dc.subject.meshAgeden
dc.subject.meshCardiovascular Diseasesen
dc.subject.meshCerebral Infarctionen
dc.subject.meshCognition Disordersen
dc.subject.meshDementiaen
dc.subject.meshFemaleen
dc.subject.meshHumansen
dc.subject.meshIcelanden
dc.subject.meshMagnetic Resonance Imagingen
dc.subject.meshMaleen
dc.subject.meshNeuropsychological Testsen
dc.subject.meshRisk Factorsen
dc.titleCerebral infarcts and cognitive performance: importance of location and number of infarctsen
dc.typeArticleen
dc.identifier.eissn1524-4628
dc.contributor.departmentDivision of Geriatric Medicine, Meyers Primary Care Institute, University of Massachusetts Medical School, Worcester, MA 01605, USA. jane.saczynski@umassmed.eduen
dc.identifier.journalStroke; a journal of cerebral circulationen
html.description.abstractBACKGROUND AND PURPOSE: Cerebral infarcts increase the risk for cognitive impairment. The relevance of location and number of infarcts with respect to cognitive function is less clear. METHODS: We studied the cross-sectional association between number and location of infarcts and cognitive performance in 4030 nondemented participants of the Age Gene/Environment Susceptibility-Reykjavik Study. Composite scores for memory, processing speed, and executive function were created from a neuropsychological battery. Subcortical, cortical, and cerebellar infarcts were identified on brain MRI. We performed linear regression analyses adjusted for demographic and vascular risk factors, depression, white matter lesions, and atrophy. RESULTS: Compared to participants with no infarcts, those with infarcts in multiple locations (n=287, 7%) had slower processing speed (beta=-0.19; P<0.001) and poorer memory (beta=-0.16; P<0.001) and executive function (beta=-0.12; P=0.003). Compared to no infarcts, the presence of either subcortical infarcts only (n=275; beta=-0.12; P=0.016) or cortical infarcts only (n=215; beta=-0.17; P=0.001) was associated with poorer memory performance. Compared to no infarcts, a combination of cortical and subcortical infarcts (n=45) was associated with slower processing speed (beta=-0.38; P<0.001) and poorer executive function (beta=-0.22; P=0.02), whereas a combination of cerebellar and subcortical infarcts (n=89) was associated with slower processing speed (beta=-0.15; P=0.04). Infarcts in all 3 locations was associated with slower processing speed (beta=-0.33; P=0.002). CONCLUSIONS: Having infarcts in >1 location is associated with poor performance in memory, processing speed, and executive function, independent of cardiovascular comorbidities, white matter lesions, and brain atrophy, suggesting that both the number and the distribution of infarcts jointly contribute to cognitive impairment.


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