134| The Neuropsychology of Stroke – A Conversation With Dr. Ronald Lazar

In this episode, we discuss the neuropsychology of stroke with Dr. Ronald Lazar. Specific topics covered include definitions of cerebrovascular terminology, stroke epidemiology, neurovascular anatomy, neuroimaging techniques, risk factors, health disparities, prognosis, mental health factors, and both acute and long-term treatment strategies.

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About Ron

Dr. Lazar is a neuropsychologist with broad interests in aging and vascular disease, with emphases on reversible causes of cognitive decline, risk-factor modification to promote cognitive resiliency, and recovery after stroke. Dr. Lazar has been the Principal Investigator (PI) of multiple grants investigating stroke and cognitive functioning, funded by NIH, NHLBI, NICHD, NIDDK, NCI, and NIAID. His publications have appeared in the New England Journal of Medicine, Nature, Circulation, Brain, Neurology, Lancet Neurology, JAMA Neurology, Annals of Neurology, Brain, Cerebral Cortex, Stroke, JAMA Internal Medicine, the Journal of the American College of Cardiology, among many others. He has served as a permanent member of NIH study section and FDA advisory panel. He was Editor-in-Chief of Neuropsychology Review. His book, Neurovascular Neuropsychology (Springer), was published in 2009, with the next edition published in 2020.

References

Aburto, N. J., Ziolkovska, A., Hooper, L., Elliott, P., Cappuccio, F. P., & Meerpohl, J. J. (2013). Effect of lower sodium intake on Health: Systematic Review and Meta-analyses. BMJ, 346. https://doi.org/10.1136/bmj.f1326

Agarwal, S., Presciutti, A., Roth, W., Matthews, E., Rodriguez, A., Roh, D. J., Park, S., Claassen, J., & Lazar, R. M. (2018). Determinants of long-term neurological recovery patterns relative to hospital discharge among cardiac arrest survivors. Critical Care Medicine, 46(2). https://doi.org/10.1097/ccm.0000000000002846

AlHarbi, A., Alhayan, M.S., Alnami, S.K., Traad, R.S., Aldawsari, M.A., Saleh, Alharbi, A., Sharif, A.O., Alboqami, S., Alshammari, S.A., Alzeer, M.K., & Alshammari, M.A. (2020). Epidemiology and Risk Factors of Stroke.

Aparicio, H. J., Carr, B. G., Kasner, S. E., Kallan, M. J., Albright, K. C., Kleindorfer, D. O., & Mullen, M. T. (2015). Racial disparities in intravenous recombinant tissue plasminogen activator use persist at primary stroke centers. Journal of the American Heart Association, 4(10). https://doi.org/10.1161/jaha.115.001877

Barthels, D., & Das, H. (2020). Current advances in ischemic stroke research and therapies. Biochimica et Biophysica Acta (BBA) – Molecular Basis of Disease, 1866(4), 165260. https://doi.org/10.1016/j.bbadis.2018.09.012

Bertolin, M., Van Patten, R., Greif, T., & Fucetola, R. (2017). Predicting cognitive functioning, activities of daily living, and participation 6 months after mild to moderate stroke. Archives of Clinical Neuropsychology, 33(5), 562–576. https://doi.org/10.1093/arclin/acx096

Biesbroek, J. M., Weaver, N. A., & Biessels, G. J. (2017). Lesion location and cognitive impact of cerebral small vessel disease. Clinical Science, 131(8), 715–728. https://doi.org/10.1042/cs20160452

Boehme, A. K., Martin-Schild, S., Marshall, R. S., & Lazar, R. M. (2016). Effect of aphasia on acute stroke outcomes. Neurology87(22), 2348–2354. https://doi.org/10.1212/WNL.0000000000003297

Booth, J., Connelly, L., Lawrence, M., Chalmers, C., Joice, S., Becker, C., & Dougall, N. (2015). Evidence of perceived psychosocial stress as a risk factor for stroke in adults: A meta-analysis. BMC Neurology, 15(1). https://doi.org/10.1186/s12883-015-0456-4

Bowen, A., Lincoln, N., & Dewey, M. (2002). Cognitive rehabilitation for spatial neglect following stroke. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.cd003586

Bray, B. D., Paley, L., Hoffman, A., James, M., Gompertz, P., Wolfe, C. D., Hemingway, H., & Rudd, A. G. (2018). Socioeconomic disparities in first stroke incidence, quality of care, and survival: A nationwide registry-based Cohort Study of 44 million adults in England. The Lancet Public Health, 3(4). https://doi.org/10.1016/s2468-2667(18)30030-6

Bryan, R. N., Bilello, M., Davatzikos, C., Lazar, R. M., Murray, A., Horowitz, K., Lovato, J., Miller, M. E., Williamson, J., & Launer, L. J. (2014). Effect of diabetes on brain structure: the action to control cardiovascular risk in diabetes MR imaging baseline data. Radiology272(1), 210–216. https://doi.org/10.1148/radiol.14131494

Bushnell, C. D., Chaturvedi, S., Gage, K. R., Herson, P. S., Hurn, P. D., Jiménez, M. C., Kittner, S. J., Madsen, T. E., McCullough, L. D., McDermott, M., Reeves, M. J., & Rundek, T. (2018). Sex differences in stroke: Challenges and opportunities. Journal of Cerebral Blood Flow & Metabolism, 38(12), 2179–2191. https://doi.org/10.1177/0271678×18793324

Cai, W., Mueller, C., Li, Y.-J., Shen, W.-D., & Stewart, R. (2019). Post stroke depression and risk of stroke recurrence and mortality: A systematic review and meta-analysis. Ageing Research Reviews, 50, 102–109. https://doi.org/10.1016/j.arr.2019.01.013

