Effect of White Matter Changes on Cognitive Impairment in Patients With Lacunar Infarcts

Wen, Haixia; Mok, Vincent; Fan, Yu; Lam, Wynnie W M; Tang, Wai Kwong; Wong, Adrian; Huang, Ru Xun; Wong, Ka Sing

doi:10.1161/01.str.0000133686.29320.58

Cited by 90 publications

(59 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…19,32,33 In these studies, WMH were found to be related to cognitive impairment, but there were no independent associations between lacunes and cognitive dysfunction. In addition, there has been a large population-based study assessing risk factors and functional consequence of lacunes that showed associations between lacunes and cognitive function, even after correction for WMH.…”

Section: Discussionmentioning

confidence: 81%

Small Vessel Disease and General Cognitive Function in Nondisabled Elderly

Flier

Straaten

Barkhof

et al. 2005

Stroke

291

189

View full text Add to dashboard Cite

on behalf of the LADIS Study GroupBackground and Purpose-On cerebral magnetic resonance imaging (MRI), white matter hyperintensities (WMH) and lacunes are generally viewed as evidence of small vessel disease. The clinical significance of small vessel disease in terms of global cognitive function has as yet not been completely clarified. We investigated the independent contribution of WMH and lacunes to general cognitive function in a group of independently living elderly with varying degrees of small vessel disease. Methods-Data were drawn from the multicenter, multinational Leukokraurosis and Disability (LADIS) study. There were 633 independently living participants. General cognitive function was assessed using the Mini Mental State Examination (MMSE) and the modified Alzheimer Disease Assessment Scale (ADAS). On MRI, WMH was rated as mild, moderate, or severe. Lacunes were rated as none, few (1 to 3), or many (4 or more). Results-In the basic analysis, increasing severity of both WMH and lacunes was related to deteriorating score on the MMSE and ADAS. When WMH and lacunes were entered simultaneously, both MRI measures remained significantly associated with MMSE score. Increasing severity of WMH remained associated with ADAS score, whereas the association with lacunes became less prominent. These associations were independent of other risk factors for dementia, like education, depression, vascular risk factors, or stroke. Conclusion-We found WMH and lacunes to be independently associated with general cognitive function in a sample of independently living elderly. These results highlight the fact that WMH and lacunes should both be evaluated when assessing small vessel disease in relation to cognitive function. (Stroke. 2005;36:2116-2120.)

show abstract

Section: Discussionmentioning

confidence: 81%

Small Vessel Disease and General Cognitive Function in Nondisabled Elderly

Flier

Straaten

Barkhof

et al. 2005

Stroke

291

189

View full text Add to dashboard Cite

show abstract

“…Additionally, lacunar infarction in certain ‘strategic locations’ alone, such as the basal ganglia, may result in profound cognitive deficits and even dementia [5]. Multiple studies also demonstrate that the presence of leukoaraiosis is independently related to cognitive impairment and decline in the elderly [15,16,17], and when present in patients with lacunar strokes, leukoaraiosis indicates increased severity of small-vessel ischemic vascular disease and exacerbates adverse effects of these lesions on cognitive performance [18]. In elderly individuals, cerebral manifestations of small-vessel ischemic vascular disease are also important components of vascular dementia [14,19,20,21,22].…”

Section: Discussionmentioning

confidence: 99%

Small-Vessel Vascular Disease in Human Immunodeficiency Virus Infection: The Hawaii Aging with HIV Cohort Study

McMurtray¹,

Nakamoto²,

Shikuma³

et al. 2007

Cerebrovasc Dis

View full text Add to dashboard Cite

Background: This study is designed to determine the relationship between age and occurrence of cerebral manifestations of small-vessel ischemic vascular disease in human immunodeficiency virus (HIV)-seropositive individuals. Methods: Periventricular leukoaraiosis severity and white matter lesion volume were determined by magnetic resonance imaging of the brain of 57 HIV-seropositive individuals. Results: Cerebral small-vessel ischemic vascular disease manifestations correlated with age and systolic blood pressure, but not with HIV infection-related parameters. Conclusions: These findings suggest that, in the era of highly active antiretroviral therapy, leukoaraiosis severity and white matter lesion volume may be more indicative of small-vessel ischemic vascular disease than HIV-related CNS pathology, and support the need for aggressive treatment of vascular risk factors in HIV-seropositive individuals.

show abstract

“…Some studies have found a correlation between neuropsychological deficits and severity of leukoaraiosis, while others failed to demonstrate any association [10, 11]. One recent study compared performance on the MMSE, Mattis Dementia Rating Scale-initiation/ perseveration subscale (MDRS I/P) and Alzhei-mer’s Disease Assessment Scale-cognition between lacunar infarct patients with and without leukoaraiosis and found a significant association only with frontal executive functions as assessed by the MDRS I/P [9]. In the study, this difference was found to be dependent on the presence of subjects with a severe degree of white matter change, suggesting the possibility of a ‘threshold’ of white matter change that needed to be exceeded before executive function is affected.…”

Section: Discussionmentioning

confidence: 99%

“…In the elderly, leukoaraiosis is independently related to cognitive impairment and cognitive decline [6,7,8]. Additionally, some studies of patients with lacunar infarcts report correlation between degree of cognitive impairment and severity of leukoaraiosis [9, 10]. However, other studies have failed to demonstrate an association between lacunar infarcts, leukoaraiosis and cognitive impairment [11].…”

Section: Introductionmentioning

confidence: 99%

Cognitive Performance after Lacunar Stroke Correlates with Leukoaraiosis Severity

et al. 2007

View full text Add to dashboard Cite

Background: This study investigates the effect of leukoaraiosis on patients presenting with cognitive impairment after lacunar stroke. Methods: Fourty-six patients with cognitive impairment and newly discovered lacunar stroke detected by brain magnetic resonance imaging underwent neuropsychological testing. Results: Patients with both lacunar infarct and leukoaraiosis performed less well on cognitive measures, compared to those with lacunar infarcts alone. Additionally, leukoaraiosis severity inversely correlated with cognitive performance. Conclusions: In patients with lacunar stroke, presence of leukoaraiosis is associated with worse performance in multiple cognitive domains. These findings suggest lacunar infarcts plus leukoaraiosis is a common etiology for vascular dementia.

show abstract

Effect of White Matter Changes on Cognitive Impairment in Patients With Lacunar Infarcts

Cited by 90 publications

References 36 publications

Small Vessel Disease and General Cognitive Function in Nondisabled Elderly

Small Vessel Disease and General Cognitive Function in Nondisabled Elderly

Small-Vessel Vascular Disease in Human Immunodeficiency Virus Infection: The Hawaii Aging with HIV Cohort Study

Cognitive Performance after Lacunar Stroke Correlates with Leukoaraiosis Severity

Contact Info

Product

Resources

About