Intracranial Stenosis, Cerebrovascular Diseases, and Cognitive Impairment in Chinese

Abstract

Extracranial carotid artery disease has been shown to be related to cognitive deficits. However, limited data are available on intracranial stenosis (ICS) and cognitive impairment. We investigate the association between ICS and cognitive impairment in Chinese. Subjects (n=278), recruited from the Epidemiology of Dementia in Singapore Study, underwent comprehensive clinical evaluation, neuropsychological testing, and brain magnetic resonance imaging (MRI), including 3-dimensional-time-of-flight magnetic resonance angiography (MRA). Cognitive function was expressed as composite and domain-specific Z-scores. Cognitive impairment no dementia and dementia were diagnosed according to internationally accepted diagnostic criteria. Linear and logistic regression models were adjusted for age, sex, education, vascular risk factors, and other MRI markers. A total of 29 (10.4%) persons had ICS on MRA, which was significantly associated with both composite cognitive Z-scores [mean difference in Z-score, presence vs. absence of ICS: -0.37 (95% confidence interval: -0.63, -0.12)] and specific domains including executive function, language, visuomotor speed, verbal memory, and visual memory. ICS was also related to significant cognitive impairment (odds ratio: 5.10 [1.24 to 21.02]). With respect to other MRI markers, adjusted for the presence of lacunar infarcts, the associations of ICS with both composite and domain-specific Z-scores, and significant cognitive impairment became nonsignificant; however, adjustment for other MRI markers did not alter these associations. In this Chinese population, presence of ICS was associated with cognitive impairment independent of vascular risk factors. These associations may be mediated through the presence of infarcts.

Growth differentiation factor-15 and white matter hyperintensities in cognitive impairment and dementia

“…Additionally, potential mechanistic associations between GDF-15 and other putative biomarkers, such as brain natriuretic peptide, cardiac troponin-T, C-reactive protein, and markers of insulin resistance remain to be studied. [36,46–48] Moreover, although we controlled for potential effects of NSAID medications on GDF-15 levels, other concurrently administered medications such as statins and proton-pump inhibitors may need to be considered as well, although in the case of statins, a previous study did not show any associations with GDF-15. [46] Lastly, while we have deliberately excluded VaD subjects in the present study due to our focus on markers of CeVD in AD, epidemiological studies have shown that at least a proportion of CIND with CeVD would go on to develop VaD.…”

“…CIND was determined by clinical judgment based on published guidelines, [36] namely, impairment in at least one domain of the neuropsychological test battery without any significant dysfunction in activities of daily living. Participants were considered to have failed a test if they scored 1.5 SD (standard deviation) below education-adjusted cutoff values on each individual test.…”

The Association Between Retinal Neuronal Layer and Brain Structure is Disrupted in Patients with Cognitive Impairment and Alzheimer’s Disease

“…The diagnosis of CIND was determined by clinical judgment and was defined as, no loss of independence in daily activities, and impairment in at least one domain of the neuropsychological test battery. Participants were considered to have failed a test if they scored 1.5 SD below the education-adjusted cut-off values of each test [28]. Failure in at least half of the tests in each domain was considered as impairment in that domain.…”

Association of Magnetic Resonance Imaging Markers of Cerebrovascular Disease Burden and Cognition

“…The images were first visually assessed on the reconstruction images, and the final decision on stenosis (>50%) was made on the source images. 18 3. Lacunes were defined as lesions, 3 to 15 mm in diameter, with low signal on T1-weighted image and fluid attenuated inversion recovery, a high signal on T2-weighted image, and a hyperintense rim with a center following cerebrospinal fluid intensity on fluid attenuated inversion recovery.…”