Campbell, B. C., De Silva, D. A., Macleod, M. R., Coutts, S. B., Schwamm, L. H., Davis, S. M., & Donnan, G. A. (2019). Ischaemic stroke. Nature Reviews Disease Primers, 5(1). https://doi.org/10.1038/s41572-019-0118-8

Churchwell, K., Elkind, M. S. V., Benjamin, R. M., Carson, A. P., Chang, E. K., Lawrence, W., Mills, A., Odom, T. M., Rodriguez, C. J., Rodriguez, F., Sanchez, E., Sharrief, A. Z., Sims, M., & Williams, O. (2020). Call to action: Structural racism as a fundamental driver of Health Disparities: A presidential advisory from the American Heart Association. Circulation, 142(24). https://doi.org/10.1161/cir.0000000000000936

Coupland, A. P., Thapar, A., Qureshi, M. I., Jenkins, H., & Davies, A. H. (2017). The definition of stroke. Journal of the Royal Society of Medicine, 110(1), 9–12. https://doi.org/10.1177/0141076816680121

Cumming, T. B., Marshall, R. S., & Lazar, R. M. (2012). Stroke, cognitive deficits, and rehabilitation: Still an incomplete picture. International Journal of Stroke, 8(1), 38–45. https://doi.org/10.1111/j.1747-4949.2012.00972.x

Cushman, M., Cantrell, R. A., McClure, L. A., Howard, G., Prineas, R. J., Moy, C. S., Temple, E. M., & Howard, V. J. (2008). Estimated 10-year stroke risk by region and race in the United States. Annals of Neurology, 64(5), 507–513. https://doi.org/10.1002/ana.21493

Das, J., & G.K., R. (2018). Post stroke depression: The sequelae of cerebral stroke. Neuroscience & Biobehavioral Reviews, 90, 104–114. https://doi.org/10.1016/j.neubiorev.2018.04.005

Dehlendorff, C., Andersen, K. K., & Olsen, T. S. (2015). Sex disparities in stroke: Women have more severe strokes but better survival than men. Journal of the American Heart Association, 4(7). https://doi.org/10.1161/jaha.115.001967

Dunn, L. E., Schweber, A. B., Manson, D. K., Lendaris, A., Herber, C., Marshall, R. S., & Lazar, R. M. (2016). Variability in motor and language recovery during the acute stroke period. Cerebrovascular Diseases Extra, 6(1), 12–21. https://doi.org/10.1159/000444149

Elliott, M., & Parente, F. (2014). Efficacy of Memory Rehabilitation therapy: A meta-analysis of TBI and stroke cognitive rehabilitation literature. Brain Injury, 28(12), 1610–1616. https://doi.org/10.3109/02699052.2014.934921

Evans, F. A., Wong, D., & Stolwyk, R. J. (2020). Retrieval practice enhances memory for names in survivors of stroke. Neuropsychology, 34(8), 874–880. https://doi.org/10.1037/neu0000701

Feigin, V. L., & Norrving, B. (2014). A new paradigm for primary prevention strategy in people with elevated risk of stroke. International Journal of Stroke, 9(5), 624–626. https://doi.org/10.1111/ijs.12300

Feigin et al., Global, regional, and country-specific lifetime risks of stroke, 1990 and 2016. (2018). New England Journal of Medicine, 379(25), 2429–2437. https://doi.org/10.1056/nejmoa1804492

Feigin, V. L., Brainin, M., Norrving, B., Martins, S., Sacco, R. L., Hacke, W., Fisher, M., Pandian, J., & Lindsay, P. (2022). World Stroke Organization (WSO): Global stroke fact sheet 2022. International Journal of Stroke, 17(1), 18–29. https://doi.org/10.1177/17474930211065917

Feigin, V. L., Roth, G. A., Naghavi, M., Parmar, P., Krishnamurthi, R., Chugh, S., Mensah, G. A., Norrving, B., Shiue, I., Ng, M., Estep, K., Cercy, K., Murray, C. J., & Forouzanfar, M. H. (2016). Global burden of stroke and risk factors in 188 countries, during 1990–2013: A systematic analysis for the global burden of disease study 2013. The Lancet Neurology, 15(9), 913–924. https://doi.org/10.1016/s1474-4422(16)30073-4

Festa, J. R., Schwarz, L. R., Pliskin, N., Cullum, C. M., Lacritz, L., Charbel, F. T., Mathews, D., Starke, R. M., Connolly, E. S., Marshall, R. S., & Lazar, R. M. (2009). Neurocognitive dysfunction in adult moyamoya disease. Journal of Neurology, 257(5), 806–815. https://doi.org/10.1007/s00415-009-5424-8

Gardener, H., Sacco, R. L., Rundek, T., Battistella, V., Cheung, Y. K., & Elkind, M. S. V. (2020). Race and ethnic disparities in stroke incidence in the northern Manhattan study. Stroke, 51(4), 1064–1069. https://doi.org/10.1161/strokeaha.119.028806

Gerstenecker, A., & Lazar, R. M. (2019). Language recovery following stroke. The Clinical Neuropsychologist, 33(5), 928–947. https://doi.org/10.1080/13854046.2018.1562093

Gerstenecker, A., Norling, A. M., Jacob, A., & Lazar, R. M. (2022). Silent brain infarction, delirium, and cognition in three invasive cardiovascular procedures: A systematic review. Neuropsychology Review, 33(2), 474–491. https://doi.org/10.1007/s11065-022-09548-1

Gillespie, D. C., Bowen, A., Chung, C. S., Cockburn, J., Knapp, P., & Pollock, A. (2014). Rehabilitation for post-stroke Cognitive impairment: An overview of recommendations arising from systematic reviews of current evidence. Clinical Rehabilitation, 29(2), 120–128. https://doi.org/10.1177/0269215514538982

