Medial temporal lobe atrophy in stroke patients: relation to pre-existing dementia
- aDepartment of Neurology, Stroke Unit, France, bDepartment of Neurology, Memory Clinic, cDepartment of Neuroradiology, Hôpital Roger Salengro, F-59037 Lille, France
- Dr Florence Pasquier, Department of Neurology, Memory unit, Hôpital Roger Salengro, F-59037 Lille, France. Telephone 0033 320 44 5785; fax 0033 320 44 6028; email pasquier{at}chru-lille.fr
- Received 23 December 1997
- Revised 7 April 1998
- Accepted 13 May 1998
Abstract
OBJECTIVE The links between stroke and Alzheimer’s disease seem to be closer than expected by chance. In a previous study it was shown that up to 16% of patients admitted for stroke had pre-existing dementia. Medial temporal lobe atrophy (MTLA) is strongly associated with Alzheimer’s disease. The aim of this study was to determine the prevalence of MTLA and its relation with pre-existing dementia.
METHOD The study was conducted on 170 consecutive stroke patients (87 women; median age 75 years; 152 infarcts), who underwent non-contrast CT with temporal lobe oriented 2 mm contiguous slices at admission. A cut off point of 11.5 mm was used to differentiate patients with and without MTLA. Pre-existing dementia was assessed using the informant questionnaire on cognitive decline in the elderly (IQCODE) with a cut off score of 104.
RESULTS Ninety four patients (55.3%) had MTLA, of whom 23 (24.5%) had pre-existing dementia; of 76 patients without MTLA, only four (5.3%) had pre-existing dementia (p=0.0007). The logistic regression analysis with MTLA as dependent variable found the following independent variables: increasing age (p<0.05), and global cerebral atrophy scores (p<0.01). The IQCODE scores just reached significance (p=0.05).
CONCLUSION Stroke patients with MTLA are more likely to have pre-existing dementia; this suggests that Alzheimer’s disease might contribute to the dementia syndrome. A longitudinal follow up is now necessary to determine whether stroke patients with MTLA and without pre-existing dementia are at increased risk of Alzheimer’s disease over subsequent years.
