Mild Cognitive Impairment after Lacunar Infarction: Voxel-Based Morphometry and Neuropsychological Assessment

Abstract

Background: The aim of the present study was to investigate whether there were differences in neuroradiological features, including white-matter lesions and gray-matter volumes, between patients with lacunar infarction with and without mild cognitive impairment of the vascular type (MCI-V). Methods: A total of 40 patients with lacunar infarction were studied within 1 month after stroke. Results: MCI-V was found in 22 patients, who in comparison with patients without cognitive impairment were significantly older and had fewer years of formal education. MRI subcortical hyperintensities especially in the basal ganglia (putamen and thalamus) were significantly more frequent in the MCI-V group. In the voxel-based morphometric study, patients with MCI-V showed more atrophy bilaterally in the middle temporal gyrus, right and left frontal and posterior bilateral occipitoparietal regions including the posterior cingulate as well as in the cerebellum. A region of interest analysis restricted to the parahippocampi and hippocampi showed further reduced bilateral parahippocampal gyrus and right hippocampus volume reductions in this group of patients. Finally, the amount of white-matter lesions among MCI-V showed negative correlations with gray-matter volume in frontal and temporal areas as well as with the thalamus and mesencephalon. Conclusions: The present findings provide support for an anatomical substrate of the MCI entity in patients with lacunar infarction. Both gray- and white-matter changes seem to contribute to the cognitive impairment of such patients.

Cognitive Impairment in Ischaemic Lacunar Stroke

“…34 In these patients voxel-based morphometry was used for assessing grey matter atrophy. 35 It was observed that grey matter shrinkages mainly affected the following cerebral regions: bilaterally the temporal lobes, parietal and frontal regions and the left cerebellum as well as bilaterally the parahippocampal gyro and the right hippocampus (the latter two regions emerged when region of interest analysis was restricted to these specific regions) (see Figure 2). These findings may be interpreted as corroborating those of the functional neuroimaging literature in which the remote effects of subcortical damage beyond the immediate area of infarction were described.…”

Можливості Превентивної Терапії Когнітивної Дисфункції: Антиаритмічна Терапія В пацієнтів Із фібриляцією Передсердь

“…Упродовж багатьох років БАБ займають одне з провід-них місць у терапії порушень серцевого ритму, будучи однією з основних груп ААП [18], що знижують ризик розвитку церебрального інсульту на 30-50 % [10]. Ре-зультати досліджень, спрямованих на оцінку впливу БАБ на когнітивні функції пацієнтів, суперечливі.…”

“…Îðèã³íàëüí³ äîñë³äaeåííÿ /Original Researches/ показників когнітивних функцій, що супроводжува-лися поліпшенням мозкового кровотоку за даними перфузійної сцинтиграфії мозку [2,18].…”

Alterations of the cerebral cortex in sporadic small vessel disease: A systematic review of in vivo MRI data

“…No association between cortical estimates obtained through VBM analyses and lacunes was reported. 27,28 In summary, despite the strong heterogeneity of the samples of patients with SVD or high risk profile, significant inverse relationships between most MRI estimates of cortex structure and the extent of WMH were consistently reported. By contrast, the relationships between cortex alterations and lacunes or microbleeds have been more rarely assessed and showed mostly non-significant associations.…”

“…27,28 In seven studies, lacunes were defined as lesions appearing hyperintense on T2 sequence and hypointense on T1 sequence and Flair sequences, and rated either by splitting the population according to the presence and absence of lacunes 19,21 or by assessing the number and/ or volume of lacunes. 20,[26][27][28] Lacunes were not assessed in one study 22 or assessed globally with other infarct types in two others. 24,25 The number of microbleeds was only assessed in two studies based on the same cohort.…”