title: Cognitive decline after stroke: relation to inflammatory biomarkers and hippocampal volume.
abstract: OBJECTIVE
  Inflammation may contribute to cognitive impairment after stroke. Inflammatory markers are associated with hippocampal atrophy. We tested whether markers of inflammation, erythrocyte sedimentation rate (ESR), and serum levels of C-reactive protein are associated with reduced hippocampal volume and poor cognitive performance among stroke survivors.
  
  
  METHODS
  We analyzed 368 consecutive cases from our prospective study of first-ever mild-moderate stroke patients. MRI, cognitive tests, and inflammatory markers were determined. Patients were reevaluated 6 and 12 months after the event.
  
  
  RESULTS
  ESR remained unchanged in follow-up examinations, suggesting a chronic inflammation background in some patients. Higher levels of C-reactive protein and ESR were associated with worse performance in cognitive tests, particularly memory scores. This association was maintained for ESR (but not C-reactive protein) after adjustment for confounders (P=0.002). Patients with smaller hippocampi had inferior cognitive results. Moreover, in a multivariate regression model, higher ESR values (but not C-reactive protein) were related to reduced hippocampal volume (P=0.049).
  
  
  CONCLUSIONS
  This report shows a strong relationship between ESR and hippocampal volume, as well as with cognitive performance among poststroke patients. This could plausibly relate to incipient cognitive decline via hippocampal pathways.
authors: Tel Aviv Sourasky Medical Center, Tel Aviv 64239, Israel.
authors: Efrat
authors: E
authors: Kliper
authors: Dafna Ben
authors: DB
authors: Bashat
authors: Natan M
authors: NM
authors: Bornstein
authors: Shani
authors: S
authors: Shenhar-Tsarfaty
authors: Hen
authors: H
authors: Hallevi
authors: Eitan
authors: E
authors: Auriel
authors: Ludmila
authors: L
authors: Shopin
authors: Sivan
authors: S
authors: Bloch
authors: Shlomo
authors: S
authors: Berliner
authors: Nir
authors: N
authors: Giladi
authors: Uri
authors: U
authors: Goldbourt
authors: Itzhak
authors: I
authors: Shapira
authors: Amos D
authors: AD
authors: Korczyn
authors: Einor Ben
authors: EB
authors: Assayag
mesh_terms: D000328:Adult; D000368:Aged; D001284:Atrophy / Q000150:complications / Q000473:pathology; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein; D003072:Cognition Disorders / Q000097:blood / Q000209:etiology / Q000473:pathology / Q000523:psychology*; D005260:Female; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications / Q000473:pathology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011446:Prospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000097:blood / Q000150:complications / Q000473:pathology / Q000523:psychology*
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein