Strategic infarct location for post-stroke cognitive impairment: A multivariate lesion-symptom mapping study

Area of Science:

• Neuroscience
• Neurology
• Cognitive Science

Background:

• Lesion location significantly influences cognitive impairment following a stroke.
• Previous research identified some 'strategic' brain regions, but a comprehensive map is missing due to sample size and methodological limitations.

Purpose of the Study:

• To identify strategic brain regions associated with post-stroke cognitive impairment using a large patient cohort.
• To create a detailed map of brain areas critical for cognitive function after ischemic stroke.

Main Methods:

• Multivariate lesion-symptom mapping was applied to 410 acute ischemic stroke patients.
• Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) at 3-6 months post-stroke.
• Voxel-level and region-of-interest analyses utilized support vector regression to correlate infarct location with cognitive outcomes.

Main Results:

• The left angular gyrus, left basal ganglia, and surrounding white matter were consistently identified as strategic for global cognitive impairment.
• Specific overlapping cortical and subcortical networks were found to be associated with individual cognitive domains (memory, language, attention, executive, visuospatial).

Conclusions:

• The left angular gyrus and left basal ganglia are critical brain regions for cognitive function after stroke.
• Domain-specific strategic networks exist for various cognitive functions, highlighting the complexity of post-stroke cognitive impairment.
• Future multicenter studies with larger cohorts are needed for more comprehensive infarct location-based models.