title: Atrophy of the left dorsolateral prefrontal cortex is associated with poor performance in verbal fluency in elderly poststroke women.
abstract: This study aimed to investigate the association between atrophy in the prefrontal cortex with executive function and verbal fluency in elderly male and female patients poststroke. Thirty elderly female patients with non-aphasic ischemic stroke aged ≥ 60 years and 30 age-matched non-aphasic male patients with ischemic stroke were recruited. Automatic magnetic resonance imaging segmentation was used to assess the volume of the whole prefrontal cortex, along with its subdivisions: anterior cingulate cortex, orbitofrontal cortex and dorsolateral prefrontal cortex. The Semantic Verbal Fluency Test was administered at 3 and 15 months poststroke. At 3 months poststroke, left dorsolateral prefrontal cortex volume was significantly correlated with Verbal Fluency Test score in female patients only (partial coefficient = 0.453, P = 0.045), after controlling for age, education, diabetes, neurological deficit, white matter lesions volume, as well as the location and volume of infarcts. At 15 months poststroke, there remained a significant association between the left dorsolateral prefrontal cortex volume and Verbal Fluency Test (partial coefficient = 0.661, P = 0.001) and between the left prefrontal cortex volume and Verbal Fluency Test (partial coefficient = 0.573, P = 0.004) in female patients after the same adjustments. These findings indicate that atrophy of the left dorsolateral prefrontal cortex contributes to the impairment of verbal fluency in elderly female patients with stroke. Sex differences may be present in the neuropsychological mechanisms of verbal fluency impairment in patients with stroke.
authors.affiliation: Department of Neurology, Dongguan People's Hospital, Dongguan 523059, Guangdong Province, China.
authors.forename: Yang-Kun
authors.initials: YK
authors.lastname: Chen
authors.affiliation: Department of Neurology, Dongguan People's Hospital, Dongguan 523059, Guangdong Province, China.
authors.forename: Wei-Min
authors.initials: WM
authors.lastname: Xiao
authors.affiliation: Department of Diagnostic Radiology and Organ Imaging, the Chinese University of Hong Kong, Hong Kong SAR 999077, China.
authors.forename: Defeng
authors.initials: D
authors.lastname: Wang
authors.affiliation: Department of Diagnostic Radiology and Organ Imaging, the Chinese University of Hong Kong, Hong Kong SAR 999077, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Shi
authors.affiliation: Department of Diagnostic Radiology and Organ Imaging, the Chinese University of Hong Kong, Hong Kong SAR 999077, China.
authors.forename: Winnie Cw
authors.initials: WC
authors.lastname: Chu
authors.affiliation: Department of Medicine and Therapeutics, the Chinese University of Hong Kong, Hong Kong SAR 999077, China.
authors.forename: Vincent Ct
authors.initials: VC
authors.lastname: Mok
authors.affiliation: Department of Medicine and Therapeutics, the Chinese University of Hong Kong, Hong Kong SAR 999077, China.
authors.forename: Ka Sing
authors.initials: KS
authors.lastname: Wong
authors.affiliation: Graylands Hospital, School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth 6005, Australia.
authors.forename: Gabor S
authors.initials: GS
authors.lastname: Ungvari
authors.affiliation: Department of Psychiatry, the Chinese University of Hong Kong, Hong Kong SAR 999077, China.
authors.forename: Wai Kwong
authors.initials: WK
authors.lastname: Tang
keywords: brain atrophy; dorsolateral prefrontal cortex; executive function; grants-supported paper; magnetic resonance imaging; neural regeneration; neuroimaging; neuroregeneration; photographs-containing paper; prefrontal cortex; sex differences; stroke; verbal fluency