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Maki K, Ohara T, Hata J, Shibata M, Hirabayashi N, Honda T, Sakata S, Furuta Y, Akiyama M, Yamasaki K, Tatewaki Y, Taki Y, Kitazono T, Mikami T, Maeda T, Ono K, Mimura M, Nakashima K, Iga JI, Takebayashi M, Ninomiya T. CKD, Brain Atrophy, and White Matter Lesion Volume: The Japan Prospective Studies Collaboration for Aging and Dementia. Kidney Med 2023; 5:100593. [PMID: 36874508 PMCID: PMC9982615 DOI: 10.1016/j.xkme.2022.100593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 10/26/2022] [Indexed: 12/24/2022] Open
Abstract
Rationale & Objective Chronic kidney disease, defined by albuminuria and/or reduced estimated glomerular filtration rate (eGFR), has been reported to be associated with brain atrophy and/or higher white matter lesion volume (WMLV), but there are few large-scale population-based studies assessing this issue. This study aimed to examine the associations between the urinary albumin-creatinine ratio (UACR) and eGFR levels and brain atrophy and WMLV in a large-scale community-dwelling older population of Japanese. Study Design Population-based cross-sectional study. Setting & Participants A total of 8,630 dementia-free community-dwelling Japanese aged greater than or equal to 65 years underwent brain magnetic resonance imaging scanning and screening examination of health status in 2016-2018. Exposures UACR and eGFR levels. Outcomes The total brain volume (TBV)-to-intracranial volume (ICV) ratio (TBV/ICV), the regional brain volume-to-TBV ratio, and the WMLV-to-ICV ratio (WMLV/ICV). Analytical Approach The associations of UACR and eGFR levels with the TBV/ICV, the regional brain volume-to-TBV ratio, and the WMLV/ICV were assessed by using an analysis of covariance. Results Higher UACR levels were significantly associated with lower TBV/ICV and higher geometric mean values of the WMLV/ICV (P for trend = 0.009 and <0.001, respectively). Lower eGFR levels were significantly associated with lower TBV/ICV, but not clearly associated with WMLV/ICV. In addition, higher UACR levels, but not lower eGFR, were significantly associated with lower temporal cortex volume-to-TBV ratio and lower hippocampal volume-to-TBV ratio. Limitations Cross-sectional study, misclassification of UACR or eGFR levels, generalizability to other ethnicities and younger populations, and residual confounding factors. Conclusions The present study demonstrated that higher UACR was associated with brain atrophy, especially in the temporal cortex and hippocampus, and with increased WMLV. These findings suggest that chronic kidney disease is involved in the progression of morphologic brain changes associated with cognitive impairment.
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Affiliation(s)
- Kenji Maki
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomoyuki Ohara
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mao Shibata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Naoki Hirabayashi
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanori Honda
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Satoko Sakata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihiko Furuta
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masato Akiyama
- Department of Ocular Pathology and Imaging Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Keisuke Yamasaki
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasuko Tatewaki
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Yasuyuki Taki
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tatsuya Mikami
- Department of Preemptive Medicine, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
| | - Tetsuya Maeda
- Division of Neurology and Gerontology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Kenjiro Ono
- Department of Neurology, Kanazawa University Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Kenji Nakashima
- National Hospital Organization, Matsue Medical Center, Shimane, Japan
| | - Jun-Ichi Iga
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Ehime University, Ehime, Japan
| | - Minoru Takebayashi
- Faculty of Life Sciences, Department of Neuropsychiatry, Kumamoto University, Kumamoto, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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2
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Schwarz NF, Nordstrom LK, Pagen LHG, Palombo DJ, Salat DH, Milberg WP, McGlinchey RE, Leritz EC. Differential associations of metabolic risk factors on cortical thickness in metabolic syndrome. NEUROIMAGE-CLINICAL 2017; 17:98-108. [PMID: 29062686 PMCID: PMC5641920 DOI: 10.1016/j.nicl.2017.09.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 08/31/2017] [Accepted: 09/26/2017] [Indexed: 12/31/2022]
Abstract