Gonzales, S., Mullen, M. T., Skolarus, L., Thibault, D. P., Udoeyo, U., & Willis, A. W. (2017). Progressive rural-urban disparity in acute stroke care. Neurology88(5), 441–448. https://doi.org/10.1212/WNL.0000000000003562

Gorelick, P. B. (2019). The global burden of stroke: Persistent and disabling. The Lancet Neurology, 18(5), 417–418. https://doi.org/10.1016/s1474-4422(19)30030-4

Grotta, J. C., Yamal, J.-M., Parker, S. A., Rajan, S. S., Gonzales, N. R., Jones, W. J., Alexandrov, A. W., Navi, B. B., Nour, M., Spokoyny, I., Mackey, J., Persse, D., Jacob, A. P., Wang, M., Singh, N., Alexandrov, A. V., Fink, M. E., Saver, J. L., English, J., … Bowry, R. (2021). Prospective, multicenter, controlled trial of Mobile Stroke Units. New England Journal of Medicine, 385(11), 971–981. https://doi.org/10.1056/nejmoa2103879

Guo, J., Wang, J., Sun, W., & Liu, X. (2021). The advances of post-stroke depression: 2021 update. Journal of Neurology, 269(3), 1236–1249. https://doi.org/10.1007/s00415-021-10597-4

Hachinski, V., Einhäupl, K., Ganten, D., Alladi, S., Brayne, C., Stephan, B. C. M., Sweeney, M. D., Zlokovic, B., Iturria‐Medina, Y., Iadecola, C., Nishimura, N., Schaffer, C. B., Whitehead, S. N., Black, S. E., Østergaard, L., Wardlaw, J., Greenberg, S., Friberg, L., Norrving, B., … Khachaturian, Z. S. (2019). Preventing dementia by preventing stroke: The Berlin Manifesto. Alzheimer’s & Dementia, 15(7), 961–984. https://doi.org/10.1016/j.jalz.2019.06.001

Harrington, R. A., Califf, R. M., Balamurugan, A., Brown, N., Benjamin, R. M., Braund, W. E., Hipp, J., Konig, M., Sanchez, E., & Joynt Maddox, K. E. (2020). Call to action: Rural health: A presidential advisory from the American Heart Association and American Stroke Association. Circulation, 141(10). https://doi.org/10.1161/cir.0000000000000753

Hathidara, M. Y., Saini, V., & Malik, A. M. (2019). Stroke in the young: A global update. Current Neurology and Neuroscience Reports, 19(11). https://doi.org/10.1007/s11910-019-1004-1

Howard, G., Cushman, M., Kissela, B. M., Kleindorfer, D. O., McClure, L. A., Safford, M. M., Rhodes, J. D., Soliman, E. Z., Moy, C. S., Judd, S. E., & Howard, V. J. (2011). Traditional risk factors as the underlying cause of racial disparities in stroke. Stroke, 42(12), 3369–3375. https://doi.org/10.1161/strokeaha.111.625277

Howard, G., Kissela, B. M., Kleindorfer, D. O., McClure, L. A., Soliman, E. Z., Judd, S. E., Rhodes, J. D., Cushman, M., Moy, C. S., Sands, K. A., & Howard, V. J. (2016). Differences in the role of black race and stroke risk factors for first vs. recurrent stroke. Neurology86(7), 637–642. https://doi.org/10.1212/WNL.0000000000002376

Hugenschmidt, C. E., Lovato, J. F., Ambrosius, W. T., Bryan, R. N., Gerstein, H. C., Horowitz, K. R., Launer, L. J., Lazar, R. M., Murray, A. M., Chew, E. Y., Danis, R. P., Williamson, J. D., Miller, M. E., & Ding, J. (2014). The cross-sectional and longitudinal associations of diabetic retinopathy with cognitive function and brain MRI findings: The action to control cardiovascular risk in diabetes (ACCORD) trial. Diabetes Care, 37(12), 3244–3252. https://doi.org/10.2337/dc14-0502

Jaeger, B. C., Anstey, D. E., Bress, A. P., Booth, J. N., Butler, M., Clark, D., Howard, G., Kalinowski, J., Long, D. L., Ogedegbe, G., Plante, T. B., Shimbo, D., Sims, M., Supiano, M. A., Whelton, P. K., & Muntner, P. (2019). Cardiovascular disease and mortality in adults aged ≥60 years according to recommendations by the American College of Cardiology/American Heart Association and American College of Physicians/American Academy of Family Physicians. Hypertension, 73(2), 327–334. https://doi.org/10.1161/hypertensionaha.118.12291

Jiménez-Balado, J., Riba-Llena, I., Abril, O., Garde, E., Penalba, A., Ostos, E., Maisterra, O., Montaner, J., Noviembre, M., Mundet, X., Ventura, O., Pizarro, J., & Delgado, P. (2019). Cognitive impact of cerebral small vessel disease changes in patients with hypertension. Hypertension, 73(2), 342–349. https://doi.org/10.1161/hypertensionaha.118.12090

Jokinen, H., Melkas, S., Ylikoski, R., Pohjasvaara, T., Kaste, M., Erkinjuntti, T., & Hietanen, M. (2015). Post‐stroke cognitive impairment is common even after successful clinical recovery. European Journal of Neurology, 22(9), 1288–1294. https://doi.org/10.1111/ene.12743

Kalaria, R. N. (2016). Neuropathological diagnosis of vascular cognitive impairment and vascular dementia with implications for alzheimer’s disease. Acta Neuropathologica, 131(5), 659–685. https://doi.org/10.1007/s00401-016-1571-z

Kalaria, R. N., Akinyemi, R., & Ihara, M. (2016). Stroke injury, cognitive impairment and vascular dementia. Biochimica et Biophysica Acta (BBA) – Molecular Basis of Disease, 1862(5), 915–925. https://doi.org/10.1016/j.bbadis.2016.01.015

