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Neuronal substrate of cognitive impairment in post-stroke dementia

Vincent Deramecourt, Florence Pasquier
DOI: http://dx.doi.org/10.1093/brain/awu188 2404-2405 First published online: 14 August 2014

This scientific commentary refers to ‘Pyramidal neurons of the prefrontal cortex in post-stroke, vascular and other ageing-related dementias’, by V. Foster et al. (doi: 10.1093/brain/awu172).

Post-stroke dementia is a frequent cause of loss of independence following stroke, whereas post-stroke cognitive decline affects an even greater number of stroke survivors. The burden of post-stroke dementia and cognitive decline is likely to increase because of falling mortality rates after stroke, the ageing of Western populations, and longer life expectancies in developing countries. However, the pathological processes that increase vulnerability to cognitive decline in previously non-demented stroke survivors are unknown. In this issue of Brain, Foster et al. provide new clinicopathological evidence that selective regional pyramidal neuron atrophy in the dorsolateral prefrontal cortex, rather than a change in neuronal density per se, is associated with executive dysfunction in post-stroke dementia and vascular dementia (Foster et al., 2014).

The neuropathology of vascular cognitive impairment remains controversial for several reasons. First, cerebrovascular lesions are …

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