Objective Metabolic syndrome (MetS) refers to a cluster of risk factors for cardiovascular disease, including obesity, hypertension, dyslipidemia, and hyperglycemia. While sizable prior literature has examined associations between individual risk factors and quantitative measures of cortical thickness (CT), only very limited research has investigated such measures in MetS. Furthermore, the relative contributions of these risk factors to MetS-related effects on brain morphology have not yet been studied. The primary goal of this investigation was to examine how MetS may affect CT. A secondary goal was to explore the relative contributions of individual risk factors to regional alterations in CT, with the potential to identify risk factor combinations that may underlie structural changes. Methods Eighteen participants with MetS (mean age = 59.78 years) were age-matched with 18 healthy control participants (mean age = 60.50 years). CT measures were generated from T1-weighted images and groups were contrasted using whole-brain general linear modeling. A follow-up multivariate partial least squares correlation (PLS) analysis, including the full study sample with complete risk factor measurements (N = 53), was employed to examine which risk factors account for variance in group structural differences. Results Participants with MetS demonstrated significantly reduced CT in left hemisphere inferior parietal, rostral middle frontal, and lateral occipital clusters and in a right hemisphere precentral cluster. The PLS analysis revealed that waist circumference, high-density lipoprotein cholesterol (HDL-C), triglycerides, and glucose were significant contributors to reduced CT in these clusters. In contrast, diastolic blood pressure showed a significantly positive association with CT while systolic blood pressure did not emerge as a significant contributor. Age was not associated with CT. Conclusion These results indicate that MetS can be associated with regionally specific reductions in CT. Importantly, a novel link between a risk factor profile comprising indices of obesity, hyperglycemia, dyslipidemia and diastolic BP and localized alterations in CT emerged. While the pathophysiological mechanisms underlying these associations remain incompletely understood, these findings may be relevant for future investigations of MetS and might have implications for treatment approaches that focus on specific risk factor profiles with the aim to reduce negative consequences on the structural integrity of the brain. Cortical thickness is reduced bilaterally in metabolic syndrome. Five out of six risk factor components contribute to altered cortical thickness. Particular risk factor combination may be an important target for intervention.
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Affiliation(s)
- Nicolette F Schwarz
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Leslie K Nordstrom
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Linda H G Pagen
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Daniela J Palombo
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Boston University School of Medicine, Boston, MA, USA
| | - David H Salat
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; The Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA, USA
| | - William P Milberg
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Regina E McGlinchey
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Elizabeth C Leritz
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
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3
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Baron JC. Mapping neuronal density in peri-infarct cortex with PET. Hum Brain Mapp 2017; 38:5822-5824. [PMID: 28731596 DOI: 10.1002/hbm.23733] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 07/05/2017] [Accepted: 07/10/2017] [Indexed: 11/11/2022] Open
Affiliation(s)
- Jean-Claude Baron
- Department of Neurology, Hopital Sainte-Anne, Inserm U894, Paris Descartes University, France.,Department of Clinical Neurosciences, Stroke Research Group, University of Cambridge, United Kingdom
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4
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Kim HJ, Yang JJ, Kwon H, Kim C, Lee JM, Chun P, Kim YJ, Jung NY, Chin J, Kim S, Woo SY, Choe YS, Lee KH, Kim ST, Kim JS, Lee JH, Weiner MW, Na DL, Seo SW. Relative impact of amyloid-β, lacunes, and downstream imaging markers on cognitive trajectories. Brain 2016; 139:2516-27. [PMID: 27329772 DOI: 10.1093/brain/aww148] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 05/05/2016] [Indexed: 11/12/2022] Open
Abstract
SEE COHEN DOI101093/AWW183 FOR A SCIENTIFIC COMMENTARY ON THIS ARTICLE: Amyloid-β and cerebral small vessel disease are the two major causes of cognitive impairment in the elderly. However, the underlying mechanisms responsible for precisely how amyloid-β and cerebral small vessel disease affect cognitive impairment remain unclear. We investigated the effects of amyloid-β and lacunes on downstream imaging markers including structural network and cortical thickness, further analysing their relative impact on cognitive trajectories. We prospectively recruited a pool of 117 mild cognitive impairment patients (45 amnestic type and 72 subcortical vascular type), from which 83 patients received annual follow-up with neuropsychological tests and brain magnetic resonance imaging for 3 years, and 87 patients received a second Pittsburgh compound B positron emission tomography analysis. Structural networks based on diffusion tensor imaging and cortical thickness were analysed. We used linear mixed effect regression models to evaluate the effects of imaging markers on cognitive decline. Time-varying Pittsburgh compound B uptake was associated with temporoparietal thinning, which correlated with memory decline (verbal memory test, unstandardized β = -0.79, P < 0.001; visual memory test, unstandardized β = -2.84, P = 0.009). Time-varying lacune number was associated with the degree of frontoparietal network disruption or thinning, which further affected frontal-executive function