Kamin Mukaz, D., Zakai, N. A., Cruz-Flores, S., McCullough, L. D., & Cushman, M. (2020). Identifying genetic and biological determinants of race-ethnic disparities in stroke in the United States. Stroke, 51(11), 3417–3424. https://doi.org/10.1161/strokeaha.120.030425

Khan, A., Kalaria, R. N., Corbett, A., & Ballard, C. (2016). Update on vascular dementia. Journal of Geriatric Psychiatry and Neurology, 29(5), 281–301. https://doi.org/10.1177/0891988716654987

Khan, M. I. (2018). The epidemiology of stroke in a developing country (Pakistan). Journal of Neurology & Stroke, 8(1). https://doi.org/10.15406/jnsk.2018.08.00275

Kim, J., Thayabaranathan, T., Donnan, G. A., Howard, G., Howard, V. J., Rothwell, P. M., Feigin, V., Norrving, B., Owolabi, M., Pandian, J., Liu, L., Cadilhac, D. A., & Thrift, A. G. (2020). Global stroke statistics 2019. International Journal of Stroke, 15(8), 819–838. https://doi.org/10.1177/1747493020909545

Kim, J. Y., Kang, K., Kang, J., Koo, J., Kim, D.-H., Kim, B. J., Kim, W.-J., Kim, E.-G., Kim, J. G., Kim, J.-M., Kim, J.-T., Kim, C., Nah, H.-W., Park, K.-Y., Park, M.-S., Park, J.-M., Park, J.-H., Park, T. H., Park, H.-K., … Bae, H.-J. (2019). Executive summary of stroke statistics in Korea 2018: A report from the Epidemiology Research Council of the korean stroke society. Journal of Stroke, 21(1), 42–59. https://doi.org/10.5853/jos.2018.03125

Kuriakose, D., & Xiao, Z. (2020). Pathophysiology and treatment of stroke: Present status and future perspectives. International Journal of Molecular Sciences, 21(20), 7609. https://doi.org/10.3390/ijms21207609

Lambertsen, K. L., Finsen, B., & Clausen, B. H. (2018). Post-stroke inflammation—target or tool for therapy? Acta Neuropathologica, 137(5), 693–714. https://doi.org/10.1007/s00401-018-1930-z

Lau, L., Lew, J., Borschmann, K., Thijs, V., & Ekinci, E. I. (2018). Prevalence of diabetes and its effects on stroke outcomes: A meta‐analysis and literature review. Journal of Diabetes Investigation, 10(3), 780–792. https://doi.org/10.1111/jdi.12932

Lawson, D. W., Stolwyk, R. J., Ponsford, J. L., McKenzie, D. P., Downing, M. G., & Wong, D. (2020). Telehealth delivery of memory rehabilitation following stroke. Journal of the International Neuropsychological Society, 26(1), 58–71. https://doi.org/10.1017/s1355617719000651

Lazar, R. M., & Antoniello, D. (2008). Variability in recovery from aphasia. Current neurology and neuroscience reports8(6), 497–502. https://doi.org/10.1007/s11910-008-0079-x

Lazar, R. M., & Marshall, R. S. (2013). Cerebral hemodynamics and cognitive decline: swimming against the current. Neurology80(23), 2086–2087. https://doi.org/10.1212/WNL.0b013e318295d7c3

Lazar, R. M., Minzer, B., Antoniello, D., Festa, J. R., Krakauer, J. W., & Marshall, R. S. (2010). Improvement in aphasia scores after stroke is well predicted by initial severity. Stroke, 41(7), 1485–1488. https://doi.org/10.1161/strokeaha.109.577338

Lazar, R. M., Howard, V. J., Kernan, W. N., Aparicio, H. J., Levine, D. A., Viera, A. J., Jordan, L. C., Nyenhuis, D. L., Possin, K. L., Sorond, F. A., & White, C. L. (2021). A primary care agenda for Brain Health: A Scientific Statement from the American Heart Association. Stroke, 52(6). https://doi.org/10.1161/str.0000000000000367

Lazar, R. M., Wadley, V. G., Myers, T., Jones, M. R., Heck, D. V., Clark, W. M., Marshall, R. S., Howard, V. J., Voeks, J. H., Manly, J. J., Moy, C. S., Chaturvedi, S., Meschia, J. F., Lal, B. K., Brott, T. G., & Howard, G. (2021). Baseline cognitive impairment in patients with asymptomatic carotid stenosis in the crest-2 trial. Stroke, 52(12), 3855–3863. https://doi.org/10.1161/strokeaha.120.032972

Levine, D. A., Galecki, A. T., Langa, K. M., Unverzagt, F. W., Kabeto, M. U., Giordani, B., & Wadley, V. G. (2015). Trajectory of cognitive decline after incident stroke. JAMA, 314(1), 41. https://doi.org/10.1001/jama.2015.6968

Levine, D. A., Chen, B., Galecki, A. T., Gross, A. L., Briceño, E. M., Whitney, R. T., Ploutz-Snyder, R. J., Giordani, B. J., Sussman, J. B., Burke, J. F., Lazar, R. M., Howard, V. J., Aparicio, H. J., Beiser, A. S., Elkind, M. S., Gottesman, R. F., Koton, S., Pendlebury, S. T., Sharma, A., … Hayward, R. A. (2023). Associations between vascular risk factor levels and cognitive decline among stroke survivors. JAMA Network Open, 6(5). https://doi.org/10.1001/jamanetworkopen.2023.13879

Lincoln, N., Majid, M., & Weyman, N. (2000). Cognitive rehabilitation for attention deficits following stroke. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.cd002842

Lyerly, M. J., Wu, T.-C., Mullen, M. T., Albright, K. C., Wolff, C., Boehme, A. K., Branas, C. C., Grotta, J. C., Savitz, S. I., & Carr, B. G. (2015). The effects of telemedicine on racial and ethnic disparities in access to acute stroke care. Journal of Telemedicine and Telecare, 22(2), 114–120. https://doi.org/10.1177/1357633×15589534

