Neural Regeneration Research ›› 2013, Vol. 8 ›› Issue (4): 346-356.doi: 10.3969/j.issn.1673-5374.2013.04.007

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Atrophy of the left dorsolateral prefrontal cortex is associated with poor performance in verbal fluency in elderly poststroke women

Yang-Kun Chen1, Wei-Min Xiao1, Defeng Wang2, Lin Shi2, Winnie CW Chu2, Vincent CT Mok3, Ka Sing Wong3, Gabor S Ungvari4, Wai Kwong Tang5   

  1. 1 Department of Neurology, Dongguan People’s Hospital, Dongguan 523059, Guangdong Province, China
    2 Department of Diagnostic Radiology and Organ Imaging, the Chinese University of Hong Kong, Hong Kong SAR 999077, China
    3 Department of Medicine and Therapeutics, the Chinese University of Hong Kong, Hong Kong SAR 999077, China
    4 Graylands Hospital, School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth 6005, Australia
    5 Department of Psychiatry, the Chinese University of Hong Kong, Hong Kong SAR 999077, China
  • Received:2012-11-12 Revised:2013-01-10 Online:2013-02-05 Published:2013-02-05
  • Contact: Wai Kwong Tang, M.D., Professor, Department of Psychiatry, Shatin Hospital, Shatin, N.T., Hong Kong, China, tangwk@cuhk.edu.hk.
  • About author:Yang-Kun Chen☆, M.D., Ph.D
  • Supported by:

    This study was supported by the Research Grants Council of the Hong Kong SAR, No. 452906.

Abstract:

This study aimed to investigate the association between atrophy in the prefrontal cortex with executive function and verbal fluency in elderly male and female patients poststroke. Thirty elderly female patients with non-aphasic ischemic stroke aged ≥ 60 years and 30 age-matched non-aphasic male patients with ischemic stroke were recruited. Automatic magnetic resonance imaging segmentation was used to assess the volume of the whole prefrontal cortex, along with its subdivisions: anterior cingulate cortex, orbitofrontal cortex and dorsolateral prefrontal cortex. The Semantic Verbal Fluency Test was administered at 3 and 15 months poststroke. At 3 months poststroke, left dorsolateral prefrontal cortex volume was significantly correlated with Verbal Fluency Test score in female patients only (partial coefficient = 0.453, P = 0.045), after controlling for age, education, diabetes, neurological deficit, white matter lesions volume, as well as the location and volume of infarcts. At 15 months poststroke, there remained a significant association between the left dorsolateral prefrontal cortex volume and Verbal Fluency Test (partial coefficient = 0.661, P = 0.001) and between the left prefrontal cortex volume and Verbal Fluency Test (partial coefficient = 0.573, P = 0.004) in female patients after the same adjustments. These findings indicate that atrophy of the left dorsolateral prefrontal cortex contributes to the impairment of verbal fluency in elderly female patients with stroke. Sex differences may be present in the neuropsychological mechanisms of verbal fluency impairment in patients with stroke.

Key words: neural regeneration, neuroimaging, brain atrophy, verbal fluency, executive function, stroke, sex differences, prefrontal cortex, dorsolateral prefrontal cortex, magnetic resonance imaging, grants-supported paper, photographs-containing paper, neuroregeneration