Abstract Details

Title Cerebrovascular Ischemic Location and Domain-Specific Cognitive Dysfunction after Mild Stroke or Transient Ischemic Attack

Topic Behavioral Neurology

Presentation(s) P07 - (-)

Poster/Presentation
Number 165

Objective

Background BACKGROUND: Cognitive disorders are a common consequence of cerebrovascular disease. Left hemisphere and cortical strokes correlate with acute cognitive impairment following a cerebrovascular event, but subcortical strokes may be the prominent pathology in a pure "vascular dementia." We investigated the relationship between ischemic location and DSCD following mild stroke or TIA.

Design/Methods DESIGN/METHODS: Patients with mild stroke (NIHSS ?5) or TIA underwent a comprehensive cognitive battery within 24 hours of symptom onset. Domains assessed included verbal learning and memory, visuospatial learning and memory, immediate recall, working memory, and processing speed. Scores were corrected for age and level of education. The one way ANOVA or Kruskal Wallis rank test was used to determine the significance of differences in Z scores between lesion locations (stratified as cortical, subcortical, infratentorial, or multiple). The t-test or Wilcoxon Rank Sum test was used to evaluate for differences in Z scores between right and left sided ischemic insults.

Results RESULTS: Twenty-four patients were enrolled (20 stroke, 4 TIA). Mean age and level of education were 65 and 14 years, respectively. Neither ischemic location nor laterality demonstrated a statistically significant correlation with DSCD. Patients with right-sided ischemic insults showed a trend towards having more difficulty with visuospatial learning and memory tasks (Rey-Osterreith Complex Figure [ROCF] Test Copy mean Z scores: right -2.09, left -0.77, p = 0.19; ROCF Immediate Recall mean Z scores: right -0.95, left -0.51, p = 0.19).

Conclusions CONCLUSIONS: Ischemic location did not correlate with DSCD in this small series of patients. Acute focal ischemia may produce more widespread, rather than domain-specific, cognitive dysfunction. Future studies may investigate relationships between cerebrovascular ischemia and specific neurocognitive syndromes that do not respect anatomical boundaries.

Authors/Disclosures
Rahul Karamchandani, MD PRESENTER	No disclosure on file
John Corboy, MD, FAAN (U of Colorado School of Medicine)	Dr. Corboy has received personal compensation for serving as an employee of U of Coloado. Dr. Corboy has received personal compensation for serving as an employee of Rocky Mountain MS Center. Dr. Corboy has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Mylan. Dr. Corboy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squib. Dr. Corboy has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AAN. Dr. Corboy has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Neurological Association. Dr. Corboy has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Mylan. The institution of Dr. Corboy has received research support from MedDay. The institution of Dr. Corboy has received research support from Novartis. The institution of Dr. Corboy has received research support from NMSS. The institution of Dr. Corboy has received research support from PCORI. The institution of Dr. Corboy has received research support from EMD Serono.
	No disclosure on file
Andrew Bursaw, DO	No disclosure on file
Farhaan S. Vahidy, MBBS, PhD (Houston Methodist)	Dr. Vahidy has nothing to disclose.
Sean I. Savitz, MD	Dr. Savitz has nothing to disclose.

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