title: Prevalence of silent cerebral ischemia in paroxysmal and persistent atrial fibrillation and correlation with cognitive function.
abstract: OBJECTIVE
  The aim of this study was to compare the prevalence of silent cerebral ischemia (SCI) and cognitive performance in patients with paroxysmal and persistent atrial fibrillation (AF) and controls in sinus rhythm.
  
  
  BACKGROUND
  Large registries have reported a similar risk for symptomatic stroke in both paroxysmal and persistent AF. The relationship among paroxysmal and persistent AF, SCI, and cognitive impairment has remained uncharted.
  
  
  METHODS
  Two hundred seventy subjects were enrolled: 180 patients with AF (50% paroxysmal and 50% persistent) and 90 controls. All subjects underwent clinical assessment, neurological examination, cerebral magnetic resonance, and the Repeatable Battery for the Assessment of Neuropsychological Status.
  
  
  RESULTS
  At least 1 area of SCI was present in 80 patients (89%) with paroxysmal AF, 83 (92%) with persistent AF (paroxysmal vs. persistent, p = 0.59), and 41 (46%) controls (paroxysmal vs. controls and persistent vs. controls, p < 0.01). The number of areas of SCI per subject was higher in patients with persistent AF than in those with paroxysmal AF (41.1 ± 28.0 vs. 33.2 ± 22.8, p = 0.04), with controls reporting lower figures (12.0 ± 26.7, p < 0.01 for both). Cognitive performance was significantly worse in patients with persistent and paroxysmal AF than in controls (Repeatable Battery for the Assessment of Neuropsychological Status scores 82.9 ± 11.5, 86.2 ± 13.8, and 92.4 ± 15.4 points, respectively, p < 0.01).
  
  
  CONCLUSIONS
  Patients with paroxysmal and persistent AF had a higher prevalence and number of areas of SCI per patient than controls and worse cognitive performance than subjects in sinus rhythm.
authors.affiliation: Cardiology Division, Department of Medical Sciences, University of Turin, Turin, Italy. Electronic address: fiorenzo.gaita@unito.it.
authors.forename: Fiorenzo
authors.initials: F
authors.lastname: Gaita
authors.affiliation: Cardiology Division, Department of Medical Sciences, University of Turin, Turin, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Corsinovi
authors.affiliation: Cardiology Division, Department of Medical Sciences, University of Turin, Turin, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Anselmino
authors.affiliation: Cardiology Division, Department of Medical Sciences, University of Turin, Turin, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Raimondo
authors.affiliation: Cardiology Division, Department of Medical Sciences, University of Turin, Turin, Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Pianelli
authors.affiliation: Cardiology Division, Department of Medical Sciences, University of Turin, Turin, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Toso
authors.affiliation: Department of Surgical Sciences, University of Turin, Turin, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Bergamasco
authors.affiliation: Neuroradiology Department, IRCCS Foundation, Neurological Institute "C. Besta," Milan, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Boffano
authors.affiliation: Division of Neuroradiology, Azienda Ospedaliera Città Della Salute e Della Scienza, Turin, Italy.
authors.forename: Maria Consuelo
authors.initials: MC
authors.lastname: Valentini
authors.affiliation: Division of Radiology, Cardinal Guglielmo Massaia Hospital, Asti, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Cesarani
authors.affiliation: Division of Cardiology, Cardinal Guglielmo Massaia Hospital, Asti, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Scaglione
mesh_terms: D001281:Atrial Fibrillation / Q000150:complications*; D002545:Brain Ischemia / Q000209:etiology*; D003071:Cognition; D003072:Cognition Disorders / Q000209:etiology*; D006801:Humans
keywords: AF; CI; FLAIR; MR; OR; RBANS; Repeatable Battery for the Assessment of Neuropsychological Status; SCI; SR; atrial fibrillation; cognitive function; confidence interval; fluid-attenuated inversion recovery; magnetic resonance; odds ratio; paroxysmal and persistent atrial fibrillation; silent cerebral ischemia; sinus rhythm