Factors related to executive dysfunction after acute infarct

PLoS One. 2014 Sep 23;9(9):e108574. doi: 10.1371/journal.pone.0108574. eCollection 2014.

Abstract

Aim: The aim of this study was to investigate the association of infarct location with post-stroke executive dysfunction.

Methods: One hundred seventy-seven patients hospitalized with acute infarction were enrolled. General information and NIHSS score at admission were recorded. The infarct site was recorded from magnetic resonance T2-W1 and FLAIR images, and the extent of white matter disease was assessed using the Fazekas score. Seven days after symptoms, executive function was assessed using the validated Chinese version of Mattis Dementia Rating Scale (MDRS) Initiation/Perseveration (I/P) [MDRS I/P].

Results: The average MDRS I/P score of the 177 infarction patients was 24.16 ± 5.21, considerably lower than the average score (32.7 ± 3.1) of a control group of normal individuals. Patients with infarcts in the corona radiata or basal ganglia had significantly lower MDRS I/P scores that those without infarcts at these locations. The number of infarcts in the basal ganglia was also significantly associated with low MDRS I/P scores. Male gender and low NIHSS score were significantly associated with low MDRS I/P score, and high-density lipoprotein cholesterol was significantly associated with high MDRS I/P score. The number of infarcts in areas other than the basal ganglia as well as corona radiata and the extent of white matter disease had no influence on this score.

Conclusions: The number of infarcts in the basal ganglia corona radiata, low NIHSS score, and male gender are significantly and independently related to poor executive function (that is, low MDRS I/P score) after acute infarct.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Basal Ganglia / blood supply
  • Basal Ganglia / pathology*
  • Cerebral Infarction / blood
  • Cerebral Infarction / pathology
  • Cerebral Infarction / psychology*
  • Cholesterol, HDL / blood
  • Cognition Disorders / blood
  • Cognition Disorders / etiology*
  • Cognition Disorders / pathology
  • Executive Function*
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Pyramidal Tracts / blood supply
  • Pyramidal Tracts / pathology*
  • Severity of Illness Index
  • Sex Factors
  • White Matter / pathology

Substances

  • Cholesterol, HDL

Grants and funding

This work is funded by the National Natural Science Foundation Youth Science Fund (81000508) and the Pearl River Science and Technology Star Fund (2012J2200090). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.