Deep microbleeds and periventricular white matter disintegrity are independent predictors of attention/executive dysfunction in non-dementia patients with small vessel disease

Cao, Wenwei; Wang, Yao; Dong, Quan; Xue, Chen; Li, Yansheng; Zhou, Yan; Gao, Li; Deng, Yuan; Xu, Qun

doi:10.1017/s1041610216002118

Cited by 12 publications

(11 citation statements)

References 28 publications

(35 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An additional five papers were identified from reference lists. Eight of these 42 papers met inclusion criteria [8,12,29–31,38–40]. Supplementary Table S2 details these papers and includes key findings from each study.…”

Section: Resultsmentioning

confidence: 99%

Using DTI to assess white matter microstructure in cerebral small vessel disease (SVD) in multicentre studies

et al. 2017

View full text Add to dashboard Cite

Diffusion tensor imaging (DTI) metrics such as fractional anisotropy (FA) and mean diffusivity (MD) have been proposed as clinical trial markers of cerebral small vessel disease (SVD) due to their associations with outcomes such as cognition. However, studies investigating this have been predominantly single-centre. As clinical trials are likely to be multisite, further studies are required to determine whether associations with cognition of similar strengths can be detected in a multicentre setting. One hundred and nine patients (mean age =68 years) with symptomatic lacunar infarction and confluent white matter hyperintensities (WMH) on MRI was recruited across six sites as part of the PRESERVE DTI substudy. After handling missing data, 3T-MRI scanning was available from five sites on five scanner models (Siemens and Philips), alongside neuropsychological and quality of life (QoL) assessments. FA median and MD peak height were extracted from DTI histogram analysis. Multiple linear regressions were performed, including normalized brain volume, WMH lesion load, and n° lacunes as covariates, to investigate the association of FA and MD with cognition and QoL. DTI metrics from all white matter were significantly associated with global cognition (standardized β =0.268), mental flexibility (β =0.306), verbal fluency (β =0.376), and Montreal Cognitive Assessment (MoCA) (β =0.273). The magnitudes of these associations were comparable with those previously reported from single-centre studies found in a systematic literature review. In this multicentre study, we confirmed associations between DTI parameters and cognition, which were similar in strength to those found in previous single-centre studies. The present study supports the use of DTI metrics as biomarkers of disease progression in multicentre studies.

show abstract

Section: Resultsmentioning

confidence: 99%

Using DTI to assess white matter microstructure in cerebral small vessel disease (SVD) in multicentre studies

et al. 2017

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

“…29,30 The disruption of brain networks involving the frontal lobe and periventricular white matter was important to determine executive dysfunction and cognitive impairment seen in cSVD, and this may also be the case for CMBs. 31,32 Another possible pathophysiological mechanism by which CMBs could impair cognition is suggested by studies from animal models, which reported that CMBs induced functional and structural disturbances in the surrounding brain environment: experimentally induced microbleeds disrupted the function of nearby neurons and astrocytes, 33 and promoted an inflammatory response via microglia proliferation and migration, 34 although most of these effects were transient. Alternatively, CMBs might relate to cognition via an indirect effect, through an arteriolar narrowing leading to cerebral hypoperfusion and microischemic damage.…”

Section: Discussionmentioning

confidence: 99%

Cognitive impact of cerebral microbleeds in patients with symptomatic small vessel disease

