Cerebellar Atrophy in Patients with Subcortical-Type Vascular Cognitive Impairment

Abstract

Recent studies suggest that the role of the cerebellum extends into cognitive regulation and that subcortical vascular dementia (SVaD) can result in cerebellar atrophy. However, there has been no evaluation of the cerebellar volume in the preclinical stage of SVaD. We aimed to compare cerebellar volume among patients with amnestic mild cognitive impairment (aMCI) and subcortical vascular mild cognitive impairment (svMCI) and evaluate which factors could have contributed to the cerebellar volume. Participants were composed of 355 patients with aMCI, svMCI, Alzheimer's disease (AD), and SVaD. Cerebellar volumes were measured using automated methods. A direct comparison of the cerebellar volume in SVaD and AD groups showed that the SVaD group had a statistically smaller cerebellar volume than the AD group. Additionally, the svMCI group had a smaller cerebellar volume than the aMCI group, with the number of lacunes (especially in the supratentorial regions) being associated with cerebellar volume. Cerebellar volumes were associated with some neuropsychological tests, digit span backward and ideomotor apraxia. These findings suggest that cerebellar atrophy may be useful in differentiating subtypes of dementia and the cerebellum plays a potential role in cognition.

Multimodal Discrimination of Alzheimer’s Disease Based on Regional Cortical Atrophy and Hypometabolism

“…We aligned FDG-PET images to the corresponding structural MRI using a rigid body transformation, segmented the cerebellum [58] where glucose utilization is relatively preserved [59], and extracted the distribution volume ratio (DVR) image for intensity normalization. The three partial volume estimation maps of GM, WM and CSF indicating the portion of tissues within each voxel were calculated from MRI scans, and a weighted partial volume estimation map (wPVE) was calculated by the weighted sum of three partial volume estimation maps under the assumption that CSF is a non-uptake region and WM uptake is approximately one fourth that of GM [60].…”

Consensus Paper: Radiological Biomarkers of Cerebellar Diseases

“…Cerebellar changes can occur in several types of dementia [65, 79–82]. Generally, these findings are organized in neuroimaging secondarily, on the other hand, some cerebellar diseases may also present with dementia.…”

“…In vascular dementia, cerebellar changes are diverse and brain atrophy can occur directly by vascular lesion in the cerebellum or secondary to cerebrum atrophy [89]. Studies have already found the fact that after stroke, the cerebellum suffered from reduction in metabolism and blood flow in the cerebellar hemisphere contralateral to a destructive cerebral lesion [79, 90]. But there is a particular change in subcortical vascular dementia that present with cerebellar volume reduction, and the number of subcortical lacunes correlates with cerebellar atrophy [91].…”

“…In Sporadic Creutzfeldt-Jakob disease (sCJD), there is a hypometabolism in the cerebellum measured by SPECT or PET and the presence of hyperintensities on MRI. In familiar form, there is reduction of metabolism as in sCJD [79]. …”

Characterizing Brain Iron Deposition in Patients with Subcortical Vascular Mild Cognitive Impairment Using Quantitative Susceptibility Mapping: A Potential Biomarker

“…Patients with svMCI have been shown to exhibit cognitive impairments in executive, language, visuospatial, and memory functions (Seo et al, 2009, 2010) and have been associated with structural and functional alterations in widespread regions (Seo et al, 2010; Yi et al, 2012, 2015; Yoon et al, 2013; Kim et al, 2014), while these functions are further impaired in cases of SVaD (Kim et al, 2014). In svMCI patients, subcortical areas, such as the basal ganglia and thalamus, are more prominently involved than the frontal region.…”