title: Prediction of cognitive decline after stroke using proton magnetic resonance spectroscopy.
abstract: Structural MRI measures have been used to predict cognitive decline in elderly subjects, but few studies have used proton magnetic resonance spectroscopy ((1)H-MRS) for this purpose, particularly after stroke. We studied the potential of (1)H-MRS to predict cognitive decline in patients with stroke or TIA and healthy ageing controls over 12 months and 3 years. Structural MRI and single-voxel (1)H-MRS in the frontal white matter and the occipito-parietal gray matter were performed at the index assessment (3-6 months post-stroke) in 49 stroke/TIA patients and 60 controls. Neuropsychological testing was performed at the index assessment and repeated at 12 months in 30 stroke/TIA patients and 49 controls, and at 3 years in 25 patients and 48 controls. In stroke/TIA patients, frontal NAA/Cr predicted cognitive decline over 12 months and 3 years, and in elderly control subjects frontal NAA predicted cognitive decline over 12 months only. In stroke/TIA patients, the (1)H-MRS measures were better predictors of cognitive decline than structural measures. (1)H-MRS may be useful in assessing early cognitive impairment after stroke/TIA and in normal ageing.
authors.affiliation: Neuropsychiatric Institute, Euroa Centre, Prince of Wales Hospital, Barker Street, Randwick, NSW, Australia.
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Ross
authors.forename: Perminder S
authors.initials: PS
authors.lastname: Sachdev
authors.forename: Wei
authors.initials: W
authors.lastname: Wen
authors.forename: Henry
authors.initials: H
authors.lastname: Brodaty
authors.forename: Amy
authors.initials: A
authors.lastname: Joscelyne
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Lorentz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001224:Aspartic Acid / Q000378:metabolism; D001923:Brain Chemistry; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D003401:Creatine / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D005625:Frontal Lobe / Q000378:metabolism; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011522:Protons; D012016:Reference Values; D020521:Stroke / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology*; D013997:Time Factors
chemical_list: D011522:Protons; D001224:Aspartic Acid; D003401:Creatine