decline (Digit span backward test, unstandardized β = -0.05, P = 0.002; Stroop colour test, unstandardized β = -0.94, P = 0.008). Of the multiple imaging markers analysed, Pittsburgh compound B uptake and the number of lacunes had the greatest association with memory decline and frontal-executive function decline, respectively: Time-varying Pittsburgh compound B uptake (standardized β = -0.25, P = 0.010) showed the strongest effect on visual memory test, followed by time-varying temporoparietal thickness (standardized β = 0.21, P = 0.010) and time-varying nodal efficiency (standardized β = 0.17, P = 0.024). Time-varying lacune number (standardized β = -0.25, P = 0.014) showed the strongest effect on time-varying digit span backward test followed by time-varying nodal efficiency (standardized β = 0.17, P = 0.021). Finally, time-varying lacune number (β = -0.22, P = 0.034) showed the strongest effect on time-varying Stroop colour test followed by time-varying frontal thickness (standardized β = 0.19, P = 0.026). Our multimodal imaging analyses suggest that cognitive trajectories related to amyloid-β and lacunes have distinct paths, and that amyloid-β or lacunes have greatest impact on cognitive decline. Our results provide rationale for the targeting of amyloid-β and lacunes in therapeutic strategies aimed at ameliorating cognitive decline.
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Affiliation(s)
- Hee Jin Kim
- 1 Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea 2 Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Jin Ju Yang
- 3 Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - Hunki Kwon
- 3 Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - Changsoo Kim
- 4 Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Min Lee
- 3 Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - Phillip Chun
- 5 Department of Emergency Medicine Behavioral Emergencies Research Lab, San Diego, CA, USA 6 Department of Biology, University of California San Diego, CA, USA
| | - Yeo Jin Kim
- 1 Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea 2 Neuroscience Center, Samsung Medical Center, Seoul, Korea 7 Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
| | - Na-Yeon Jung
- 1 Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea 2 Neuroscience Center, Samsung Medical Center, Seoul, Korea 8 Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Republic of Korea
| | - Juhee Chin
- 1 Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea 2 Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Seonwoo Kim
- 9 Biostatistics team, Samsung Biomedical Research Institute
| | - Sook-Young Woo
- 9 Biostatistics team, Samsung Biomedical Research Institute
| | - Yearn Seong Choe
- 10 Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung-Han Lee
- 10 Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Tae Kim
- 11 Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Seung Kim
- 12 Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Hong Lee
- 13 Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Michael W Weiner
- 14 Center for Imaging of Neurodegenerative Diseases, University of California, San Francisco, CA, USA
| | - Duk L Na
- 1 Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea 2 Neuroscience Center, Samsung Medical Center, Seoul, Korea 15 Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea
| | - Sang Won Seo
- 1 Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea 2 Neuroscience Center, Samsung Medical Center, Seoul, Korea 16 Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea
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Peres R, De Guio F, Chabriat H, Jouvent E. Alterations of the cerebral cortex in sporadic small vessel disease: A systematic review of in vivo MRI data. J Cereb Blood Flow Metab 2016; 36:681-95. [PMID: 26787108 PMCID: PMC4821027 DOI: 10.1177/0271678x15625352] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 12/10/2015] [Indexed: 11/16/2022]
Abstract
Cerebral small vessel diseases of the brain are a major determinant of cognitive impairment in the elderly. In small vessel diseases, the most easily identifiable lesions, both at post-mortem evaluation and magnetic resonance imaging, lie in subcortical areas. However, recent results obtained post-mortem, particularly in severe cases, have highlighted the burden of cortex lesions such as microinfarcts and diffuse neuronal loss. The recent development of image post-processing methods allows now assessing in vivo multiple aspects of the cerebral cortex. This systematic review aimed to analyze in vivo magnetic resonance imaging studies evaluating cortex alterations at different stages of small vessel diseases. Studies assessing the relationships between small vessel disease magnetic resonance imaging markers obtained at the subcortical level and cortex estimates were reviewed both in community-dwelling elderly and in patients with symptomatic small vessel diseases. Thereafter, studies analyzing cortex estimates in small vessel disease patients compared with healthy subjects were evaluated. The results support that important cortex alterations develop along the course of small vessel diseases independently of concomitant neurodegenerative processes. Easy detection and quantification of cortex changes in small vessel diseases as well as understanding their underlying mechanisms are challenging tasks for better understanding cognitive decline in small vessel diseases.