Magnani, J. W., Norby, F. L., Agarwal, S. K., Soliman, E. Z., Chen, L. Y., Loehr, L. R., & Alonso, A. (2016). Racial differences in atrial fibrillation-related cardiovascular disease and mortality. JAMA Cardiology, 1(4), 433. https://doi.org/10.1001/jamacardio.2016.1025

Marshall, R. S., Festa, J. R., Cheung, Y. K., Pavol, M. A., Derdeyn, C. P., Clarke, W. R., Videen, T. O., Grubb, R. L., Slane, K., Powers, W. J., Lazar, R. M., & RECON Investigators (2014). Randomized Evaluation of Carotid Occlusion and Neurocognition (RECON) trial: main results. Neurology82(9), 744–751. https://doi.org/10.1212/WNL.0000000000000167

Marshall, I. J., Wang, Y., Crichton, S., McKevitt, C., Rudd, A. G., & Wolfe, C. D. (2015). The effects of socioeconomic status on stroke risk and outcomes. The Lancet. Neurology14(12), 1206–1218. https://doi.org/10.1016/S1474-4422(15)00200-8

Marshall, R. S., Liebeskind, D. S., III, J. H., Edwards, L. J., Howard, G., Meschia, J. F., Brott, T. G., Lal, B. K., Heck, D., Lanzino, G., Sangha, N., Kashyap, V. S., Morales, C. D., Cotton-Samuel, D., Rivera, A. M., Brickman, A. M., & Lazar, R. M. (2023). Cortical thinning in high-grade asymptomatic carotid stenosis. Journal of Stroke, 25(1), 92–100. https://doi.org/10.5853/jos.2022.02285

Mathias, J. L., & Burke, J. (2009). Cognitive functioning in alzheimer’s and vascular dementia: A meta-analysis. Neuropsychology, 23(4), 411–423. https://doi.org/10.1037/a0015384

Medeiros, G. C., Roy, D., Kontos, N., & Beach, S. R. (2020). Post-stroke Depression: A 2020 updated review. General Hospital Psychiatry, 66, 70–80. https://doi.org/10.1016/j.genhosppsych.2020.06.011

Mendis S. (2010). Prevention and care of stroke in low- and middle-income countries; the need for a public health perspective. International journal of stroke : official journal of the International Stroke Society5(2), 86–91. https://doi.org/10.1111/j.1747-4949.2010.00406.x

Nannoni, S., de Groot, R., Bell, S., & Markus, H. S. (2020). Stroke in COVID-19: A systematic review and meta-analysis. International Journal of Stroke, 16(2), 137–149. https://doi.org/10.1177/1747493020972922

Nguyen, T. N., Qureshi, M. M., Klein, P., Yamagami, H., Mikulik, R., Czlonkowska, A., Abdalkader, M., Sedova, P., Sathya, A., Lo, H. C., Mansour, O. Y., Vanguru, H. R., Lesaine, E., Tsivgoulis, G., Loochtan, A. I., Demeestere, J., Uchino, K., Inoa, V., Goyal, N., … Nogueira, R. G. (2022). Global impact of the COVID-19 pandemic on stroke volumes and cerebrovascular events. Neurology, 100(4). https://doi.org/10.1212/wnl.0000000000201426

Norling, A. M., Marshall, R. S., Pavol, M. A., Howard, G., Howard, V., Liebeskind, D., Huston, J., Lal, B. K., Brott, T. G., & Lazar, R. M. (2019, January). Is Hemispheric Hypoperfusion a Treatable Cause of Cognitive Impairment? Current Cardiology Reports, 21(1). https://doi.org/10.1007/s11886-019-1089-9

O’Brien, J. T., & Thomas, A. (2015). Vascular dementia. Lancet (London, England)386(10004), 1698–1706. https://doi.org/10.1016/S0140-6736(15)00463-8

O’Donnell, M. J., Xavier, D., Liu, L., Zhang, H., Chin, S. L., Rao-Melacini, P., Rangarajan, S., Islam, S., Pais, P., McQueen, M. J., Mondo, C., Damasceno, A., Lopez-Jaramillo, P., Hankey, G. J., Dans, A. L., Yusoff, K., Truelsen, T., Diener, H. C., Sacco, R. L., Ryglewicz, D., … INTERSTROKE investigators (2010). Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet (London, England)376(9735), 112–123. https://doi.org/10.1016/S0140-6736(10)60834-3

Ojike, N., & Azizi, S. (2016). Racial Disparity in Stroke Awareness in the US: An Analysis of the 2014 National Health Interview Survey. Journal of Neurology & Neurophysiology, 07(02). https://doi.org/10.4172/2155-9562.1000365

Østergaard, L., Engedal, T. S., Moreton, F., Hansen, M. B., Wardlaw, J. M., Dalkara, T., Markus, H. S., & Muir, K. W. (2015, October 14). Cerebral small vessel disease: Capillary pathways to stroke and cognitive decline. Journal of Cerebral Blood Flow & Metabolism, 36(2), 302–325. https://doi.org/10.1177/0271678×15606723

Owolabi, M. O., Thrift, A. G., Mahal, A., Ishida, M., Martins, S., Johnson, W. D., Pandian, J., Abd-Allah, F., Yaria, J., Phan, H. T., Roth, G., Gall, S. L., Beare, R., Phan, T. G., Mikulik, R., Akinyemi, R. O., Norrving, B., Brainin, M., Feigin, V. L., . . . Zhang, P. (2022, January). Primary stroke prevention worldwide: translating evidence into action. The Lancet Public Health, 7(1), e74–e85. https://doi.org/10.1016/s2468-2667(21)00230-9

