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NINDS AIREN neuroimaging criteria do not distinguish stroke patients with and without dementia

From the Wolfson Centre for Age Related Diseases (Dr. Ballard), King’s College London, and Institute for Aging and Health (Drs. Burton, Barber, Kenny, Kalaria, and O’Brien, S. Stephens), University of Newcastle, UK.

Address correspondence and reprint requests to Dr. C.G. Ballard, Wolfson Centre for Age Related Diseases, Guys Campus, King’s College London, London, UK; e-mail: clive.ballard{at}kcl.ac.uk

Objective: To determine the utility of the neuroimaging component within the National Institute of Neurological Disorders and Stroke (NINDS) Association Internationale pour la Recherche et l’Enseignement en Neurosciences (AIREN) criteria for vascular dementia for distinguishing between patients with and without dementia in the context of cerebrovascular disease.

Method: One hundred twenty-five poststroke patients age 75 (27 with and 98 without poststroke dementia) from representative hospital-based stroke registers in the North East of England were evaluated using a 1.5 T MR scanner. The proportion of patients with and without poststroke dementia meeting the imaging component of the NINDS AIREN criteria was determined, and hippocampal atrophy (measured using the Schelten scale) was compared between the two groups.

Results: There were no significant differences between the patients with and without poststroke dementia on any criteria of the imaging parameters within the NINDS AIREN criteria. In addition, there were no significant differences in the number or size of cortical or subcortical infarcts between the two groups, with 13 patients without dementia having cortical infarcts >50 mm. Patients with dementia had greater hippocampal atrophy (right: Mann–Whitney U test, Z = 2.5, p = 0.01; left: Mann–Whitney U test, Z = 2.5, p = 0.01).

Conclusion: The neuroimaging component of the NINDS AIREN criteria does not distinguish between older patients with and without poststroke dementia.

Received December 12, 2003. Accepted in final form May 17, 2004.

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