Abstract
BackgroundAlthough the most serious consequence of neuronal ischemia is acute neuronal death, mounting evidence suggests similarities between stroke and neurodegenerative disease. Brain atrophy visualized on structural MRI and pathological cerebrospinal fluid (CSF) concentrations of microtubule-associated protein tau (T-tau) and phosphorylated microtubule-associated protein tau indicate neurofibrillary degeneration. We aimed to explore the association between CSF T-tau and brain atrophy 1 year post-stroke.MethodsWe included 210 patients with first-ever ischemic stroke or transitory ischemic attack without pre-existing cognitive impairment. After 12 months, subjects underwent MRI, and CSF biomarkers were assessed. Using SIENAX (part of FSL), ventricular CSF volume and total brain volume were estimated and normalized for subject head size. The association between T-tau as explanatory variable and ventricular and total brain volume as outcome variables were studied using linear regression.ResultsOne hundred eighty-two patients completed the follow-up. Forty-four had a lumbar puncture. Of these, 31 had their MRI with identical scan parameters. Mean age was 70.2 years (SD 11.7). Ventricular volume on MRI was significantly associated with age, but not with gender. In the multiple regression model, there was a significant association between T-tau and both ventricular (beta 0.44, 95% CI 376.3, 394.9, p = 0.021) and global brain volume (beta −0.50, 95% CI −565.9, −78.3, p = 0.011). There was no significant association between CSF T-tau 1 year post-stroke and baseline volumes.ConclusionT-tau measured 1 year post-stroke is associated with measures of brain atrophy. The findings indicate that acute stroke may enhance or trigger tau-linked neurodegeneration with loss of neurons.Trial registrationClinicaltrials.gov NCT00506818, July 23, 2007.Inclusion from February 2007, randomization and intervention from May 2007 and trial registration in July 2007.
Highlights
The most serious consequence of neuronal ischemia is acute neuronal death, mounting evidence suggests similarities between stroke and neurodegenerative disease
Stroke considerably increases the risk of dementia, up to 50% will develop dementia post-stroke and stroke is more common in patients with dementia [5,6,7]
One year after first-ever stroke, we found a significant association between total microtubule-associated protein tau (T-tau) and measures of brain atrophy like ventricular and total brain volume
Summary
The most serious consequence of neuronal ischemia is acute neuronal death, mounting evidence suggests similarities between stroke and neurodegenerative disease. Brain atrophy visualized on structural MRI and pathological cerebrospinal fluid (CSF) concentrations of microtubule-associated protein tau (T-tau) and phosphorylated microtubule-associated protein tau indicate neurofibrillary degeneration. The most serious consequence of neuronal ischemia is acute neuronal death, mounting evidence suggests similarities between stroke and neurodegenerative diseases such as Alzheimer’s disease (AD) [1,2,3,4]. Vascular dementia and AD have many shared risk factors, and there seems to be an Established biomarkers of AD are cerebrospinal fluid (CSF) amyloid-β peptide (Aβ)-42 from amyloid plaques, CSF total microtubule-associated protein tau (T-tau) and phosphorylated microtubule-associated protein tau (P-tau). CSF T-tau is significantly increased the first days after ischemic stroke, peaking after 1–3 weeks with an apparent normalization after 3–5 months, and the
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