Investigation of reactive astrogliosis effect on post-stroke cognitive impairment

Kuo Lun Huang, Ing Tsung Hsiao, Meng Yang Ho, Jung Lung Hsu, Yeu Jhy Chang, Ting Yu Chang, Chi Hung Liu, Chien Hung Chang, Yi Ming Wu, Kuan Yi Wu, Shiaw Pyng Wey, Tzu Chen Yen, Nobuyuki Okamura, Tsong Hai Lee*, Kun Ju Lin*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

6 Scopus citations


Background: The aim of this study is to investigate the associations between post-stroke cognitive impairment (PSCI) severity and reactive astrogliosis (RA) extent on normalized 18F-THK-5351 positron-emission tomography (PET) imaging in amyloid-negative patients with first-ever stroke. Methods: We prospectively enrolled 63 amyloid-negative patients with first-ever stroke. Neurocognitive evaluation, MRI, 18F-THK-5351, and 18F-florbetapir PET were performed around 3 months after stroke. The 18F-THK-5351 uptake intensity was normalized using a signal distribution template to obtain the Z-SUM scores as the RA extent in the whole brain and cerebral hemisphere ipsilateral to stroke lesion. We evaluated stroke volume, leukoaraiosis, and brain atrophy on MRI. We used a comprehensive neurocognitive battery to obtain composite cognitive scores, and defined PSCI as a general cognitive function score < − 1. We analyzed the influence of Z-SUM scores on PSCI severity after adjusting for demographic, vascular, and neurodegenerative variables. Results: Twenty-five of 63 stroke patients had PSCI. Patients with PSCI had older age, lower education, and more severe cortical atrophy and total Z-SUM scores. Total Z-SUM scores were significantly associated with general cognitive and executive functions at multiple regression models. Path analyses showed that stroke can exert cognitive influence directly by stroke itself as well as indirectly through RA, including total and ipsilateral Z-SUM scores, in patients with either right or left hemisphere stroke. Conclusion: The patterns and intensity of 18F-THK-5351 uptake in amyloid-negative patients with first-ever stroke were associated with PSCI manifestations, which suggests that RA presents a modulating effect in PSCI development.

Original languageEnglish
Article number308
JournalJournal of Neuroinflammation
Issue number1
StatePublished - 01 12 2020

Bibliographical note

Publisher Copyright:
© 2020, The Author(s).


  • PET
  • Post-stroke cognitive impairment
  • Reactive astrogliosis
  • Stroke


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