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Risk Factors for Aphasia in Cerebral Small Vessel Diseases: A Retrospective Analysis

Author(s):

Jiawei Xin, Xuanyu Huang*, Xiaodong Pan, Lin Lin, Mingyao Sun, Chen Liu and Qinyong Ye*  

Abstract:


Background: Lacunes and white matter hyperintensities (WMH) are two common findings seen on neuroimaging of cerebral small vessel disease (cSVD). Clinically we observed that some patients with cSVD have aphasia through the language assessment scale. Our study aimed to explore the underlying risk factors for aphasia in cSVD patients, and provide an effective method of assessment and intervention for clinical practice.

Methods: This study retrospectively analyzed 38 patients, with and without aphasia, aged 50 or over, Chinese Han population, diagnosed as cSVD with lacunes and/or WMH. Two groups were frequency matched according to race, nation and index year, and were similar in sex and age. We collected characteristics and prospective risk factors. The severity of WMH was assessed by the Age Related White Matter Changes (ARWMC) rating scale. All the prospective risk factors were examined.

Results: Risk factors associated with aphasia were lower education (p = 0.029), higher total cholesterol (TC) levels (p = 0.023), higher low-density lipoprotein cholesterol (LDL-C) levels (p = 0.027). After controlling for age and sex, levels of TC (odds ratios, 1.96; 95% confidence interval, 1.06-3.62; p = 0.032) remained associated with aphasia independently.

Conclusion: High levels of TC and LDL-C were significantly associated with a higher risk of aphasia in clinically silent cSVD patients. Early interventions including lipid-lowering treatment, cranial MRI and ARWMC rating scale should be performed. Further studies are needed to explore proper methods of prevention and treatment for aphasia in clinically silent cSVD patients, in addition to understanding the pathophysiological mechanism.

Keywords:

aphasia, cerebral small vessel disease, cSVD, lacune, risk factors, white matter hyperintensities, WMH

Affiliation:

Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, Fujian, , Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, Fujian, , Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, Fujian, , Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, Fujian, , Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, Fujian, , Fujian Medical University, Fuzhou, Fujian, Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, Fujian



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