Poststroke Executive Function in Relation to White Matter Damage on Clinically Acquired CT Brain Imaging.

Area of Science:

• Neurology
• Neuroimaging
• Cognitive Science

Background:

• Executive function (EF) impairments are common after stroke.
• White matter (WM) damage is often associated with these impairments, typically studied using MRI.
• The role of CT imaging in assessing post-stroke EF and WM damage is less understood.

Purpose of the Study:

• To explore the association between post-stroke executive function and white matter damage visualized on CT scans.
• To investigate the relationship between stroke lesions, white matter hyperintensities (WMHs), and EF deficits.
• To determine the prognostic value of CT-derived imaging markers for cognitive outcomes post-stroke.

Main Methods:

• Analysis of data from the Oxford Cognitive Screening Program, including 87 stroke survivors assessed 6 months post-stroke.
• Manual delineation of stroke lesions and quantification of WM damage using the HCP-842 atlas.
• Visual rating and dichotomization of WMHs using the Age-Related White Matter Changes Scale.
• Multivariable linear regression to assess the relationship between WM damage markers and EF, adjusting for age and education.

Main Results:

• Stroke damage to the medial lemniscus was significantly associated with poorer executive function (B = -8.86, P < 0.001).
• The presence of white matter hyperintensities (WMHs) on CT was also linked to poorer executive function (B = -5.42, P = 0.005).
• These associations remained significant after adjusting for age and education.

Conclusions:

• Poorer executive function post-stroke is associated with white matter damage, including stroke lesions and WMHs, as seen on CT imaging.
• White matter integrity is crucial for executive function recovery after stroke.
• CT-derived imaging markers hold prognostic utility for predicting cognitive outcomes in stroke survivors.