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Frontal lobe atrophy is associated with small vessel disease in ischemic stroke patients

Yangkun Chen1, Xiangyan Chen, Weimin Xiao

  • 1Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China. davischan78@gmail.com

Clinical Neurology and Neurosurgery
|September 12, 2009
PubMed
Abstract

Insights

Frontal lobe atrophy in stroke patients is linked to small vessel disease, particularly white matter lesions. The frontal lobe appears more vulnerable to these ischemic changes than parietal or temporal lobes.

Area of Science:

  • Neurology
  • Radiology
  • Stroke Medicine

Background:

  • The causes of frontal lobe atrophy (FLA) in stroke survivors remain unclear.
  • Investigating the link between subcortical ischemic changes and FLA versus other lobar atrophy types (parietal lobe atrophy - PLA, temporal lobe atrophy - TLA).

Purpose of the Study:

  • To determine if subcortical ischemic changes are more associated with FLA than PLA or TLA.
  • Identify risk factors for FLA and severe FLA in ischemic stroke patients.

Main Methods:

  • Analysis of brain MRI scans from 471 Chinese ischemic stroke patients.
  • Assessment of lobar atrophy using a visual rating scale and white matter lesions (WMLs) using the Fazekas' scale.
  • Logistic regression to identify independent risk factors for lobar atrophy.

Main Results:

  • FLA was observed in 36.9% of patients; severe FLA in 6.4%.
  • Independent risk factors for FLA included age, previous stroke, and periventricular hyperintensities (PVH).
  • Age and deep white matter hyperintensities (DWMH) were independent risk factors for severe FLA; PVH and DWMH were not significant for PLA or TLA.

Conclusions:

  • FLA in ischemic stroke may be associated with underlying small vessel disease.
  • WMLs show a stronger association with FLA compared to PLA and TLA.
  • The frontal lobe demonstrates particular vulnerability to subcortical ischemic changes.

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