title: Impact of white matter lesions on cognition in stroke patients free from pre-stroke cognitive impairment: a one-year follow-up study.
abstract: OBJECTIVE
  Post-stroke cognitive impairment and dementia may be caused by pure vascular, pure degenerative or mixed disease. The relation between post-stroke cognitive impairment and the combination of vascular pathology and degenerative changes is less evaluated. We aimed to evaluate the associations between white matter lesions (WMLs) and patient performance 1 year after stroke on tests of executive functioning, memory and visuospatial function, adjusted for the effects of lifestyle and disease-related factors, including medial temporal lobe atrophy (MTLA).
  
  
  METHODS
  Patients with a first-ever stroke or transient ischemic attack were invited to participate in the study. The associations between the cognitive test performances and WMLs were studied using linear regression [Trail Making Test B (TMT B) and 10-word test] and logistic regression (Clock Drawing Test).
  
  
  RESULTS
  In total, 199 patients completed the follow-up. The TMT B (p = 0.029) and the 10-word test (p = 0.014) were significantly associated with WMLs; however, the Clock Drawing Test (p = 0.19) was not. The TMT B (p = 0.018) and the 10-word test (p ≤ 0.001) were both significantly associated with MTLA.
  
  
  CONCLUSIONS
  Impaired executive functioning and memory are significantly associated with WMLs and MTLA. The mechanisms explaining post-stroke cognitive impairment are multifactorial, including different types of vascular pathology and coexisting vascular and degenerative changes.
authors.affiliation: Department of Geriatric Medicine, Bærum Hospital, Vestre Viken Hospital Trust, Rud, Oslo, Norway.
authors.forename: Hege
authors.initials: H
authors.lastname: Ihle-Hansen
authors.forename: Bente
authors.initials: B
authors.lastname: Thommessen
authors.forename: Morten Wang
authors.initials: MW
authors.lastname: Fagerland
authors.forename: Torgeir Bruun
authors.initials: TB
authors.lastname: Wyller
authors.forename: Knut
authors.initials: K
authors.lastname: Engedal
authors.forename: Anne Rita
authors.initials: AR
authors.lastname: Oksengård
authors.forename: Vidar
authors.initials: V
authors.lastname: Stenset
authors.forename: Kirsti
authors.initials: K
authors.lastname: Løken
authors.forename: Brynjar
authors.initials: B
authors.lastname: Fure