Binswanger's disease and quantitative fractional anisotropy

Abstract

-Objective: To study the integrity of the white matter in Binswanger's disease (BD) patients with quantitative fractional anisotropy (DTI-FA). Method: Controls (12) and patients with BD (12) were included. Scans performed with MR (GE Signa Horizon/1.5T). Fazekas's score=6 with white matter hyperintensities extension ≥75% assessed on FLAIR scans. Standard parameters for DTI-FA were used. ROIs placed in symmetrical regions on two axial planes, data pooled in anterior (frontal) and posterior (temporo-parieto-occipital) regions. Analysis with Functool. Statistics for anterior and posterior regions comparison. Results: DTI-FA showed reduction of anisotropy, reflecting axonal damage and demyelination of fibers, more prominent in anterior in relation to posterior region, in BD patients in comparison to controls. Conclusion: Loss of integrity of fiber tracts reflects interruption of neural networks that subserve cognitive, behavioral, and motor integration. The more severely affected frontal region is related to executive dysfunction, a characteristic feature of Binswanger's disease.KEy wORDS: Binswanger's disease, white matter, leukoaraiosis, diffusion tensor, fractional anisotropy. doença de Binswanger e anisotropia fracionada quantitativa resumo -Objetivo: Estudar a integridade da substância branca em pacientes com doença de Binswanger (DB) com anisotropia fracionada quantitativa (DTI-FA). Método: Incluídos controles (12) e pacientes com DB (12). Obtidas imagens de RM (GE Signa Horizon/1,5T). Escore=6 de Fazekas com hiperintensidades da substância branca com extensão ≥75% avaliados em imagens em FLAIR. Utilizados parâmetros padrão para DTI-FA. ROIs colocados em regiões simétricas de dois planos axiais, dados das regiões anterior (frontal) e posterior (têmporo-parieto-occipital) reunidos. Análise com Functool. Estatística para comparar regiões anteriores e posteriores. Resultados: DTI-FA mostrou redução da anisotropia, refletindo lesão axonal e desmielinazação de fibras, com predomínio na região anterior em relação à posterior, nos pacientes com DB em comparação aos controles. Conclusão: Perda da integridade de feixes de fibras reflete interrupção de redes neurais subjacentes à integração cognitiva, comportamental e motora. A região frontal, mais gravemente atingida, está relacionada à disfunção executiva, aspecto característico da doença de Binswanger.PALAvRAS-CHAvE: doença de Binswanger, substância branca, leucoaraiose, tensor de difusão, anisotropia fracionada.

White matter hyperintensities, executive function and global cognitive performance in vascular mild cognitive impairment

“…A study using quantitative fractional anisotropy (DTI-FA) detected higher levels of interrupted fibers in anterior ( frontal) brain regions in comparison to posterior regions-of-interest in patients with Binswanger disease, which might be compatible to disconnection of prefrontal-basal ganglia-thalamic circuits associated to executive function 21 . Both abstract thinking subtest in CAMCOG and TMT B require integrity of the prefrontal cortex and of its connections to basal ganglia.…”

Cognitive disconnective syndrome by single strategic strokes in vascular dementia

“…It forms the circuit network associative, limbic and paralimbic, and performs the function of integrating the cognitive and psychological/behavioral information processed in these circuits [10][11][12][13][14][15]. The mechanism involved in the production of demential syndrome by the vascular insult, comprises the direct injury and disconnection of the structures and networks listed above, producing a functional disconnection of systems [6,[16][17][18].…”

Dysexecutive syndrome and cerebrovascular disease in non-amnestic mild cognitive impairment: a systematic review of the literature

“… 29 , 30 Interruption of white matter fibers in frontal lobe connections, as detected by DTI-FA techniques, has been reported as a possible neuropathological mechanism for dysexecutive syndrome in patients with Binswanger Disease. 35 , 36 Likewise, studies using DTI-FA corroborated the importance of parietal-subcortical connections in dysexecutive syndromes. 29 , 30 Reduction of anisotropy was identified in parietal regions and centrum semiovale in VaMCI, which was related to executive dysfunction.…”