Pan, B., Jin, X., Jun, L., Qiu, S., Zheng, Q., & Pan, M. (2019). The relationship between smoking and stroke: A meta-analysis. Medicine98(12), e14872. https://doi.org/10.1097/MD.0000000000014872

Pandian, J. D., Gall, S. L., Kate, M. P., Silva, G. S., Akinyemi, R. O., Ovbiagele, B. I., Lavados, P. M., Gandhi, D. B. C., & Thrift, A. G. (2018). Prevention of stroke: a global perspective. Lancet (London, England)392(10154), 1269–1278. https://doi.org/10.1016/S0140-6736(18)31269-8

Pavol, M. A., Stein, J., Kabir, F. M., Yip, J., Sorkin, L. Y., Marshall, R. S., & Lazar, R. M. (2017). Understanding the Connection between Cognitive Impairment and Mobility: What Can Be Gained from Neuropsychological Assessment? Rehabilitation Research and Practice, 2017, 1–7. https://doi.org/10.1155/2017/4516219

Pavol, M. A., Boehme, A. K., Willey, J. Z., Festa, J. R., Lazar, R. M., Nakagawa, S., Casida, J., Yuzefpolskaya, M., & Colombo, P. C. (2020, September 10). Predicting post-LVAD outcome: Is there a role for cognition? The International Journal of Artificial Organs, 44(4), 237–242. https://doi.org/10.1177/0391398820956661

Phipps, M. S., & Cronin, C. A. (2020, February 13). Management of acute ischemic stroke. BMJ, l6983. https://doi.org/10.1136/bmj.l6983

Price, C. C., Jefferson, A. L., Merino, J. G., Heilman, K. M., & Libon, D. J. (2005). Subcortical vascular dementia: integrating neuropsychological and neuroradiologic data. Neurology65(3), 376–382. https://doi.org/10.1212/01.wnl.0000168877.06011.15

Prior, P. L., & Suskin, N. (2018, June). Exercise for stroke prevention. Stroke and Vascular Neurology, 3(2), 59–68. https://doi.org/10.1136/svn-2018-000155

Rabinstein A. A. (2020). Update on Treatment of Acute Ischemic Stroke. Continuum (Minneapolis, Minn.)26(2), 268–286. https://doi.org/10.1212/CON.0000000000000840

Ramos-Lima, M. J. M., Brasileiro, I. D. C., de Lima, T. L., & Braga-Neto, P. (2018). Quality of life after stroke: impact of clinical and sociodemographic factors. Clinics, 73, e418. https://doi.org/10.6061/clinics/2017/e418

Reford, E., & Kellner, C. P. (2022, March). Stroke and COVID-19: The Value of Narrative Medicine. Stroke, 53(3). https://doi.org/10.1161/strokeaha.121.037003

Rexrode, K. M., Madsen, T. E., Yu, A. Y., Carcel, C., Lichtman, J. H., & Miller, E. C. (2022, February 18). The Impact of Sex and Gender on Stroke. Circulation Research, 130(4), 512–528. https://doi.org/10.1161/circresaha.121.319915

Robinson, R. G., & Jorge, R. E. (2016). Post-Stroke Depression: A Review. The American journal of psychiatry173(3), 221–231. https://doi.org/10.1176/appi.ajp.2015.15030363

Rogers, J. M., Foord, R., Stolwyk, R. J., Wong, D., & Wilson, P. H. (2018, July 13). General and Domain-Specific Effectiveness of Cognitive Remediation after Stroke: Systematic Literature Review and Meta-Analysis. Neuropsychology Review, 28(3), 285–309. https://doi.org/10.1007/s11065-018-9378-4

Román, G. C., Erkinjuntti, T., Wallin, A., Pantoni, L., & Chui, H. C. (2002). Subcortical ischaemic vascular dementia. The Lancet. Neurology1(7), 426–436. https://doi.org/10.1016/s1474-4422(02)00190-4

Sacco, R. L., Boden-Albala, B., Abel, G., Lin, I. F., Elkind, M., Hauser, W. A., Paik, M. C., & Shea, S. (2001). Race-ethnic disparities in the impact of stroke risk factors: the northern Manhattan stroke study. Stroke32(8), 1725–1731. https://doi.org/10.1161/01.str.32.8.1725

Sacco, R. L., Kasner, S. E., Broderick, J. P., Caplan, L. R., Connors, J. B., Culebras, A., Elkind, M. S., George, M. G., Hamdan, A. D., Higashida, R. T., Hoh, B. L., Janis, L. S., Kase, C. S., Kleindorfer, D. O., Lee, J. M., Moseley, M. E., Peterson, E. D., Turan, T. N., Valderrama, A. L., & Vinters, H. V. (2013, July). An Updated Definition of Stroke for the 21st Century. Stroke, 44(7), 2064–2089. https://doi.org/10.1161/str.0b013e318296aeca

Sacco, R. L., Gardener, H., Wang, K., Dong, C., Ciliberti‐Vargas, M. A., Gutierrez, C. M., Asdaghi, N., Burgin, W. S., Carrasquillo, O., Garcia‐Rivera, E. J., Nobo, U., Oluwole, S., Rose, D. Z., Waters, M. F., Zevallos, J. C., Robichaux, M., Waddy, S. P., Romano, J. G., Rundek, T., . . . Yavagal, D. (2017, February 2). Racial‐Ethnic Disparities in Acute Stroke Care in the Florida‐Puerto Rico Collaboration to Reduce Stroke Disparities Study. Journal of the American Heart Association, 6(2). https://doi.org/10.1161/jaha.116.004073

Safford, M. M., Brown, T. M., Muntner, P. M., Durant, R. W., Glasser, S., Halanych, J. H., Shikany, J. M., Prineas, R. J., Samdarshi, T., Bittner, V. A., Lewis, C. E., Gamboa, C., Cushman, M., Howard, V., Howard, G., & REGARDS Investigators (2012). Association of race and sex with risk of incident acute coronary heart disease events. JAMA308(17), 1768–1774. https://doi.org/10.1001/jama.2012.14306

