Background: Although the most serious consequence of neuronal ischemia is acute neuronal death, mounting\nevidence suggests similarities between stroke and neurodegenerative disease. Brain atrophy visualized on structural\nMRI and pathological cerebrospinal fluid (CSF) concentrations of microtubule-associated protein tau (T-tau) and\nphosphorylated microtubule-associated protein tau indicate neurofibrillary degeneration. We aimed to explore the\nassociation between CSF T-tau and brain atrophy 1 year post-stroke.\nMethods: We included 210 patients with first-ever ischemic stroke or transitory ischemic attack without pre-existing\ncognitive impairment. After 12 months, subjects underwent MRI, and CSF biomarkers were assessed. Using SIENAX\n(part of FSL), ventricular CSF volume and total brain volume were estimated and normalized for subject head size.\nThe association between T-tau as explanatory variable and ventricular and total brain volume as outcome variables\nwere studied using linear regression.\nResults: One hundred eighty-two patients completed the follow-up. Forty-four had a lumbar puncture. Of these, 31\nhad their MRI with identical scan parameters. Mean age was 70.2 years (SD 11.7). Ventricular volume on MRI was\nsignificantly associated with age, but not with gender. In the multiple regression model, there was a significant\nassociation between T-tau and both ventricular (beta 0.44, 95% CI 376.3, 394.9, p = 0.021) and global brain volume\n(beta âË?â??0.50, 95% CI âË?â??565.9, âË?â??78.3, p = 0.011). There was no significant association between CSF T-tau 1 year poststroke\nand baseline volumes.\nConclusion: T-tau measured 1 year post-stroke is associated with measures of brain atrophy. The findings indicate\nthat acute stroke may enhance or trigger tau-linked neurodegeneration with loss of neurons.
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