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The Neuropsychological profile of vascular cognitive impairement in stroke and TIA patients

Sachdev, Perminder Singh; Brodaty, Henry; Valenzuela, Michael; Lorentz, Lisa; Looi, Jeffrey; Wendler, E; Zagami, Alessandro

Description

Objective: To characterize the neuropsychological profile of vascular cognitive impairment (VCI) and vascular dementia (VaD). Methods: The authors examined 170 patients with stroke or TIA at 3 to 6 months after the vascular event, and 96 age-matched healthy controls, with detailed neuropsychological and medical-psychiatric assessments, with a majority (66.7%) undergoing MRI brain scans. The subjects were diagnosed as having VaD, VCI, or no cognitive impairment by consensus. The...[Show more]

dc.contributor.authorSachdev, Perminder Singh
dc.contributor.authorBrodaty, Henry
dc.contributor.authorValenzuela, Michael
dc.contributor.authorLorentz, Lisa
dc.contributor.authorLooi, Jeffrey
dc.contributor.authorWendler, E
dc.contributor.authorZagami, Alessandro
dc.date.accessioned2015-12-13T22:56:47Z
dc.identifier.issn0028-3878
dc.identifier.urihttp://hdl.handle.net/1885/82946
dc.description.abstractObjective: To characterize the neuropsychological profile of vascular cognitive impairment (VCI) and vascular dementia (VaD). Methods: The authors examined 170 patients with stroke or TIA at 3 to 6 months after the vascular event, and 96 age-matched healthy controls, with detailed neuropsychological and medical-psychiatric assessments, with a majority (66.7%) undergoing MRI brain scans. The subjects were diagnosed as having VaD, VCI, or no cognitive impairment by consensus. The neuropsychological tests were classified into cognitive domains, and composite z-scores adjusted for age and education. Results: VaD subjects had disturbance in all cognitive domains, with verbal memory, especially retention, being less affected. VCI subjects had similar but less severe disturbance. The domains that best discriminated cognitively impaired from unimpaired patients were abstraction, mental flexibility, information processing speed, and working memory. Cognitive impairment had a significant correlation with deep white matter hyperintensities, but not with volume and number of infarctions, even though the VaD subjects had larger infarct volumes than VCI subjects. The MRI variables did not provide additional discrimination between subgroups. Conclusions: The cognitive deficits in VaD and VCI are characterized by disturbance of frontal functions, with less verbal memory impairment. VaD and VCI differ in severity but not pattern of disturbance. The brain lesions that best account for these deficits are noninfarct subcortical white matter and gray matter changes due to ischemia. The picture of VaD/VCI presented shows subcortical deficits embellished by cognitive deficits from cortical infarctions.
dc.publisherLippincott Williams & Wilkins
dc.sourceNeurology
dc.subjectKeywords: adult; aged; article; Australia; brain infarction size; cognitive defect; controlled study; disease severity; female; frontal lobe; gray matter; human; major clinical study; male; memory consolidation; multiinfarct dementia; neuropsychological test; neuro
dc.titleThe Neuropsychological profile of vascular cognitive impairement in stroke and TIA patients
dc.typeJournal article
local.description.notesImported from ARIES
local.description.refereedYes
local.identifier.citationvolume62
dc.date.issued2004
local.identifier.absfor170199 - Psychology not elsewhere classified
local.identifier.ariespublicationMigratedxPub11137
local.type.statusPublished Version
local.contributor.affiliationSachdev, Perminder Singh, University of New South Wales
local.contributor.affiliationBrodaty, Henry, Prince of Wales Hospital
local.contributor.affiliationValenzuela, Michael, University of New South Wales
local.contributor.affiliationLorentz, Lisa, University of New South Wales
local.contributor.affiliationLooi, Jeffrey, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationWendler, E, Friedrich Schiller University of Jena
local.contributor.affiliationZagami, Alessandro, Prince of Wales Hospital
local.description.embargo2037-12-31
local.bibliographicCitation.issue6
local.bibliographicCitation.startpage912
local.bibliographicCitation.lastpage919
dc.date.updated2015-12-11T11:17:12Z
local.identifier.scopusID2-s2.0-1842562386
CollectionsANU Research Publications

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