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Affiliation(s)
- Roxane Peres
- Univ Paris Diderot, Sorbonne Paris Cité, UMR-S 1161 INSERM, Paris, France DHU NeuroVasc Sorbonne Paris Cité, Paris, France
| | - François De Guio
- Univ Paris Diderot, Sorbonne Paris Cité, UMR-S 1161 INSERM, Paris, France DHU NeuroVasc Sorbonne Paris Cité, Paris, France
| | - Hugues Chabriat
- Univ Paris Diderot, Sorbonne Paris Cité, UMR-S 1161 INSERM, Paris, France DHU NeuroVasc Sorbonne Paris Cité, Paris, France Department of Neurology, AP-HP, Lariboisière Hosp, F-75475 Paris, France
| | - Eric Jouvent
- Univ Paris Diderot, Sorbonne Paris Cité, UMR-S 1161 INSERM, Paris, France DHU NeuroVasc Sorbonne Paris Cité, Paris, France Department of Neurology, AP-HP, Lariboisière Hosp, F-75475 Paris, France
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Cortical thinning related to periventricular and deep white matter hyperintensities. Neurobiol Aging 2012; 33:1156-67. [DOI: 10.1016/j.neurobiolaging.2010.12.003] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2010] [Revised: 12/01/2010] [Accepted: 12/04/2010] [Indexed: 11/17/2022]
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Jouvent E, Mangin JF, Duchesnay E, Porcher R, Düring M, Mewald Y, Guichard JP, Hervé D, Reyes S, Zieren N, Dichgans M, Chabriat H. Longitudinal changes of cortical morphology in CADASIL. Neurobiol Aging 2012; 33:1002.e29-36. [DOI: 10.1016/j.neurobiolaging.2011.09.013] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2011] [Revised: 08/24/2011] [Accepted: 09/10/2011] [Indexed: 11/26/2022]
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de Laat KF, Reid AT, Grim DC, Evans AC, Kötter R, van Norden AGW, de Leeuw FE. Cortical thickness is associated with gait disturbances in cerebral small vessel disease. Neuroimage 2011; 59:1478-84. [PMID: 21854857 DOI: 10.1016/j.neuroimage.2011.08.005] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2011] [Revised: 07/27/2011] [Accepted: 08/04/2011] [Indexed: 10/17/2022] Open
Abstract
Although gait disturbances are present in a substantial portion of patients with cerebral small vessel disease (SVD), their pathogenesis has not been clarified as they are not entirely explained by the white matter lesions (WMLs) and lacunar infarcts. The role of cortical thickness in these patients remains largely unknown. We aimed to assess the regions of cortical thickness associated with distinct gait parameters in patients with SVD, and whether these associations were dependent on WMLs and lacunar infarcts. MRI data were obtained from 415 subjects with SVD, aged between 50 and 85 years. We assessed cortical thickness using surface-based cortical thickness analysis, and gait performance using the GAITRite system. Cortical thickness of predominantly the orbitofrontal and ventrolateral prefrontal cortex, the inferior parietal lobe, cingulate areas and visual association cortices was positively related to stride length. Thickness of the primary and supplementary motor cortices and the cingulate cortex was positively related to cadence, while thickness of the orbitofrontal and ventrolateral prefrontal cortex, anterior cingulate cortex and especially the inferior parietal lobe and superior temporal gyrus was negatively related to stride width. The associations with stride length and width were partially explained by the subcortical WMLs and lacunar infarcts. Cortical thickness may therefore be important in gait disturbances in individuals with SVD, with different cortical patterns for specific gait parameters. We suggest that cortical atrophy is part of the disease processes in patients with SVD.
