Einor Ben Assayag (Israel)
Tel- Aviv Sourasky medical center NeurologyAuthor Of 1 Presentation
INTRACRANIAL CALCIFICATION – A MARKER FOR BRAIN ATROPHY AND FUTURE POST STROKE COGNITIVE DECLINE, DATA FROM THE TABASCO PROSPECTIVE COHORT
Abstract
Background and Aims
Vascular calcifications are considered to be part of active atherosclerosis. Coronary calcification have long become a prognostic marker. Calcifications of intracranial vessels(ICC) are frequently observed on non-contrast CT and their effect on post-stroke cognitive impairment(PSCI) remains unclear. Our aim was to explore the association of ICC with long-term cognitive and advanced MRI measures in a large prospective cohort of mild stroke/transient ischemic attack(TIA) patients
Methods
Data from the Tel Aviv brain acute stroke cohort(TABASCO) was analyzed. This prospective cohort study(n=575)aimed to identify predictors of PSCI. The ICC score(ICCS) on initial NCCT was calculated using a calcium quantification application. Participants underwent a 3T-MRI and comprehensive cognitive assessments at enrollment, 6, 12 and 24 months thereafter
Results
Baseline data were available for 531 subjects(mean age 67.4 years,59.5% males). The incidence of cognitive impairment at the two-year time mark was doubled in the high ICCS group(26% vs.13.7%,p<0.001).On multiple regression analysis higher ICCS was associated with brain atrophy manifested by lower normalized white matter(WM), gray matter(GM), hippocampal and thalamic volumes(β=-0.178,β=-0.200,β=-0.137,β=-0.157;p<0.05)and with lower cognitive scores at baseline,6- and 12-month post-stroke (β-0.14,β=-0.12, β=-0.12,respectively;p<0.05). Microstructural damage, defined by DTI analysis of the normal appearing white matter(NAWM), as well as all small vessel disease(SVD) markers were significantly increased in the high ICCS group(p<0.001, p=0.002, respectively).
Conclusions
Our findings suggest that the ICCS correlates with brain atrophy, the extent of SVD and long-term PSCI. This score, which is a readily available imaging marker, can assist in post-stroke prognostication and help provide individually tailored therapy by adjusting treatment targets in stroke survivors.