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White matter tract microstructure and cognitive performance after transient ischemic attack.

Sana Tariq1,2, Adrian Tsang1,2, Meng Wang3

  • 1Seaman Family MR Center, Foothills Medical Centre, Calgary, AB, Canada.

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|October 23, 2020
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Summary
This summary is machine-generated.

Diffusion tensor imaging (DTI) reveals white matter changes in patients with transient ischemic attack (TIA). These microstructural alterations correlate with cognitive impairments, particularly in memory and processing speed.

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Area of Science:

  • Neuroimaging
  • Neurology
  • Radiology

Background:

  • Patients with transient ischemic attack (TIA) often experience cognitive impairment, but the underlying causes remain unclear.
  • Diffusion tensor imaging (DTI) offers a method to measure microstructural changes in white matter (WM), potentially serving as a valuable outcome measure.
  • This study investigates WM integrity using DTI and its association with neuropsychological performance in TIA and non-TIA subjects.

Purpose of the Study:

  • To assess white matter microstructural integrity in TIA patients using DTI.
  • To investigate the relationship between DTI-derived WM metrics and neuropsychological test performance.
  • To explore the potential of DTI as an early indicator of cognitive changes post-TIA.

Main Methods:

  • Ninety-five TIA subjects and 51 non-TIA control subjects underwent DTI and comprehensive neuropsychological assessments.
  • Fractional anisotropy (FA) and mean diffusivity (MD) maps were generated to quantify WM microstructure.
  • Statistical models (adjusted mixed effects regression) were employed to analyze group differences and correlations between DTI metrics and cognitive scores.

Main Results:

  • TIA subjects showed significantly higher mean diffusivity (MD) in the fornix and lower fractional anisotropy (FA) in the superior longitudinal fasciculus (SLF), genu, and uncinate fasciculus (UF) compared to controls.
  • The TIA group performed worse on the Addenbrooke's Cognitive Assessment-Revised, specifically in memory and processing speed domains, but not on the Montreal Cognitive Assessment or Mini-Mental State Examination.
  • Reduced FA and increased MD in specific WM tracts (fornix, SLF, UF) were associated with poorer performance in visual memory and executive function tests, including the Trail Making Test Part B.

Conclusions:

  • DTI can detect microstructural white matter abnormalities in TIA patients, potentially preceding overt cognitive symptoms.
  • DTI parameters, alongside white matter hyperintensities and vascular risk factors, contribute to the observed cognitive deficits in TIA.
  • DTI shows promise as a sensitive tool for identifying subclinical brain changes and assessing cognitive function in TIA.