Schöttke, H., & Giabbiconi, C. M. (2015, July 16). Post-stroke depression and post-stroke anxiety: prevalence and predictors. International Psychogeriatrics, 27(11), 1805–1812. https://doi.org/10.1017/s1041610215000988

Schroff, P., Gamboa, C. M., Durant, R. W., Oikeh, A., Richman, J. S., & Safford, M. M. (2017, September 22). Vulnerabilities to Health Disparities and Statin Use in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study. Journal of the American Heart Association, 6(9). https://doi.org/10.1161/jaha.116.005449

Seabury, S., Bognar, K., Xu, Y., Huber, C., Commerford, S. R., & Tayama, D. (2017, September). Regional disparities in the quality of stroke care. The American Journal of Emergency Medicine, 35(9), 1234–1239. https://doi.org/10.1016/j.ajem.2017.03.046

Shehjar, F., Maktabi, B., Rahman, Z. A., Bahader, G. A., James, A. W., Naqvi, A., Mahajan, R., & Shah, Z. A. (2023, January). Stroke: Molecular mechanisms and therapies: Update on recent developments. Neurochemistry International, 162, 105458. https://doi.org/10.1016/j.neuint.2022.105458

Shi, Y., Yang, D., Zeng, Y., & Wu, W. (2017, July 11). Risk Factors for Post-stroke Depression: A Meta-analysis. Frontiers in Aging Neuroscience, 9. https://doi.org/10.3389/fnagi.2017.00218

Shufflebarger, E. F., Walter, L. A., Gropen, T. I., Madsen, T. E., Harrigan, M. R., Lazar, R. M., Bice, J., Baldwin, C. S., & Lyerly, M. J. (2022, June). Educational Intervention in the Emergency Department to Address Disparities in Stroke Knowledge. Journal of Stroke and Cerebrovascular Diseases, 31(6), 106424. https://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106424

Skolarus, L. E., Sharrief, A., Gardener, H., Jenkins, C., & Boden-Albala, B. (2020, November). Considerations in Addressing Social Determinants of Health to Reduce Racial/Ethnic Disparities in Stroke Outcomes in the United States. Stroke, 51(11), 3433–3439. https://doi.org/10.1161/strokeaha.120.030426

Small, C., Mehkri, Y., Panther, E., Felisma, P., & Lucke-Wold, B. (2022, June 28). Coronavirus Disease-2019 and Stroke: Pathophysiology and Management. Canadian Journal of Neurological Sciences / Journal Canadien Des Sciences Neurologiques, 50(4), 495–502. https://doi.org/10.1017/cjn.2022.267

Smith, E. (2017, May 17). Clinical presentations and epidemiology of vascular dementia. Clinical Science, 131(11), 1059–1068. https://doi.org/10.1042/cs20160607

Soun, J., Chow, D., Nagamine, M., Takhtawala, R., Filippi, C., Yu, W., & Chang, P. (2020, November 26). Artificial Intelligence and Acute Stroke Imaging. American Journal of Neuroradiology, 42(1), 2–11. https://doi.org/10.3174/ajnr.a6883

Spence, J. D., de Freitas, G. R., Pettigrew, L. C., Ay, H., Liebeskind, D. S., Kase, C. S., Del Brutto, O. H., Hankey, G. J., & Venketasubramanian, N. (2020). Mechanisms of Stroke in COVID-19. Cerebrovascular Diseases, 49(4), 451–458. https://doi.org/10.1159/000509581

Stamm, B., Huang, D., Royan, R., Lee, J., Marquez, J., & Desai, M. (2022, January 29). Pathomechanisms and Treatment Implications for Stroke in COVID-19: A Review of the Literature. Life, 12(2), 207. https://doi.org/10.3390/life12020207

Stefanidis, K. B., Askew, C. D., Greaves, K., & Summers, M. J. (2017, August 30). The Effect of Non-Stroke Cardiovascular Disease States on Risk for Cognitive Decline and Dementia: A Systematic and Meta-Analytic Review. Neuropsychology Review, 28(1), 1–15. https://doi.org/10.1007/s11065-017-9359-z

Strambo, D., De Marchis, G. M., Bonati, L. H., Arnold, M., Carrera, E., Galletta, S., Nedeltchev, K., Kahles, T., Cereda, C. W., Bianco, G., Kägi, G., Luft, A. R., Bolognese, M., Lakatos, L., Salmen, S., Correia, P., Sturzenegger, R., Sylvan, A., Medlin, F., . . . Michel, P. (2021, December 9). Ischemic stroke in COVID‐19 patients: Mechanisms, treatment, and outcomes in a consecutive Swiss Stroke Registry analysis. European Journal of Neurology, 29(3), 732–743. https://doi.org/10.1111/ene.15199

Sun, J. H., Tan, L., Wang, H. F., Tan, M. S., Tan, L., Li, J. Q., Xu, W., Zhu, X. C., Jiang, T., & Yu, J. T. (2015, June 25). Genetics of Vascular Dementia: Systematic Review and Meta-Analysis. Journal of Alzheimer’s Disease, 46(3), 611–629. https://doi.org/10.3233/jad-143102

Tang, E. Y., Amiesimaka, O., Harrison, S. L., Green, E., Price, C., Robinson, L., Siervo, M., & Stephan, B. C. (2018, January 23). Longitudinal Effect of Stroke on Cognition: A Systematic Review. Journal of the American Heart Association, 7(2). https://doi.org/10.1161/jaha.117.006443

Trinh, M. H., Agénor, M., Austin, S. B., & Jackson, C. L. (2017, December). Health and healthcare disparities among U.S. women and men at the intersection of sexual orientation and race/ethnicity: a nationally representative cross-sectional study. BMC Public Health, 17(1). https://doi.org/10.1186/s12889-017-4937-9

