title: Association of Leukoaraiosis With Convalescent Rehabilitation Outcome in Patients With Ischemic Stroke.
abstract: OBJECTIVE
  We investigated the factors influencing inpatient convalescent rehabilitation outcomes in patients with ischemic stroke, particularly severity of leukoaraiosis on magnetic resonance imaging.
  
  
  METHODS
  Participants included 520 patients with ischemic stroke (317 men and 203 women; mean age, 72.8±8.4 years) who were transferred from acute care hospitals for inpatient convalescent rehabilitation. Ischemic stroke subtypes included lacunar infarction (n=41), atherothrombosis (n=223), artery-to-artery embolism (n=67), cardiogenic embolism (n=97), undetermined embolism (n=76), and uncategorized ischemic stroke (n=16). Leukoaraiosis was graded according to periventricular hyperintensity (PVH) and deep white matter hyperintensity on magnetic resonance imaging. Functional Independence Measure scores were assessed on admission and at discharge.
  
  
  RESULTS
  Multiple regression analysis revealed that rehabilitation outcomes, measured as total Functional Independence Measure scores, were significantly associated with leukoaraiosis estimated by PVH grade. This association was observed after adjustment for factors such as severity, age, and poststroke history. In all patients, PVH grades were associated with Functional Independence Measure motor scores (P<0.001), whereas in patients with artery-to-artery embolism or cardiogenic embolism and deep white matter hyperintensity grades were associated with Functional Independence Measure cognitive scores (P<0.05).
  