Nannoni

Ohlmeier

Brown

et al. 2021

International Journal of Stroke

View full text Add to dashboard Cite

Background and aim Whether cerebral microbleeds (CMBs) cause cognitive impairment remains uncertain. We analysed whether CMBs are associated with cognitive dysfunction in patients with symptomatic cerebral small vessel disease (cSVD), and whether this association is independent of other cSVD neuroimaging markers. Methods We analysed consecutive patients with MRI-confirmed lacunar stroke included in DNA-Lacunar-2 multicentre study. CMBs were graded using the Brain Observer Microbleed Rating Scale (BOMBS). Neuropsychological assessment was performed using the Brief Memory and Executive Test (BMET). We analysed the association between CMBs, BMET and the following subdomains: executive function/processing speed (EF/PS) and orientation/memory (O/M). We also searched for an independent association between CMBs and vascular cognitive impairment (VCI), defined as BMETâ¤13. Results Out of 688 included patients, CMBs were detected in 192 (27.9%). After adjusting for WMH severity, lacune count and other confounders, both the presence and number of CMBs were significantly associated with impaired cognitive performance [Î²=-13.0; 95%CI= (-25.3;-0.6) and Î²=-13.1; 95%CI= (-19.8;-6.4), respectively]. On analysis of specific cognitive domains, associations were present for EF/PS [Î²=-5.8; 95%CI= (-9.3;-2.2) and Î²=-4.3; 95%CI= (-6.2;-2.4), respectively] but not for O/M [Î²=-0.4; 95%CI= (-4.0;3.2) and Î²=-2.1; 95%CI= (-4.0;0.1), respectively]. We also found an independent association between the presence and number of CMBs and VCI [adjusted OR=1.48; 95%CI= (1.01;2.18) and OR=1.43; 95%CI= (1.15;1.79), respectively). Conclusion In a large cohort of symptomatic cSVD patients, after controlling for other neuroimaging markers of cSVD severity, CMBs were associated with cognitive dysfunction. Executive function and processing speed were predominantly impaired. This might suggest a causal role of CMBs in determining VCI.

show abstract

“…22 Previous studies have shown a diversified cognitive profile in patients with VaMCI depending on the characteristics of the sample compared. These studies reported impairment in executive functioning in VaMCI patients compared to normal controls 19 and in attention/executive, memory and visuospatial functioning compared against individuals with small-vessel disease but without cognitive impairment, 53 and decreased impairment in episodic memory (verbal and visual) and executive functioning relative to MCI patients. 54 …”

Section: Discussionmentioning

confidence: 99%

Cognitive performance in patients with Mild Cognitive Impairment and Alzheimer's disease with white matter hyperintensities: An exploratory analysis

Holz

Kochhann

Ferreira

et al. 2017

Dement. neuropsychol.

View full text Add to dashboard Cite

ABSTRACT.Background:White matter hyperintensities (WMH) are commonly associated with vascular dementia and poor executive functioning. Notwithstanding, recent findings have associated WMH with Alzheimer's disease as well as other cognitive functions, but there is no consensus.Objective:This study aimed to verify the relationship between WMH and cognitive performance in Mild Cognitive Impairment (MCI) and Alzheimer's disease (AD) patients. The study also sought to identify cognitive and demographic/cultural factors that might explain variability of WMH.Methods:The sample was composed of 40 participants (18 MCI and 22 AD patients) aged ≥ 65 years. Spearman's correlation was performed among cognitive performance (memory, language, visuospatial ability, and executive function) and WMH evaluated by the Fazekas and ARWMC scales. Two stepwise linear regressions were carried out, one with cognitive and the other with demographic/cultural variables as predictors.Results:Only naming showed significant correlation with ARWMC. Fazekas score exhibited significant correlation with all cognitive domains evaluated. Fazekas score was better predicted by episodic visual memory and age.Conclusion:This study found that the most relevant cognitive profile in MCI and AD patients with WMH was related to episodic memory. And, without taking clinical aspects into consideration, age was the best predictor of WMH.

show abstract

Deep microbleeds and periventricular white matter disintegrity are independent predictors of attention/executive dysfunction in non-dementia patients with small vessel disease

Abstract: Arteriosclerotic CMBs and periventricular white matter disintegrity seem to be independent MRI surrogated markers in the early stage of cognitive impairment in SVD.

Cited by 12 publications

References 28 publications

Using DTI to assess white matter microstructure in cerebral small vessel disease (SVD) in multicentre studies

Using DTI to assess white matter microstructure in cerebral small vessel disease (SVD) in multicentre studies

Cognitive impact of cerebral microbleeds in patients with symptomatic small vessel disease

Cognitive performance in patients with Mild Cognitive Impairment and Alzheimer's disease with white matter hyperintensities: An exploratory analysis

Contact Info

Product

Resources

About