Medial temporal lobe atrophy, white matter hyperintensities and cognitive impairment among Nigerian African stroke survivorsReport as inadecuate

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BMC Research Notes

, 8:625



BackgroundNeuroimaging 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.

MethodsStroke 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.

ResultsIn 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.

ConclusionsMedial 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.

KeywordsAfrica Brain atrophy Dementia Neuroimaging Nigeria Stroke Vascular cognitive impairment Vascular dementia AbbreviationsCRTchoice reaction time

CDRcognitive drug research

CogFASTCognitive Function After STroke

CSIDCommunity Screening Instrument for Dementia

MRImagenetic resonance imaging

MTAmedial temporal lobe atrophy

OCSPOxford Community Stroke Project Classification

PSDpost-stroke dementia

TBVtotal brain volume

VCIvascular cognitive impairment

vCINDvascular cognitive impairment no dementia

WMHwhite matter hyperintensities

WHOWorld Health Organization

Adesola Ogunniyi and Raj N. Kalaria equally contributed to this work

Electronic supplementary materialThe online version of this article doi:10.1186-s13104-015-1552-7 contains supplementary material, which is available to authorized users.

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Author: Rufus O. Akinyemi - Michael Firbank - Godwin I. Ogbole - Louise M. Allan - Mayowa O. Owolabi - Joshua O. Akinyemi - Bol


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