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Affiliation(s)
- Karlijn F de Laat
- Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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Ceyhan E, Hosakere M, Nishino T, Alexopoulos J, Todd R, Botteron K, Miller M, Ratnanather J. STATISTICAL ANALYSIS OF CORTICAL MORPHOMETRICS USING POOLED DISTANCES BASED ON LABELED CORTICAL DISTANCE MAPS. JOURNAL OF MATHEMATICAL IMAGING AND VISION 2011; 40:20-35. [PMID: 21765611 PMCID: PMC3134886 DOI: 10.1007/s10851-010-0240-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Neuropsychiatric disorders have been demonstrated to manifest shape differences in cortical structures. Labeled Cortical Distance Mapping (LCDM) is a powerful tool in quantifying such morphometric differences and characterizes the morphometry of the laminar cortical mantle of cortical structures. Specifically, LCDM data are distances of labeled gray matter (GM) voxels with respect to the gray/white matter cortical surface. Volumes and descriptive measures (such as means and variances for each subject) based on LCDM distances provide descriptive summary information on some of the shape characteristics. However, additional morphometrics are contained in the data and their analysis may provide additional clues to underlying differences in cortical characteristics. To use more of this information, we pool (merge) LCDM distances from subjects in the same group. These pooled distances can help detect morphometric differences between groups, but do not provide information about the locations of such differences in the tissue in question. In this article, we check for the influence of the assumption violations on the analysis of pooled LCDM distances. We demonstrate that the classical parametric tests are robust to the non-normality and within sample dependence of LCDM distances and nonparametric tests are robust to within sample dependence of LCDM distances. We specify the types of alternatives for which the tests are more sensitive. We also show that the pooled LCDM distances provide powerful results for group differences in distribution of LCDM distances. As an illustrative example, we use GM in the ventral medial prefrontal cortex (VMPFC) in subjects with major depressive disorder (MDD), subjects at high risk (HR) of MDD, and healthy subjects. Significant morphometric differences were found in VMPFC due to MDD or being at HR. In particular, the analysis indicated that distances in left and right VMPFCs tend to decrease due to MDD or being at HR, possibly as a result of thinning. The methodology can also be applied to other cortical structures.
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Affiliation(s)
- E. Ceyhan
- Dept. of Mathematics, Koç University, 34450, Sariyer, Istanbul, Turkey
- Center for Imaging Science, The Johns Hopkins University, Baltimore, MD 21218
| | - M. Hosakere
- Center for Imaging Science, The Johns Hopkins University, Baltimore, MD 21218
| | - T. Nishino
- Dept. of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110
- Dept. of Radiology, Washington University School of Medicine, St. Louis, MO 63110
| | - J. Alexopoulos
- Dept. of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110
| | - R.D. Todd
- Dept. of Genetics, Washington University School of Medicine, St. Louis, MO 63110
| | - K.N. Botteron
- Dept. of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110
- Dept. of Radiology, Washington University School of Medicine, St. Louis, MO 63110
| | - M.I. Miller
- Center for Imaging Science, The Johns Hopkins University, Baltimore, MD 21218
- Institute for Computational Medicine, The Johns Hopkins University, Baltimore, MD 21218
- Dept. of Biomedical Engineering, The Johns Hopkins University, Baltimore, MD 21218
| | - J.T. Ratnanather
- Center for Imaging Science, The Johns Hopkins University, Baltimore, MD 21218
- Institute for Computational Medicine, The Johns Hopkins University, Baltimore, MD 21218
- Dept. of Biomedical Engineering, The Johns Hopkins University, Baltimore, MD 21218
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Abstract
PURPOSE OF REVIEW Study of the variability of the cortical mantle thickness is now a key issue in neuroimaging. Here we describe a more recent trend aiming at the study of the variability of the cortical folding morphology. RECENT FINDINGS Computerized three-dimensional versions of gyrification index and other morphometric features dedicated to the folding patterns are modified in psychiatric syndromes and neurologic disorders. These observations provide new insights into the mechanisms involved in abnormal development or abnormal aging. SUMMARY Quantification of the folding morphology will contribute to the global endeavor aiming at building biomarkers from neuroimaging data, with a specific focus on developmental diseases.
