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Cognitive impairment before intracerebral hemorrhage is associated with cerebral amyloid angiopathy

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Cognitive impairment before intracerebral hemorrhage is associated with cerebral amyloid angiopathy. / Banerjee, Gargi; Wilson, Duncan; Ambler, Gareth et al.
In: Stroke, Vol. 49, No. 1, 01.01.2018, p. 40-45.

Research output: Contribution to Journal/Magazine › Journal article › peer-review

Harvard

Banerjee, G, Wilson, D, Ambler, G, Appiah, KOB, Shakeshaft, C, Lunawat, S, Cohen, H, Yousry, T, Habil, M, Lip, GYH, Muir, KW, Brown, MM, Salman, RAS, Jäger, HR, Werring, DJ, Shaw, L, Sword, J, Nor, AM, Sharma, P, Veltkamp, R, Kelly, D, Harrington, F, Randall, M, Smith, M, Mahawish, K, Elmarim, A, Esisi, B, Cullen, C, Nallasivam, A, Price, C, Barry, A, Roffe, C, Coyle, J, Hassan, A, Lovelock, C, Birns, J, Cohen, D, Sekaran, L, Parry-Jones, A, Parry, A, Hargroves, D, Proschel, H, Datta, P, Darawil, K, Manoj, A, Burn, M, Patterson, C, Giallombardo, E, Smyth, N & Emsley, H 2018, 'Cognitive impairment before intracerebral hemorrhage is associated with cerebral amyloid angiopathy', Stroke, vol. 49, no. 1, pp. 40-45. https://doi.org/10.1161/STROKEAHA.117.019409

APA

Banerjee, G., Wilson, D., Ambler, G., Appiah, K. O. B., Shakeshaft, C., Lunawat, S., Cohen, H., Yousry, T., Habil, M., Lip, G. Y. H., Muir, K. W., Brown, M. M., Salman, R. A. S., Jäger, H. R., Werring, D. J., Shaw, L., Sword, J., Nor, A. M., Sharma, P., ... Emsley, H. (2018). Cognitive impairment before intracerebral hemorrhage is associated with cerebral amyloid angiopathy. Stroke, 49(1), 40-45. https://doi.org/10.1161/STROKEAHA.117.019409

Vancouver

Banerjee G, Wilson D, Ambler G, Appiah KOB, Shakeshaft C, Lunawat S et al. Cognitive impairment before intracerebral hemorrhage is associated with cerebral amyloid angiopathy. Stroke. 2018 Jan 1;49(1):40-45. Epub 2017 Dec 15. doi: 10.1161/STROKEAHA.117.019409

Author

Banerjee, Gargi ; Wilson, Duncan ; Ambler, Gareth et al. / Cognitive impairment before intracerebral hemorrhage is associated with cerebral amyloid angiopathy. In: Stroke. 2018 ; Vol. 49, No. 1. pp. 40-45.

Bibtex

@article{d6c0f7d97f5441acade4b6a76a3a800b,
title = "Cognitive impairment before intracerebral hemorrhage is associated with cerebral amyloid angiopathy",
abstract = "Background and Purpose-Although the association between cerebral amyloid angiopathy (CAA) and cognitive impairment is increasingly recognized, it is not clear whether this is because of the impact of recurrent intracerebral hemorrhage (ICH) events, disruptions caused by cerebral small vessel damage, or both. We investigated this by considering whether cognitive impairment before ICH was associated with neuroimaging features of CAA on magnetic resonance imaging. Methods-We studied 166 patients with neuroimaging-confrmed ICH recruited to a prospective multicentre observational study. Preexisting cognitive impairment was determined using the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Magnetic resonance imaging markers of cerebral small vessel disease, including CAA, were rated by trained observers according to consensus guidelines. Results-The prevalence of cognitive impairment before ICH was 24.7% (n=41) and, in adjusted analyses, was associated with fulflling the modifed Boston criteria for probable CAA at presentation (odds ratio, 4.01; 95% confdence interval, 1.53-10.51; P=0.005) and a higher composite CAA score (for each point increase, odds ratio, 1.42; 95% confdence interval, 1.03-1.97; P=0.033). We also found independent associations between pre-ICH cognitive decline and the presence of cortical superfcial siderosis, strictly lobar microbleeds, and lobar ICH location, but not with other neuroimaging markers, or a composite small vessel disease score. Conclusions-CAA (defned using magnetic resonance imaging markers) is associated with cognitive decline before symptomatic ICH. This provides evidence that small vessel disruption in CAA makes an independent contribution to cognitive impairment, in addition to effects due to brain injury caused directly by ICH.",
keywords = "Cerebral amyloid angiopathy, Cerebral hemorrhage, Cerebral small vessel diseases, Cognitive dysfunction, Prevalence, Siderosis",
author = "Gargi Banerjee and Duncan Wilson and Gareth Ambler and Appiah, {Karen Osei Bonsu} and Clare Shakeshaft and Surabhika Lunawat and Hannah Cohen and Tarek Yousry and Med Habil and Lip, {Gregory Y.H.} and Muir, {Keith W.} and Brown, {Martin M.} and Salman, {Rustam Al Shahi} and J{\"a}ger, {Hans Rolf} and Werring, {David J.} and Louise Shaw and Jane Sword and Nor, {Azlisham Mohd} and Pankaj Sharma and Roland Veltkamp and Deborah Kelly and Frances Harrington and Marc Randall and Matthew Smith and Karim Mahawish and Abduelbaset Elmarim and Bernard Esisi and Claire Cullen and Arumug Nallasivam and Christopher Price and Adrian Barry and Christine Roffe and John Coyle and Ahamad Hassan and Caroline Lovelock and Jonathan Birns and David Cohen and L. Sekaran and Adrian Parry-Jones and Anthea Parry and David Hargroves and Harald Proschel and Prabel Datta and Khaled Darawil and Aravindakshan Manoj and Mathew Burn and Chris Patterson and Elio Giallombardo and Nigel Smyth and Hedley Emsley",
year = "2018",
month = jan,
day = "1",
doi = "10.1161/STROKEAHA.117.019409",
language = "English",
volume = "49",
pages = "40--45",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

