Stroke Recovery Tied to Brain Damage and Aging

During a stroke, damage that has been done to the brain partially predicts whether a person might recover their motor control. A study published in Neurology used MRI images to measure the area of the brain damaged by stroke and examined white matter hyperintensities which are damaged sites within the brain. 

The researchers also found that age-related changes within the brain’s white matter influence stroke recovery. This study is a handful to demonstrate a relationship between WMH and motor control after stroke and is part of a bigger movement. Researchers are continuing to investigate other global brain health markers on post-stroke motor recovery, and they have been studying the impact of brain ageing and are currently looking at the relationships between WMH and other brain health measures. 

Researchers have tracked 223 stroke patients across seven research sites in four countries. Participants were also asked about their motor control symptoms and those taking part in the study at different stages of recovery post-stroke.  

It was seen that white matter hyperintensity size and the area of the brain affected by stroke were both positively associated with motor control symptoms. People with fewer white matter hyperintensities had their motor control associated with the size of the area affected by the stroke. In contrast, for people with larger white matter hyperintensities, their symptoms exhibited a greater correlation with corticospinal tract damage. There were no significant differences observed between males and females. The authors suggest their findings could show that white matter hyperintensities modify an individual’s recovery of motor control after a stroke. White matter hyperintensities appear as they do on MRI scans since they represent areas where fluid is accumulated. 

They are present in over half of people over 60 and are associated with ageing. These areas have been shown to increase with age and are correlated with cognition and risk of Alzheimer’s disease (AD), though understanding of their cause is inconclusive. 

White matter hyperintensities are a radiological finding most commonly identified on a Fluid Attenuated Inversion Recovery (FLAIR) sequence of magnetic resonance imaging (MRI) brain scans. Previous research has shown that white matter hyperintensity volume is correlated with shorter telomere length. 

Telomeres are repetitive sequences of non-coding DNA that exist at the end of the chromosomes and shorten each time a cell divides, meaning that as we age, the telomeres in our cells shorten.WMH are white matter lesions in the brain that are thought to be due to reduced blood flow and/or ischemic damage due to vascular disease. They can be due to a lot of things, but recent research finds that they also be reversed. They are commonly associated with cognitive decline and risk of stroke and other vascular disorders. It is thought that lifestyle modifications to reduce high blood pressure can be very beneficial. While primary prevention is the best prevention, early secondary prevention still has great potential to significantly and positively impact many people at risk for end-stage disease such as stroke or dementia.