Linking MRI Hyperintensities With Patterns of Neuropsychological Impairment

Libon, David J.; Price, Catherine C.; Giovannetti, Tania; Swenson, Rodney; Bettcher, Brianne M.; Heilman, Kenneth M.; Pennisi, Alfio

doi:10.1161/strokeaha.107.489997

Cited by 61 publications

(45 citation statements)

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“…In patients with dementia, subcortical vascular disease is often associated with poor performance on this test (Libon et al, 2008 ;Price et al, 2005 ). Whether vascular disease is responsible for the differential impairment on executive tests in patients classifi ed as dysexecutive MCI is unknown at the present time.…”

Section: Discussionmentioning

confidence: 99%

“…We acknowledge that this test is not commonly used as a measure of executive control in dementia research. However, in numerous prior studies, this test has been shown to differentiate between dementia subtypes (see Libon et al, 2001Libon et al, , 2008Price et al, 2005 ). Also, previous research using principal component analysis (PCA) with dementia patients has shown that the WMS-Mental Control AcI (Boston Revision) consistently loads with performance on tests of letter fl uency (letters "FAS") and other executive control tests (see Giovannetti et al, 2001 ;Lamar et al, 2004 ).…”

Section: Executive Systems Functioningmentioning

confidence: 99%

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The heterogeneity of mild cognitive impairment: A neuropsychological analysis

Libon

Xie

Eppig

et al. 2009

J Int Neuropsychol Soc

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113

122

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A group of 94 nondemented patients self-referred to an outpatient memory clinic for memory diffi culties were studied to determine the incidence of single versus multi-domain mild cognitive impairment (MCI) using Petersen criteria. Fifty-fi ve community dwelling normal controls (NC) participants without memory complaints also were recruited. Tests assessing executive control, naming/lexical retrieval, and declarative memory were administered. Thirty-four patients exhibited single-domain MCI, 43 patients presented with multi-domain MCI. When the entire MCI sample ( n = 77) was subjected to a cluster analysis, 14 patients were classifi ed with amnesic MCI, 21 patients with dysexecutive MCI, and 42 patients were classifi ed into a mixed/multi-domain MCI group involving low scores on tests of letter fl uency, "animal" fl uency, and delayed recognition discriminability. Analyses comparing the three cluster-derived MCI groups versus a NC group confi rmed the presence of memory and dysexecutive impairment for the amnesic and dysexecutive MCI groups. The mixed MCI group produced lower scores on tests of letter fl uency compared with the amnesic MCI and NC groups and lower scores on tests of naming and memory compared with the NC group. In summary, multi-domain MCI is quite common. These data suggest that MCI is a highly nuanced and complex clinical entity. ( JINS , 2010, 16, 84-93.)

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Section: Discussionmentioning

confidence: 99%

Section: Executive Systems Functioningmentioning

confidence: 99%

The heterogeneity of mild cognitive impairment: A neuropsychological analysis

Libon

Xie

Eppig

et al. 2009

J Int Neuropsychol Soc

Self Cite

113

122

View full text Add to dashboard Cite

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“…threshold studies 4,5 were repeated in the current study for comparison purposes. All neuropsychological measures were administered and scored by examiners who were blind to the imaging data.…”

Section: Neuropsychological Assessment Measures Used In Prior Lamentioning

confidence: 99%

MRI-leukoaraiosis thresholds and the phenotypic expression of dementia

et al. 2012

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Objective: To examine the concept of leukoaraiosis thresholds on working memory, visuoconstruction, memory, and language in dementia.Methods: A consecutive series of 83 individuals with insidious onset/progressive dementia clinically diagnosed with Alzheimer disease (AD) or small vessel vascular dementia (VaD) completed neuropsychological measures assessing working memory, visuoconstruction, episodic memory, and language. A clinical MRI scan was used to quantify leukoaraiosis, total white matter, hippocampus, lacune, and intracranial volume. We performed analyses to detect the lowest level of leukoaraiosis associated with impairment on the neuropsychological measures.Results: Leukoaraiosis ranged from 0.63% to 23.74% of participants' white matter. Leukoaraiosis explained a significant amount of variance in working memory performance when it involved 3% or more of the white matter with curve estimations showing the relationship to be nonlinear in nature. Greater leukoaraiosis (13%) was implicated for impairment in visuoconstruction. Relationships between leukoaraiosis, episodic memory, and language measures were linear or flat.Conclusions: Leukoaraiosis involves specific threshold points for working memory and visuoconstructional tests in AD/VaD spectrum dementia. These data underscore the need to better understand the threshold at which leukoaraiosis affects and alters the phenotypic expression in insidious onset dementia syndromes. Neurology Optimal clinical management of dementia requires an appreciation of MRI-detected leukoaraiosis (LA). LA can alter cognitive dysfunction, 1 everyday living abilities, 2 and anti-cholinesterase effectiveness.3 It remains uncertain, however, how much LA is needed to alter the dementia phenotypic expression. Some have suggested that 25% of white matter needs to contain LA for dysexecutive impairment to supersede amnestic impairment. 4 This has been shown in 2 separate studies 4,5 using the Junque Scale of LA, 6 a 40-point visual rating scale. When divided into thirds, a Junque score greater than/equal to 18 (suggesting Ͼ25% LA) was associated with greater executive vs episodic memory impairment in dementia. A score less than 10 reflected striking anterograde memory impairment. A score between 10 and 17 resulted in similar executive and episodic memory dysfunction.The present study was designed to further investigate the threshold effect of LA with newer, more objective imaging techniques examining LA as a proportion of white matter while also controlling for intracranial volume which can modify brain structure-function associations. 7,8 It was hypothesized that among dementia patients this method would be positively correlated with the Junque LA Scale, but demonstrate a unique burden threshold only on measures

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“…приближался к СоД), в то время как на сопутствующий альцгейме-ровский процесс указывали лишь выраженная атро-фия гиппокампа и корковые ЦМК [51][52][53]. Хотя у пациентов с БА также выявлялся лейкоареоз, преи-мущественно перивентрикулярный в виде «шапо-чек» и узких «полос» по краю боковых желудочков, он не коррелировал с клинической картиной [6,11,23].…”

Section: Discussionunclassified