Tsivgoulis, G., Katsanos, A. H., Ornello, R., & Sacco, S. (2020, July). Ischemic Stroke Epidemiology During the COVID-19 Pandemic. Stroke, 51(7), 1924–1926. https://doi.org/10.1161/strokeaha.120.030791

Ueno, M., Chiba, Y., Matsumoto, K., Murakami, R., Fujihara, R., Kawauchi, M., Miyanaka, H., & Nakagawa, T. (2015, November 26). Blood‐brain barrier damage in vascular dementia. Neuropathology, 36(2), 115–124. https://doi.org/10.1111/neup.12262

Van Patten, R., Merz, Z. C., Mulhauser, K., & Fucetola, R. (2016, December). Multivariable Prediction of Return to Work at 6-Month Follow-Up in Patients With Mild to Moderate Acute Stroke. Archives of Physical Medicine and Rehabilitation, 97(12), 2061-2067.e1. https://doi.org/10.1016/j.apmr.2016.06.006

van Sloten, T. T., Protogerou, A. D., Henry, R. M., Schram, M. T., Launer, L. J., & Stehouwer, C. D. (2015, June). Association between arterial stiffness, cerebral small vessel disease and cognitive impairment: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 53, 121–130. https://doi.org/10.1016/j.neubiorev.2015.03.011

Villa, R. F., Ferrari, F., & Moretti, A. (2018, April). Post-stroke depression: Mechanisms and pharmacological treatment. Pharmacology & Therapeutics, 184, 131–144. https://doi.org/10.1016/j.pharmthera.2017.11.005

Wajngarten, M., & Silva, G. S. (2019). Hypertension and Stroke: Update on Treatment. European cardiology14(2), 111–115. https://doi.org/10.15420/ecr.2019.11.1

Wallin, A., Román, G. C., Esiri, M., Kettunen, P., Svensson, J., Paraskevas, G. P., & Kapaki, E. (2018, March 13). Update on Vascular Cognitive Impairment Associated with Subcortical Small-Vessel Disease. Journal of Alzheimer’s Disease, 62(3), 1417–1441. https://doi.org/10.3233/jad-170803

Wei, N., Yong, W., Li, X., Zhou, Y., Deng, M., Zhu, H., & Jin, H. (2014, October 12). Post-stroke depression and lesion location: a systematic review. Journal of Neurology, 262(1), 81–90. https://doi.org/10.1007/s00415-014-7534-1

Williamson, J. D., Launer, L. J., Bryan, R. N., Coker, L. H., Lazar, R. M., Gerstein, H. C., Murray, A. M., Sullivan, M. D., Horowitz, K. R., Ding, J., Marcovina, S., Lovato, L., Lovato, J., Margolis, K. L., Davatzikos, C., Barzilay, J., Ginsberg, H. N., Linz, P. E., Miller, M. E., & Action to Control Cardiovascular Risk in Diabetes Memory in Diabetes Investigators (2014). Cognitive function and brain structure in persons with type 2 diabetes mellitus after intensive lowering of blood pressure and lipid levels: a randomized clinical trial. JAMA internal medicine174(3), 324–333. https://doi.org/10.1001/jamainternmed.2013.13656

Withiel, T., Wong, D., Ponsford, J., Cadilhac, D., New, P., Mihaljcic, T., & Stolwyk, R. (2019). Comparing memory group training and computerized cognitive training for improving memory function following stroke: A phase II randomized controlled trial. Journal of Rehabilitation Medicine, 51(5), 343–351. https://doi.org/10.2340/16501977-2540

Wong, D., Kempnich, C., Bradshaw, J., Grayson, S., Lillywhite, L., O’Shea, M., Kim, J., Stolwyk, R., & Cadilhac, D. A. (2020, October 20). Real world implementation of a group-based memory rehabilitation program into stroke services: A knowledge translation evaluation. Topics in Stroke Rehabilitation, 28(6), 410–421. https://doi.org/10.1080/10749357.2020.1838084

Yaghi, S., Herber, C., Willey, J. Z., Andrews, H. F., Boehme, A. K., Marshall, R. S., Lazar, R. M., & Boden-Albala, B. (2015, November). Itemized NIHSS subsets predict positive MRI strokes in patients with mild deficits. Journal of the Neurological Sciences, 358(1–2), 221–225. https://doi.org/10.1016/j.jns.2015.08.1548

Yaghi, S., Cotsonis, G., de Havenon, A., Prahbakaran, S., Romano, J. G., Lazar, R. M., Marshall, R. S., Feldmann, E., & Liebeskind, D. S. (2020, April). Poststroke Montreal Cognitive Assessment and Recurrent Stroke in Patients With Symptomatic Intracranial Atherosclerosis. Journal of Stroke and Cerebrovascular Diseases, 29(4), 104663. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104663

Yoshimura, S., Sakai, N., Yamagami, H., Uchida, K., Beppu, M., Toyoda, K., Matsumaru, Y., Matsumoto, Y., Kimura, K., Takeuchi, M., Yazawa, Y., Kimura, N., Shigeta, K., Imamura, H., Suzuki, I., Enomoto, Y., Tokunaga, S., Morita, K., Sakakibara, F., Kinjo, N., … Morimoto, T. (2022). Endovascular Therapy for Acute Stroke with a Large Ischemic Region. The New England journal of medicine386(14), 1303–1313. https://doi.org/10.1056/NEJMoa2118191

Zhao, D., Liu, J., Wang, M., Zhang, X., & Zhou, M. (2018, November 22). Epidemiology of cardiovascular disease in China: current features and implications. Nature Reviews Cardiology, 16(4), 203–212. https://doi.org/10.1038/s41569-018-0119-4

 

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