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Leritz EC, Salat DH, Williams VJ, Schnyer DM, Rudolph JL, Lipsitz L, Fischl B, McGlinchey RE, Milberg WP. Thickness of the human cerebral cortex is associated with metrics of cerebrovascular health in a normative sample of community dwelling older adults. Neuroimage 2011; 54:2659-71. [PMID: 21035552 PMCID: PMC3026290 DOI: 10.1016/j.neuroimage.2010.10.050] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Revised: 09/21/2010] [Accepted: 10/13/2010] [Indexed: 11/19/2022] Open
Abstract
We examined how wide ranges in levels of risk factors for cerebrovascular disease are associated with thickness of the human cerebral cortex in 115 individuals ages 43-83 with no cerebrovascular or neurologic history. Cerebrovascular risk factors included blood pressure, cholesterol, body mass index, creatinine, and diabetes-related factors. Variables were submitted into a principal components analysis that confirmed four orthogonal factors (blood pressure, cholesterol, cholesterol/metabolic and glucose). T1-weighted MRI was used to create models of the cortex for calculation of regional cortical thickness. Increasing blood pressure factor scores were associated with numerous regions of reduced thickness. Increasing glucose scores were modestly associated with areas of regionally decreased thickness. Increasing cholesterol scores, in contrast, were associated with thicker cortex across the whole brain. All findings were primarily independent of age. These results provide evidence that normal and moderately abnormal levels of parameters used to assess cerebrovascular health may impact brain structure, even in the absence of cerebrovascular disease. Our data have important implications for the clinical management of vascular health, as well as for what is currently conceptualized as "normal aging" as they suggest that subclinical levels of risk may impact cortical gray matter before a disease process is evident.
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Affiliation(s)
- Elizabeth C Leritz
- Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA 02130, USA.
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Reid AT, van Norden AGW, de Laat KF, van Oudheusden LJB, Zwiers MP, Evans AC, de Leeuw FE, Kötter R. Patterns of cortical degeneration in an elderly cohort with cerebral small vessel disease. Hum Brain Mapp 2010; 31:1983-92. [PMID: 20336684 DOI: 10.1002/hbm.20994] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Emerging noninvasive neuroimaging techniques allow for the morphometric analysis of patterns of gray and white matter degeneration in vivo, which may help explain and predict the occurrence of cognitive impairment and Alzheimer's disease. A single center prospective follow-up study (Radboud University Nijmegen Diffusion tensor and Magnetic resonance imaging Cohort study (RUN DMC)) was performed involving 503 nondemented elderly individuals (50-85 years) with a history of symptomatic cerebral small vessel disease (SVD). Age was associated with a global reduction in cortical thickness, and this relationship was strongest for ventrolateral prefrontal cortex, auditory cortex, Wernicke's area, superior temporal lobe, and primary visual cortex. Right and left hemispheres differed in the thickness of language-related areas. White matter (WM) lesions were generally negatively correlated with cortical thickness, primarily in individuals over the age of 60, with the notable exception of Brodmann areas 4 and 5, which were positively correlated in age groups 50-60 and 60-70, respectively. The observed pattern of age-related decline may explain problems in memory and executive functions, which are already well documented in individuals with SVD. The additional gray matter loss affecting visual and auditory cortex, and specifically the head region of primary motor cortex, may indicate morphological correlates of impaired sensory and motor functions. The paradoxical positive relationship between WM lesion volume and cortical thickness in some areas may reflect early compensatory hypertrophy. This study raises a further interest in the mechanisms underlying cerebral gray and white matter degeneration in association with SVD, which will require further investigation with diffusion weighted and longitudinal MR studies.