RIS

TY - JOUR

T1 - Cognitive impairment before intracerebral hemorrhage is associated with cerebral amyloid angiopathy

AU - Banerjee, Gargi

AU - Wilson, Duncan

AU - Ambler, Gareth

AU - Appiah, Karen Osei Bonsu

AU - Shakeshaft, Clare

AU - Lunawat, Surabhika

AU - Cohen, Hannah

AU - Yousry, Tarek

AU - Habil, Med

AU - Lip, Gregory Y.H.

AU - Muir, Keith W.

AU - Brown, Martin M.

AU - Salman, Rustam Al Shahi

AU - Jäger, Hans Rolf

AU - Werring, David J.

AU - Shaw, Louise

AU - Sword, Jane

AU - Nor, Azlisham Mohd

AU - Sharma, Pankaj

AU - Veltkamp, Roland

AU - Kelly, Deborah

AU - Harrington, Frances

AU - Randall, Marc

AU - Smith, Matthew

AU - Mahawish, Karim

AU - Elmarim, Abduelbaset

AU - Esisi, Bernard

AU - Cullen, Claire

AU - Nallasivam, Arumug

AU - Price, Christopher

AU - Barry, Adrian

AU - Roffe, Christine

AU - Coyle, John

AU - Hassan, Ahamad

AU - Lovelock, Caroline

AU - Birns, Jonathan

AU - Cohen, David

AU - Sekaran, L.

AU - Parry-Jones, Adrian

AU - Parry, Anthea

AU - Hargroves, David

AU - Proschel, Harald

AU - Datta, Prabel

AU - Darawil, Khaled

AU - Manoj, Aravindakshan

AU - Burn, Mathew

AU - Patterson, Chris

AU - Giallombardo, Elio

AU - Smyth, Nigel

AU - Emsley, Hedley

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background and Purpose-Although the association between cerebral amyloid angiopathy (CAA) and cognitive impairment is increasingly recognized, it is not clear whether this is because of the impact of recurrent intracerebral hemorrhage (ICH) events, disruptions caused by cerebral small vessel damage, or both. We investigated this by considering whether cognitive impairment before ICH was associated with neuroimaging features of CAA on magnetic resonance imaging. Methods-We studied 166 patients with neuroimaging-confrmed ICH recruited to a prospective multicentre observational study. Preexisting cognitive impairment was determined using the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Magnetic resonance imaging markers of cerebral small vessel disease, including CAA, were rated by trained observers according to consensus guidelines. Results-The prevalence of cognitive impairment before ICH was 24.7% (n=41) and, in adjusted analyses, was associated with fulflling the modifed Boston criteria for probable CAA at presentation (odds ratio, 4.01; 95% confdence interval, 1.53-10.51; P=0.005) and a higher composite CAA score (for each point increase, odds ratio, 1.42; 95% confdence interval, 1.03-1.97; P=0.033). We also found independent associations between pre-ICH cognitive decline and the presence of cortical superfcial siderosis, strictly lobar microbleeds, and lobar ICH location, but not with other neuroimaging markers, or a composite small vessel disease score. Conclusions-CAA (defned using magnetic resonance imaging markers) is associated with cognitive decline before symptomatic ICH. This provides evidence that small vessel disruption in CAA makes an independent contribution to cognitive impairment, in addition to effects due to brain injury caused directly by ICH.

AB - Background and Purpose-Although the association between cerebral amyloid angiopathy (CAA) and cognitive impairment is increasingly recognized, it is not clear whether this is because of the impact of recurrent intracerebral hemorrhage (ICH) events, disruptions caused by cerebral small vessel damage, or both. We investigated this by considering whether cognitive impairment before ICH was associated with neuroimaging features of CAA on magnetic resonance imaging. Methods-We studied 166 patients with neuroimaging-confrmed ICH recruited to a prospective multicentre observational study. Preexisting cognitive impairment was determined using the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Magnetic resonance imaging markers of cerebral small vessel disease, including CAA, were rated by trained observers according to consensus guidelines. Results-The prevalence of cognitive impairment before ICH was 24.7% (n=41) and, in adjusted analyses, was associated with fulflling the modifed Boston criteria for probable CAA at presentation (odds ratio, 4.01; 95% confdence interval, 1.53-10.51; P=0.005) and a higher composite CAA score (for each point increase, odds ratio, 1.42; 95% confdence interval, 1.03-1.97; P=0.033). We also found independent associations between pre-ICH cognitive decline and the presence of cortical superfcial siderosis, strictly lobar microbleeds, and lobar ICH location, but not with other neuroimaging markers, or a composite small vessel disease score. Conclusions-CAA (defned using magnetic resonance imaging markers) is associated with cognitive decline before symptomatic ICH. This provides evidence that small vessel disruption in CAA makes an independent contribution to cognitive impairment, in addition to effects due to brain injury caused directly by ICH.

KW - Cerebral amyloid angiopathy

KW - Cerebral hemorrhage

KW - Cerebral small vessel diseases

KW - Cognitive dysfunction

KW - Prevalence

KW - Siderosis

U2 - 10.1161/STROKEAHA.117.019409

DO - 10.1161/STROKEAHA.117.019409

M3 - Journal article

C2 - 29247143

AN - SCOPUS:85043725036

VL - 49

SP - 40

EP - 45

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 1

ER -