Default mode network neurodegeneration reveals the remote effects of ischaemic stroke

Introduction

Dementia is estimated to occur in 15%–30% patients after ischaemic stroke.1 Stroke may initiate or accelerate neurodegeneration associated with cognitive impairment.1 Brain atrophy is an important marker of neurodegeneration, preceding the emergence of cognitive symptoms in Alzheimer's disease (AD).2 Atrophy occurs in distributed regions that collectively mirror known brain networks, including the default mode network (DMN). Atrophy and dysfunction within the DMN is evident in healthy ageing, accelerated in pathological ageing2 and evident in acute and subacute stroke.3 Lesion location rarely predicts long-term outcome in stroke. Network-wide changes may better explain neurodegeneration and conversion to dementia after stroke. Atrophy after stroke has not been well investigated and has been limited to cross-sectional studies and regional volume changes.

Structural covariance is an increasingly popular method of examining network-wide correlations in morphometric estimates of brain structure, such as cortical thickness or grey...

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