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. 2015 Oct 30:8:625.
doi: 10.1186/s13104-015-1552-7.

Medial temporal lobe atrophy, white matter hyperintensities and cognitive impairment among Nigerian African stroke survivors

Rufus O Akinyemi  1   2 , Michael Firbank  3 , Godwin I Ogbole  4 , Louise M Allan  5 , Mayowa O Owolabi  6 , Joshua O Akinyemi  7 , Bolutife P Yusuf  8 , Oluremi Ogunseyinde  9 , Adesola Ogunniyi  10 , Raj N Kalaria  11
Affiliations

Medial temporal lobe atrophy, white matter hyperintensities and cognitive impairment among Nigerian African stroke survivors

Rufus O Akinyemi et al. BMC Res Notes. .

Abstract

Background: Neuroimaging features associated with vascular cognitive impairment have not been examined in sub-Saharan Africans. We determined magnetic resonance imaging (MRI) features associated with cognitive impairment in a sample of Nigerian stroke survivors.

Methods: Stroke survivors underwent brain MRI with standardized assessment of brain volumes and visual rating of medial temporal lobe atrophy (MTA), and white matter hyperintensities (WMH) at 3 months post-stroke. Demographic, clinical and psychometric assessments of global cognitive function, executive function, mental speed and memory were related to changes in structural MRI.

Results: In our pilot sample of 58 stroke survivors (60.1 ± 10.7 years old) MTA correlated significantly with age (r = 0.525), WMH (r = 0.461), memory (r = -0.702), executive function (r = -0.369) and general cognitive performance (r = -0.378). On univariate analysis, age >60 years (p = 0.016), low educational attainment (p < 0.001 to p < 0.003), total brain volume (p < 0.024 and p < 0.025) and MTA (p < 0.003 to p < 0.007) but not total WMH (p < 0.073, p = 0.610) were associated with cognitive outcome. In a two-step multivariate regression analysis, MTA (p < 0.035 and p < 0.016) and low educational attainment (p < 0.012 and p < 0.019) were sustained as independent statistical predictors of cognitive outcome.

Conclusions: Medial temporal lobe atrophy was a significant neuroimaging predictor of early post-stroke cognitive dysfunction in the Nigerian African stroke survivors. These observations have implications for a vascular basis of MTA in older stroke survivors among sub-Saharan Africans.

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Figures

Fig. 1
Fig. 1
Magnetic resonance imaging (MRI) T1- and T2-weighted (a, b), and fluid-attenuated inversion recovery (c) axial images from a 69-year old male Nigerian stroke survivor showing moderate white matter hyperintensities
Fig. 2
Fig. 2
Magnetic resonance imaging (MRI) T1-weighted coronal images showing different degrees of medial temporal lobe atrophy (MTLA) in Nigerian stroke survivors: a Grade 4 MTLA in a 58 year old male; b Grade 3 MTLA in an 72 year male; c Grade 2 MTLA in a 60 year female; d Grade 1 MTLA in an 59 year male; e Grade 0 MTLA in an 49 year female
See this image and copyright information in PMC

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