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Multicenter Study
. 2012 May;43(5):1218-23.
doi: 10.1161/STROKEAHA.111.643379. Epub 2012 Mar 1.

Covert neurological symptoms associated with silent infarcts from midlife to older age: the Atherosclerosis Risk in Communities study

Beverly G Windham  1 , Michael E Griswold, Dean Shibata, Alan Penman, Diane J Catellier, Thomas H Mosley Jr
Affiliations
Multicenter Study

Covert neurological symptoms associated with silent infarcts from midlife to older age: the Atherosclerosis Risk in Communities study

Beverly G Windham et al. Stroke. 2012 May.

Abstract

Background and purpose: Unrecognized or unreported stroke-like symptoms, called covert symptoms, occur in persons free of clinical stroke. Whether covert symptoms are associated with subclinical brain infarcts (SBIs) is unknown. This study examined the association between covert stroke-like symptoms and SBI/stroke in persons with no history of stroke or transient ischemic attack.

Methods: A total of 1881 Atherosclerosis Risk in Communities (ARIC) participants free of clinical stroke or transient ischemic attack (40% male, 50% black, 47-70 years) were queried for covert symptoms and underwent cerebral MRI during the baseline MRI visit. Symptoms were reassessed after 3 years at Visit 4 (n=1001; 39% male, 50% black) and approximately 10 years with a follow-up MRI (n=1006; 40% male, 50% black, 61-83 years).

Results: Covert symptoms were associated with prevalent SBI (OR, 1.94; 95% CI, 1.21-3.11; P=0.006). No support was found for associations between baseline MRI symptoms and SBI at the follow up MRI visit. In participants without SBI at baseline, symptoms at Visit 4 (OR, 2.96; 1.23-7.13; P=0.016) and symptoms at the follow-up MRI visit (OR, 4.29; 2.51-7.33; P<0.001) were associated with a combined outcome of new SBI/clinical stroke on follow-up MRI. Covert symptoms at follow-up MRI visit were also associated with having new SBI (OR, 2.26; 1.18-4.32; P=0.014) on the follow-up MRI that were not seen on the baseline MRI.

Conclusions: Covert neurological symptoms were associated with prevalent SBI, and when ascertained at the time of follow-up MRI, with new SBI. Covert symptoms may reflect heightened risk for infarcts.

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Conflict of interest statement

Conflicts of Interest: None.

Figures

Figure 1
Figure 1
Data collection and analyses
Figure 2
Figure 2
Adjusted prevalence of SBI by symptom status across age
See this image and copyright information in PMC

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References

    1. Toole JF, Lefkowitz DS, Chambless LE, Wijnberg L, Paton CC, Heiss G. Self-reported transient ischemic attack and stroke symptoms: Methods and baseline prevalence: The ARIC study, 1987–1989. Am J Epidemiol. 1996;144:849–856. - PubMed
    1. Howard VJ, McClure LA, Meschia JF, Pulley L, Orr SC, Friday GH. High prevalence of stroke symptoms among persons without a diagnosis of stroke or transient ischemic attack in a general population: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. Arch Intern Med. 2006;166:1952–1958. - PubMed
    1. Chambless LE, Shahar E, Sharrett AR, Heiss G, Wijnberg L, Paton CC, et al. Association of transient ischemic attack/stroke symptoms assessed by standardized questionnaire and algorithm with cerebrovascular risk factors and carotid artery wall thickness: The ARIC study, 1987–1989. Am J Epidemiol. 1996;144:857–866. - PubMed
    1. Wadley VG, McClure LA, Howard VJ, Unverzagt FW, Go RC, Moy CS, et al. Cognitive status, stroke symptom reports, and modifiable risk factors among individuals with no diagnosis of stroke or transient ischemic attack in the REasons for Geographic and Racial Differences in Stroke (REGARDS)Study. Stroke. 2007;38:1143–1147. - PubMed
    1. Chambless LE, Toole JF, Nieto FJ, Rosamond W, Paton C. Association between symptoms reported in a population questionnaire and future ischemic stroke: the ARIC study. Neuroepidemiology. 2004;23:33–37. - PubMed

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