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Affiliation(s)
- Andrew T Reid
- Donders Institute for Brain, Cognition and Behaviour, Center for Neuroscience, Section Neurophysiology and Neuroinformatics (NeuroPI, 126), Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
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13
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Jouvent E, Viswanathan A, Chabriat H. Cerebral Atrophy in Cerebrovascular Disorders. J Neuroimaging 2009; 20:213-8. [DOI: 10.1111/j.1552-6569.2009.00370.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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14
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Scott M, Bromiley P, Thacker N, Hutchinson C, Jackson A. A fast, model-independent method for cerebral cortical thickness estimation using MRI. Med Image Anal 2009; 13:269-85. [DOI: 10.1016/j.media.2008.10.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2007] [Revised: 07/11/2008] [Accepted: 10/22/2008] [Indexed: 11/27/2022]
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Bernal-Rusiel JL, Atienza M, Cantero JL. Detection of focal changes in human cortical thickness: Spherical wavelets versus Gaussian smoothing. Neuroimage 2008; 41:1278-92. [DOI: 10.1016/j.neuroimage.2008.03.022] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2007] [Revised: 02/14/2008] [Accepted: 03/17/2008] [Indexed: 10/22/2022] Open
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16
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Jouvent E, Mangin JF, Porcher R, Viswanathan A, O'Sullivan M, Guichard JP, Dichgans M, Bousser MG, Chabriat H. Cortical changes in cerebral small vessel diseases: a 3D MRI study of cortical morphology in CADASIL. Brain 2008; 131:2201-8. [PMID: 18577545 DOI: 10.1093/brain/awn129] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Brain atrophy represents a key marker of disease progression in cerebrovascular disorders. The 3D changes of cortex morphology occurring during the course of small vessel diseases of the brain (SVDB) remain poorly understood. The objective of this study was to assess the changes affecting depth and surface area of cortical sulci and their clinical and radiological correlates in a cohort of patients with cerebral autosomal dominant arteriolopathy with subcortical infarcts and leukoencephalopathy (CADASIL), a genetic SVDB. Data were obtained from a series of 69 CADASIL patients. Validated methods were used to determine depth and surface area of four cortical sulci. The ratio of brain to intracranial cavity volumes (brain parenchymal fraction--BPF), volume of lacunar lesions (LL) and of white matter hyperintensities, number of cerebral microhaemorrhages, and mean apparent diffusion coefficient were also measured. Association between depth and surface area of the cortical sulci and BPF, clinical status and subcortical MRI lesions were tested. Depth and surface area of cortical sulci obtained in 54 patients were strongly correlated with both cognitive score and disability scales. Depth was related to the extent of subcortical lesions, surface area was related only to age. In additional analyses, the depth of the cingular sulcus was independently associated with the volume of LL (P = 0.001), and that of the superior frontal sulcus with the mean apparent diffusion coefficient (P = 0.003). In CADASIL, important morphological changes of cortical sulci occur in association with clinical worsening, extension of subcortical tissue damage and progression of global cerebral atrophy. These results suggest that the examination of cortical morphology may be of high clinical relevance in SVDB.
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Affiliation(s)
- Eric Jouvent
- Department of Neurology, INSERM UMR 740 and Université Paris VII, France
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17
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Wang X, Bauer W, Chiaia N, Dennis M, Gerken M, Hummel J, Kane J, Kenmuir C, Khuder S, Lane R, Mooney R, Bazeley P, Apkarian V, Wall J. Longitudinal MRI evaluations of human global cortical thickness over minutes to weeks. Neurosci Lett 2008; 441:145-8. [PMID: 18603368 DOI: 10.1016/j.neulet.2008.06.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2008] [Revised: 06/04/2008] [Accepted: 06/05/2008] [Indexed: 11/25/2022]
Abstract
Magnetic resonance imaging (MRI) was used to evaluate within-subject variability in global mean cortical thickness over test-retest intervals of minutes-weeks in five healthy adults. Within-subject measures of global mean thickness were consistent over these intervals. Test-retest assessments of absolute thickness differences and percent thickness differences indicated variations of, respectively, < or =0.05-0.06 mm and < or =+/-1.9-2.3%. There have been few evaluations of normal within-subject variations in cortical thickness. The present results suggest that within-subject variability in global mean cortical thickness can be low over test-retest intervals of minutes-weeks, and that longitudinal scans can establish useful baseline estimates of variability from which to assess changes due to injury, disease, or other experiences.