  
  CONCLUSIONS
  Our study revealed that the degree of leukoaraiosis was associated with inpatient convalescent rehabilitation outcome in patients with ischemic stroke. Furthermore, the PVH grade was associated with motor function outcome, whereas the deep white matter hyperintensity grade correlated with cognitive function outcome, likely because the progression patterns and anatomic backgrounds of PVH and deep white matter hyperintensity differ according to ischemic stroke subtype.
authors.affiliation: From the Departments of Neurology (J.S., M. Katsuno, G.S.) and Orthopaedic Surgery (Y.N., N.I.), Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Neurology and Rehabilitation, Komaki City Hospital, Komaki, Japan (J.S.); Division of Rehabilitation, Kami-iida Rehabilitation Hospital, Nagoya, Japan (J.S., K.I., T.K., M. Kanamori, H.K.); and Division of Rehabilitation, Nagoya University Hospital, Nagoya, Japan (I.K., Y.S., Y.N., N.I.). senda1@med.nagoya-u.ac.jp.
authors.forename: Joe
authors.initials: J
authors.lastname: Senda
authors.affiliation: From the Departments of Neurology (J.S., M. Katsuno, G.S.) and Orthopaedic Surgery (Y.N., N.I.), Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Neurology and Rehabilitation, Komaki City Hospital, Komaki, Japan (J.S.); Division of Rehabilitation, Kami-iida Rehabilitation Hospital, Nagoya, Japan (J.S., K.I., T.K., M. Kanamori, H.K.); and Division of Rehabilitation, Nagoya University Hospital, Nagoya, Japan (I.K., Y.S., Y.N., N.I.).
authors.forename: Keiichi
authors.initials: K
authors.lastname: Ito
authors.affiliation: From the Departments of Neurology (J.S., M. Katsuno, G.S.) and Orthopaedic Surgery (Y.N., N.I.), Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Neurology and Rehabilitation, Komaki City Hospital, Komaki, Japan (J.S.); Division of Rehabilitation, Kami-iida Rehabilitation Hospital, Nagoya, Japan (J.S., K.I., T.K., M. Kanamori, H.K.); and Division of Rehabilitation, Nagoya University Hospital, Nagoya, Japan (I.K., Y.S., Y.N., N.I.).
authors.forename: Tomomitsu
authors.initials: T
authors.lastname: Kotake
authors.affiliation: From the Departments of Neurology (J.S., M. Katsuno, G.S.) and Orthopaedic Surgery (Y.N., N.I.), Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Neurology and Rehabilitation, Komaki City Hospital, Komaki, Japan (J.S.); Division of Rehabilitation, Kami-iida Rehabilitation Hospital, Nagoya, Japan (J.S., K.I., T.K., M. Kanamori, H.K.); and Division of Rehabilitation, Nagoya University Hospital, Nagoya, Japan (I.K., Y.S., Y.N., N.I.).
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kanamori
authors.affiliation: From the Departments of Neurology (J.S., M. Katsuno, G.S.) and Orthopaedic Surgery (Y.N., N.I.), Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Neurology and Rehabilitation, Komaki City Hospital, Komaki, Japan (J.S.); Division of Rehabilitation, Kami-iida Rehabilitation Hospital, Nagoya, Japan (J.S., K.I., T.K., M. Kanamori, H.K.); and Division of Rehabilitation, Nagoya University Hospital, Nagoya, Japan (I.K., Y.S., Y.N., N.I.).
authors.forename: Hideo
authors.initials: H
authors.lastname: Kishimoto
authors.affiliation: From the Departments of Neurology (J.S., M. Katsuno, G.S.) and Orthopaedic Surgery (Y.N., N.I.), Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Neurology and Rehabilitation, Komaki City Hospital, Komaki, Japan (J.S.); Division of Rehabilitation, Kami-iida Rehabilitation Hospital, Nagoya, Japan (J.S., K.I., T.K., M. Kanamori, H.K.); and Division of Rehabilitation, Nagoya University Hospital, Nagoya, Japan (I.K., Y.S., Y.N., N.I.).
authors.forename: Izumi
authors.initials: I
authors.lastname: Kadono
authors.affiliation: From the Departments of Neurology (J.S., M. Katsuno, G.S.) and Orthopaedic Surgery (Y.N., N.I.), Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Neurology and Rehabilitation, Komaki City Hospital, Komaki, Japan (J.S.); Division of Rehabilitation, Kami-iida Rehabilitation Hospital, Nagoya, Japan (J.S., K.I., T.K., M. Kanamori, H.K.); and Division of Rehabilitation, Nagoya University Hospital, Nagoya, Japan (I.K., Y.S., Y.N., N.I.).
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: From the Departments of Neurology (J.S., M. Katsuno, G.S.) and Orthopaedic Surgery (Y.N., N.I.), Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Neurology and Rehabilitation, Komaki City Hospital, Komaki, Japan (J.S.); Division of Rehabilitation, Kami-iida Rehabilitation Hospital, Nagoya, Japan (J.S., K.I., T.K., M. Kanamori, H.K.); and Division of Rehabilitation, Nagoya University Hospital, Nagoya, Japan (I.K., Y.S., Y.N., N.I.).
authors.forename: Masahisa
authors.initials: M
authors.lastname: Katsuno
authors.affiliation: From the Departments of Neurology (J.S., M. Katsuno, G.S.) and Orthopaedic Surgery (Y.N., N.I.), Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Neurology and Rehabilitation, Komaki City Hospital, Komaki, Japan (J.S.); Division of Rehabilitation, Kami-iida Rehabilitation Hospital, Nagoya, Japan (J.S., K.I., T.K., M. Kanamori, H.K.); and Division of Rehabilitation, Nagoya University Hospital, Nagoya, Japan (I.K., Y.S., Y.N., N.I.).
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Nishida
authors.affiliation: From the Departments of Neurology (J.S., M. Katsuno, G.S.) and Orthopaedic Surgery (Y.N., N.I.), Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Neurology and Rehabilitation, Komaki City Hospital, Komaki, Japan (J.S.); Division of Rehabilitation, Kami-iida Rehabilitation Hospital, Nagoya, Japan (J.S., K.I., T.K., M. Kanamori, H.K.); and Division of Rehabilitation, Nagoya University Hospital, Nagoya, Japan (I.K., Y.S., Y.N., N.I.).
authors.forename: Naoki
authors.initials: N
authors.lastname: Ishiguro
authors.affiliation: From the Departments of Neurology (J.S., M. Katsuno, G.S.) and Orthopaedic Surgery (Y.N., N.I.), Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Neurology and Rehabilitation, Komaki City Hospital, Komaki, Japan (J.S.); Division of Rehabilitation, Kami-iida Rehabilitation Hospital, Nagoya, Japan (J.S., K.I., T.K., M. Kanamori, H.K.); and Division of Rehabilitation, Nagoya University Hospital, Nagoya, Japan (I.K., Y.S., Y.N., N.I.).
authors.forename: Gen
authors.initials: G
authors.lastname: Sobue
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation*; D003289:Convalescence; D005260:Female; D006801:Humans; D049292:Leukoaraiosis / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
keywords: convalescent rehabilitation; ischemic stroke; leukoaraiosis; magnetic resonance imaging