Frontal lobe atrophy is associated with small vessel disease in ischemic stroke patients.
BACKGROUND
The pathogenesis of frontal lobe atrophy (FLA) in stroke patients is unclear. We aimed to ascertain whether subcortical ischemic changes were more associated with FLA than with parietal lobe atrophy (PLA) and temporal lobe atrophy (TLA).


METHODS
Brain magnetic resonance images (MRIs) from 471 Chinese ischemic stroke patients were analyzed. Lobar atrophy was defined by a widely used visual rating scale. All patients were divided into non-severe, mild-moderate, and severe atrophy of the frontal, parietal, and temporal lobe groups. The severity of white matter lesions (WMLs) was rated with the Fazekas' scale. Clinical and radiological features were compared among the groups. Subsequent logistic regressions were performed to determine the risk factors of atrophy and severe atrophy of the frontal, parietal and temporal lobes.


RESULTS
The frequency of FLA in our cohort was 36.9% (174/471). Severe FLA occurred in 30 (6.4%) patients. Age, previous stroke, and periventricular hyperintensities (PVH) (odds ratio (OR)=1.640, p=0.039) were independent risk factors of FLA. Age and deep white matter hyperintensities (DWMH) (OR=3.634, p=0.002) were independent risk factors of severe FLA. PVH and DWMH were not independent risk factors of PLA and TLA.


CONCLUSIONS
Frontal lobe atrophy in ischemic stroke patients may be associated with small vessel disease. The association between WMLs and FLA was predominant over atrophy of the parietal and temporal lobes, which suggests that the frontal lobe may be vulnerable to subcortical ischemic changes.
Chen
Yangkun
Y
Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China. davischan78@gmail.com
Chen
Xiangyan
X
Xiao
Weimin
W
Mok
Vincent C T
VC
Wong
Ka Sing
KS
Tang
Wai Kwong
WK
D000368:Aged; D001284:Atrophy; D002545:Brain Ischemia / Q000473:pathology* / Q000523:psychology; D002196:Capillaries / Q000473:pathology; D002539:Cerebral Arterial Diseases / Q000473:pathology; D002544:Cerebral Infarction / Q000473:pathology; D015140:Dementia, Vascular / Q000473:pathology / Q000523:psychology; D005260:Female; D005625:Frontal Lobe / Q000473:pathology*; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010296:Parietal Lobe / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000473:pathology* / Q000523:psychology; D013702:Temporal Lobe / Q000473:pathology