Please use this identifier to cite or link to this item: http://theses.ncl.ac.uk/jspui/handle/10443/2409
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dc.contributor.authorAkinyemi, Rufus Olusola-
dc.date.accessioned2014-10-16T15:29:10Z-
dc.date.available2014-10-16T15:29:10Z-
dc.date.issued2014-
dc.identifier.urihttp://hdl.handle.net/10443/2409-
dc.descriptionPhD Thesisen_US
dc.description.abstractOne in three people over a life time will develop a stroke, dementia or both but little is known about stroke - related cognitive impairment despite current epidemiologic transition in sub - Saharan Africa. The CogFAST Study was established in Newcastle to unmask risk factors, pathological substrates and cellular mechanisms underlying cerebral injury and cognitive impairment following stroke. The overall aim of this thesis was to establish a comparative cohort in Nigerian African stroke survivors and explore mechanisms in post - mortem brains accrued from the Newcastle cohort. Two hundred and twenty Nigerian African stroke survivors were screened three months after index stroke out of whom 143 eligible participants underwent cognitive assessment in comparison with 74 stroke - free healthy controls. We found a high frequency (49.3%) of early vascular cognitive impairment and significant association with older age and low education. Pre-stroke daily fish intake and moderate – to - heavy physical activity were inversely associated. The frequency of vascular cognitive impairment no dementia (vCIND) in the cohort (39.9%) was relatively higher than earlier report from Newcastle (32%) but neuroimaging studies revealed significant findings of MTLA and correlative white matter changes in tandem with previous reports from the Newcastle cohort. Given these, we investigated neurodegenerative hippocampal Alzheimer pathology and synaptic changes, as well as frontal and temporal white matter abnormalities in post - mortem brain tissue from the Newcastle cohort. We found increased Alzheimer pathology in the post - stroke groups but largely this did not differ between the demented (PSD) and non - demented (PSND) sub - groups. However, we found significantly higher hippocampal expression of synaptic markers (vesicular glutamate transporter – 1 and Drebrin) but lower expression of microglial, astrocytic and axonal injury markers in PSND compared to PSD subjects. The protective effect of educational attainment, pre-stroke physical activity and fish intake have public brain health implications.en_US
dc.description.sponsorshipORS Award from Newcastle University, a Research Fellowship from the International Brain Research Organization (IBRO) and laboratory visit support from the International Society of Neurochemistry (ISN).en_US
dc.language.isoenen_US
dc.publisherNewcastle Universityen_US
dc.titleProfile, determinants and mechanisms of cerebral injury and cognitive impairment following strokeen_US
dc.typeThesisen_US
Appears in Collections:Institute for Ageing and Health

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