Vascular brain lesions, brain atrophy, and cognitive decline. The Second Manifestations of ARTerial disease—Magnetic Resonance (SMART-MR) study

Kooistra, Minke; Geerlings, Mirjam I.; Graaf, Yolanda van der; Mali, Wptm; Vincken, Koen L.; Kappelle, L. Jaap; Muller, Majon; Biessels, Geert Jan

doi:10.1016/j.neurobiolaging.2013.07.004

Cited by 30 publications

(23 citation statements)

References 32 publications

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“…Results from the SMART-MR study suggested that the interaction between brain atrophy and white matter hyperintensities or infarcts could aggravate cognitive decline [75]. There is evidence of the role of hippocampal mean diffusivity in the post-stroke cognitive state, above and beyond that of volume and connectivity of this structure [76].…”

Section: Neuroimagingmentioning

confidence: 99%

Post-stroke dementia – a comprehensive review

Mijajlović

Pavlović

Brainin

et al. 2017

BMC Med

517

411

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Post-stroke dementia (PSD) or post-stroke cognitive impairment (PSCI) may affect up to one third of stroke survivors. Various definitions of PSCI and PSD have been described. We propose PSD as a label for any dementia following stroke in temporal relation. Various tools are available to screen and assess cognition, with few PSD-specific instruments. Choice will depend on purpose of assessment, with differing instruments needed for brief screening (e.g., Montreal Cognitive Assessment) or diagnostic formulation (e.g., NINDS VCI battery). A comprehensive evaluation should include assessment of pre-stroke cognition (e.g., using Informant Questionnaire for Cognitive Decline in the Elderly), mood (e.g., using Hospital Anxiety and Depression Scale), and functional consequences of cognitive impairments (e.g., using modified Rankin Scale). A large number of biomarkers for PSD, including indicators for genetic polymorphisms, biomarkers in the cerebrospinal fluid and in the serum, inflammatory mediators, and peripheral microRNA profiles have been proposed. Currently, no specific biomarkers have been proven to robustly discriminate vulnerable patients (‘at risk brains’) from those with better prognosis or to discriminate Alzheimer’s disease dementia from PSD. Further, neuroimaging is an important diagnostic tool in PSD. The role of computerized tomography is limited to demonstrating type and location of the underlying primary lesion and indicating atrophy and severe white matter changes. Magnetic resonance imaging is the key neuroimaging modality and has high sensitivity and specificity for detecting pathological changes, including small vessel disease. Advanced multi-modal imaging includes diffusion tensor imaging for fiber tracking, by which changes in networks can be detected. Quantitative imaging of cerebral blood flow and metabolism by positron emission tomography can differentiate between vascular dementia and degenerative dementia and show the interaction between vascular and metabolic changes. Additionally, inflammatory changes after ischemia in the brain can be detected, which may play a role together with amyloid deposition in the development of PSD. Prevention of PSD can be achieved by prevention of stroke. As treatment strategies to inhibit the development and mitigate the course of PSD, lowering of blood pressure, statins, neuroprotective drugs, and anti-inflammatory agents have all been studied without convincing evidence of efficacy. Lifestyle interventions, physical activity, and cognitive training have been recently tested, but large controlled trials are still missing.

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Section: Neuroimagingmentioning

confidence: 99%

Post-stroke dementia – a comprehensive review

Mijajlović

Pavlović

Brainin

et al. 2017

BMC Med

517

411

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“…While this demonstrates major advances in healthcare and public health, it also presents major challenges: The human brain starts to decrease in volume and weight from our mid-twenties onwards (Fotenos et al, 2005 ; Walhovd et al, 2011 ; Oh et al, 2014 ). This structural deterioration leads progressively to functional impairments and is accompanied by an increased risk of mental illness and neurodegenerative disease (Fotenos et al, 2005 ; Kooistra et al, 2014 ). With an aging population, the incidence of cognitive decline and dementia has substantially increased in the last decades.…”

Section: Introductionmentioning

confidence: 99%

Forever Young(er): potential age-defying effects of long-term meditation on gray matter atrophy

2015

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While overall life expectancy has been increasing, the human brain still begins deteriorating after the first two decades of life and continues degrading further with increasing age. Thus, techniques that diminish the negative impact of aging on the brain are desirable. Existing research, although scarce, suggests meditation to be an attractive candidate in the quest for an accessible and inexpensive, efficacious remedy. Here, we examined the link between age and cerebral gray matter re-analyzing a large sample (n = 100) of long-term meditators and control subjects aged between 24 and 77 years. When correlating global and local gray matter with age, we detected negative correlations within both controls and meditators, suggesting a decline over time. However, the slopes of the regression lines were steeper and the correlation coefficients were stronger in controls than in meditators. Moreover, the age-affected brain regions were much more extended in controls than in meditators, with significant group-by-age interactions in numerous clusters throughout the brain. Altogether, these findings seem to suggest less age-related gray matter atrophy in long-term meditation practitioners.

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“…Numerous studies have also shown associations between LLD and white-matter lesions (Tham et al, 2011). A recent review study found that white-matter lesions are, indeed, one of the main imaging markers of vascular brain pathology (Kooistra et al, 2014). Thus, both neurodegeneration and vascular pathology may impact white-matter tracts and structures playing crucial roles in mood regulation, predisposing elderly subjects to depression.…”

Section: Introductionmentioning

confidence: 99%