title: Remote thalamic microstructural abnormalities related to cognitive function in ischemic stroke patients.
abstract: OBJECTIVE
  Ischemic stroke can lead to a continuum of cognitive sequelae, ranging from mild vascular cognitive impairment to vascular dementia. These cognitive deficits can be influenced by the disruption of cortico-subcortical circuits. We sought to explore remote thalamic microstructural abnormalities and their association with cognitive function after ischemic stroke.
  
  
  METHODS
  Seventeen patients with right hemispheric ischemic stroke and 17 controls matched for age, sex, and years of education were included. All participants underwent neurological, neuropsychological, and diffusion tensor image examination. Patients were assessed 3 months poststroke. Voxel-wise analysis was used to study thalamic diffusion differences between groups. Mean fractional anisotropy (FA) and mean diffusivity (MD) values in significant thalamic areas were calculated for each subject and correlated with cognitive performance.
  
  
  RESULTS
  Stroke patients showed lower FA values and higher MD values in specific areas of both the left and right thalamus compared with controls. In patients, decreased FA values were associated with lower verbal fluency performance in the right thalamus (R(2) = 0.45, β = 0.74) and the left thalamus (R(2) = 0.57, β = 0.77) after adjusting for diabetes mellitus. Moreover, increased MD values were associated with lower verbal fluency performance in the right thalamus (R(2) = 0.27, β = -0.54) after adjusting for diabetes mellitus. In controls, thalamic FA and MD values were not related to any cognitive function.
  
  
  CONCLUSIONS
  Our findings support the hypothesis that ischemic stroke lesions are associated with remote thalamic diffusion abnormalities, and that these abnormalities can contribute to cognitive dysfunction 3 months after a cerebrovascular event.
authors.affiliation: Department of Psychiatry and Clinical Psychobiology, University of Barcelona.
authors.forename: Marina
authors.initials: M
authors.lastname: Fernández-Andújar
authors.affiliation: Leiden University Medical Center, Leiden University.
authors.forename: Fleur
authors.initials: F
authors.lastname: Doornink
authors.affiliation: Department of Psychiatry and Clinical Psychobiology, University of Barcelona.
authors.forename: Rosalía
authors.initials: R
authors.lastname: Dacosta-Aguayo
authors.affiliation: Department of Psychiatry and Clinical Psychobiology, University of Barcelona.
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Soriano-Raya
authors.affiliation: Department of Psychiatry and Clinical Psychobiology, University of Barcelona.
authors.forename: Júlia
authors.initials: J
authors.lastname: Miralbell
authors.affiliation: Image Research Platform, Institut d'Investigacions Biomèdiques August Pi i Sunyer.
authors.forename: Núria
authors.initials: N
authors.lastname: Bargalló
authors.affiliation: Department of Psychiatry and Clinical Psychobiology, University of Barcelona.
authors.forename: Elena
authors.initials: E
authors.lastname: López-Cancio
authors.affiliation: Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona.
authors.forename: Natalia
authors.initials: N
authors.lastname: Pérez de la Ossa
authors.affiliation: Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona.
authors.forename: Meritxell
authors.initials: M
authors.lastname: Gomis
authors.affiliation: Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona.
authors.forename: Mònica
authors.initials: M
authors.lastname: Millán
authors.affiliation: Department of Methodology of Behavioral Sciences, University of Barcelona.
authors.forename: Maite
authors.identifier: 0000-0003-1979-0818
authors.initials: M
authors.lastname: Barrios
authors.affiliation: Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Cáceres
authors.affiliation: Primary Healthcare Research Support Unit Metropolitana Nord, Institut Universitari d'Investigació en Atenció Prima`ria Jordi Gol, Santa Coloma de Gramenet.
authors.forename: Guillem
authors.identifier: 0000-0003-3188-7268
authors.initials: G
authors.lastname: Pera
authors.affiliation: Primary Healthcare Research Support Unit Metropolitana Nord, Institut Universitari d'Investigació en Atenció Prima`ria Jordi Gol, Santa Coloma de Gramenet.
authors.forename: Rosa
authors.initials: R
authors.lastname: Forés
authors.affiliation: Department of Psychiatry and Clinical Psychobiology, University of Barcelona.
authors.forename: Imma
authors.initials: I
authors.lastname: Clemente
authors.affiliation: Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona.
authors.forename: Antoni
authors.initials: A
authors.lastname: Dávalos
authors.affiliation: Department of Psychiatry and Clinical Psychobiologyr, University of Barcelona.
authors.forename: Maria
authors.identifier: 0000-0002-9946-2656
authors.initials: M
authors.lastname: Mataró
mesh_terms: D000368:Aged; D016880:Anisotropy; D002545:Brain Ischemia / Q000150:complications / Q000473:pathology* / Q000523:psychology; D016022:Case-Control Studies; D003071:Cognition; D060825:Cognitive Dysfunction / Q000209:etiology / Q000473:pathology* / Q000523:psychology*; D015140:Dementia, Vascular; D056324:Diffusion Tensor Imaging / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D020521:Stroke / Q000150:complications / Q000209:etiology / Q000473:pathology* / Q000523:psychology; D013788:Thalamus / Q000002:abnormalities* / Q000098:blood supply / Q000000981:diagnostic imaging*; D014463:Ultrasonography