Presence of lacunar infarctions is associated with the spatial navigation impairment in patients with mild cognitive impairment: a DTI study

Abstract

Lacunar cerebral infarction (LI) is one of risk factors of vascular dementia and correlates with progression of cognitive impairment including the executive functions. However, little is known on spatial navigation impairment and its underlying microstructural alteration of white matter in patients with LI and with or without mild cognitive impairment (MCI). Our aim was to investigate whether the spatial navigation impairment correlated with the white matter integrity in LI patients with MCI (LI-MCI). Thirty patients with LI were included in the study and were divided into LI-MCI (n=17) and non MCI (LI-Non MCI) groups (n=13) according neuropsychological tests.The microstructural integrity of white matter was assessed by calculating a fractional anisotropy (FA) and mean diffusivity (MD) from diffusion tensor imaging (DTI) scans. The spatial navigation accuracy, separately evaluated as egocentric and allocentric, was assessed by a computerized human analogue of the Morris Water Maze tests Amunet. LI-MCI performed worse than the CN and LI-NonMCI groups on egocentric and delayed spatial navigation subtests. LI-MCI patients have spatial navigation deficits. The microstructural abnormalities in diffuse brain regions, including hippocampus, uncinate fasciculus and other brain regions may contribute to the spatial navigation impairment in LI-MCI patients at follow-up.

Nodal Global Efficiency in Front-Parietal Lobe Mediated Periventricular White Matter Hyperintensity (PWMH)-Related Cognitive Impairment

“…Cerebral small vessel disease (CSVD) is a group of clinical syndromes arising from impaired blood circulation in cerebral arterioles, small perforating arteries, capillaries and small veins in the brain. CSVD accounts for approximately 10-30% of ischaemic strokes worldwide (Patel and Markus, 2011;Xu et al, 2018) and is a leading vascular contributor to cognitive deficits and dementia, mainly involving global cognitive function, information processing speed, and executive function (Jokinen et al, 2009;Debette and Markus, 2010;Wu et al, 2016;Liu et al, 2019). The early prediction of cognitive impairment (CI) due to CSVD is of great value because managing vascular risk factors early, e.g., diabetes, hypertension, hyperlipidaemia and smoking, may decrease the risk of developing CI in individuals with CSVD (Gorelick et al, 2011;Gu et al, 2019).…”

Progression of White Matter Hyperintensities Contributes to Lacunar Infarction

“…SVD is also associated with vascular risk factors, particularly hypertension [ 6 ]. The clinical spectrum for SVD ranges from asymptomatic disease, which is detectable by brain imaging in healthy individuals, to extensive WMH and lacunar infarcts in vascular dementia [ 7 , 8 ]. Approximately 70% of people over 65 years of age present with varying degrees of WMH after undergoing MRI [ 9 , 10 ].…”

Hippocampal silent infarct leads to subtle cognitive decline that is associated with inflammation and gliosis at twenty-four hours after injury in a rat model

“…The pathophysiological mechanisms underlying the relationship between SI and cognitive decline are poorly understood. Most SI are characterized by lacunar infarcts, which are associated with microstructural abnormalities in the hippocampus and selective deficits in spatial navigation (Masuda, Nabika, & Notsu, 2001; Wu et al, 2016). Importantly, there can be lasting hippocampal tissue damage after SI which is associated with cognitive decline (Faraji, Kurio, & Metz, 2012; Sharma et al, 2019).…”