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Neurologic correlates of infarction-like lesion location on magnetic resonance imaging in the cardiovascular health study
Wednesday,2012-11-07 13:39 America/Los_Angeles — eenright
| Title | Neurologic correlates of infarction-like lesion location on magnetic resonance imaging in the cardiovascular health study |
| Publication Type | Journal Article |
| Year of Publication | 2000 |
| Authors | McClelland, RL, Kronmal, RA, Bryan, RN, Manolio, TA, Herskovits, EH, Kuller, LH, O'Leary, DH |
| Journal | J. Stroke Cerebrovascular Disease |
| Volume | 9 |
| Issue | 5 |
| Start Page | 218 |
| Pagination | 228 |
| Date Published | 2000-01-01 |
| Keywords | basal, Brain, Cerebral Cortex, ganglia, Health, history, Infarction, Magnetic Resonance Imaging, methods, Odds Ratio, Population, Prevalence, Stroke |
| Abstract | Objective: To evaluate and quantify the associations of infarction-like lesion location in the brain with cognitive and physical impairment in an elderly population. Methods: Data from magnetic resonance imaging (MRI) scans for 3647 Cardiovascular Health Study participants were analyzed. Associations between infarction-like lesion location and various neurologic and performance-based measurements were assessed by using regression models. Continuous responses were expressed in percentiles. Models excluding participants with a history of stroke were also examined. Results: Brainstem infarction-like lesions were associated with a severely reduced Mini-Mental State Examination score (difference [d] = 15 percentiles, P < .001), reduced digit-symbol score (d = 12 percentiles, P < .01), increased time to walk 15 feet (d = 15 percentiles, P < .001), and increased odds of a history of dizziness (odds ratio [OR] = 2.5, P <.01). Basal ganglia infarctions were associated with an increased prevalence of visual field deficits (OR = 1.8, P <.001), and cerebellar white matter infarction-like lesions with an increased prevalence of a history of coma (OR = 4.0, P < .01). For those with infarction-like lesions in both the cerebral cortex and brainstem, the degree of sleepiness was substantially elevated (d = 34 percentiles, P < .01). No associations with a history of migraines were detected. After exclusion of those with stroke history, all of these associations persisted. Conclusion: The estimated magnitude and statistical significance of these associations relative to those with no infarction-like lesions provides new information. Further investigation for some of the associations, such as the role of the brainstem in cognitive function and the association of basal ganglia infarction-like lesions with visual field deficits, would be worthwhile. |