# Impact of Stroke History on Cognitive Function, White Matter Hyperintensities, and Circulating BDNF Levels

## TL;DR

This study shows that a history of stroke is linked to worse cognitive function, more brain lesions, and lower levels of a brain growth protein in older adults.

## Contribution

The study introduces a multi-biomarker approach combining cognitive tests, brain imaging, and blood markers to assess post-stroke neurological status.

## Key findings

- Patients with stroke history had significantly lower MoCA scores and BDNF levels.
- Stroke patients showed higher white matter lesion burden compared to non-stroke patients.
- Adjusting for age, sex, and residency confirmed the stroke-related differences in cognitive and biological markers.

## Abstract

The present study aims to investigate the impact of stroke history on cognitive function, white matter hyperintensities (WMHs), and circulating brain-derived neurotrophic factor (BDNF) levels in brain lesion patients.

In this study, we enrolled 228 individuals exhibiting clinical symptoms of stroke from the Golestan Cohort Study. The participants were categorized into two groups based on their stroke history. Subsequently, 120 patients with a history of stroke and 108 patients without obvious brain lesions were subjected to comparative analysis using magnetic resonance imaging (MRI). Montreal Cognitive Assessment (MoCA) and Fazekas scores were used to evaluate cognitive function and WMH burden, respectively. In addition, circulating BDNF levels were measured using the Human BDNF Elisa kit.

Totally, 228 patients were recruited in the study with a mean age of 63.8 years. Stroke was found in 52.6%. MoCA scores and plasma BDNF levels were significantly lower in patients with a history of stroke compared to people without such a history after adjusting for age, sex, education and type of residency (adjusted regression coefficient (RC) (95% CI)=-4.0 (-5.0 to -3.0), -3.2 (-4.2 to -2.2), respectively). In addition, the intensity burden of white matter was higher in the stroke group (adjusted RC (95% CI)=1.2 (0.8 to 1.6).

The study suggests that a multi-biomarker approach, encompassing measures such as the MoCA score, Fazekas score, and circulating BDNF levels, can provide valuable insight into the neurological status of post-stroke patients and highlight potential avenues for improving patient outcomes through early detection and intervention strategies.