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Affiliation(s)
- Xin Wang
- Department of Neuroscience, University of Toledo Medical Center, Toledo, OH 43614, USA
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18
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Lerch JP, Carroll JB, Dorr A, Spring S, Evans AC, Hayden MR, Sled JG, Henkelman RM. Cortical thickness measured from MRI in the YAC128 mouse model of Huntington's disease. Neuroimage 2008; 41:243-51. [PMID: 18387826 DOI: 10.1016/j.neuroimage.2008.02.019] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2007] [Revised: 01/16/2008] [Accepted: 02/07/2008] [Indexed: 11/16/2022] Open
Abstract
A recent study found differences in localised regions of the cortex between the YAC128 mouse model of Huntington's Disease (HD) and wild-type mice. There are, however, few tools to automatically examine shape differences in the cortices of mice. This paper describes an algorithm for automatically measuring cortical thickness across the entire cortex from MRI of fixed mouse brain specimens. An analysis of the variance of the method showed that, on average, a 50 microm (0.05 mm) localised difference in cortical thickness can be measured using MR scans. Applying these methods to 8-month-old YAC128 mouse model mice representing an early stage of HD, we found an increase in cortical thickness in the sensorimotor cortex, and also revealed regions wherein decreasing striatal volume correlated with increasing cortical thickness, indicating a potential compensatory response.
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Affiliation(s)
- Jason P Lerch
- The Mouse Imaging Centre, The Hospital for Sick Children, Toronto, Ontario, Canada.
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Jouvent E, Viswanathan A, Mangin JF, O'Sullivan M, Guichard JP, Gschwendtner A, Cumurciuc R, Buffon F, Peters N, Pachaï C, Bousser MG, Dichgans M, Chabriat H. Brain Atrophy Is Related to Lacunar Lesions and Tissue Microstructural Changes in CADASIL. Stroke 2007; 38:1786-90. [PMID: 17446424 DOI: 10.1161/strokeaha.106.478263] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Cerebral atrophy has been recently recognized as a key marker of disease progression in cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). The contribution of subcortical cerebral lesions in this process remains undetermined. The aim of this study was to investigate the relationships between cerebral volume and different types of subcortical MRI lesions in CADASIL. METHODS Demographic, clinical, and laboratory data from 147 patients with CADASIL recruited from a prospective cohort study were analyzed. Validated methods were used to determine the ratio of brain volume to intracranial cavity volume (brain parenchymal fraction [BPF]), volume of white matter hyperintensities, volume of lacunar lesions, number of cerebral microhemorrhages, and mean apparent diffusion coefficient. Associations between BPF, clinical scales, and the different subcortical MRI markers were tested. RESULTS BPF obtained in 129 patients was significantly associated with the Mattis dementia rating scale (P<0.0001), Mini-Mental State Examination (P=0.002), and modified Rankin scale (P<0.0001) after adjustment for age and sex. Multiple linear regression modeling showed that BPF was independently associated with mean apparent diffusion coefficient (P<0.0001), volume of lacunar lesions (P=0.004), and age (P<0.0001), accounting for 46% of the observed variance in BPF but not with volume of white matter hyperintensities or number of microhemorrhages. CONCLUSIONS In association with age, mean apparent diffusion coefficient and volume of lacunar lesions are strong and independent MRI predictors of BPF, a key marker of cognitive and motor disability in CADASIL. These results suggest brain atrophy is related to remote and/or diffuse consequences of both lacunar lesions and widespread microstructural alterations within the brain outside lacunar lesions.
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Affiliation(s)
- Eric Jouvent
- Department of Neurology, CHU Lariboisière, Assistance Publique des Hôpitaux de Paris, and Université Paris VII, Paris, France
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Preul C, Hund-Georgiadis M, Forstmann BU, Lohmann G. Characterization of cortical thickness and ventricular width in normal aging: a morphometric study at 3 Tesla. J Magn Reson Imaging 2007; 24:513-9. [PMID: 16878302 DOI: 10.1002/jmri.20665] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To describe loss of cortical thickness and ventricular enlargement during normal aging in a sample of 525 neurologically and psychiatrically inconspicuous subjects (17-68 years old). MATERIALS AND METHODS An automated segmentation algorithm was applied to assess cortical thickness and compared with conventional measurements of ventricular indices (ventricular body index (VBI), anterior horn index (AHI), and third ventricular width) as performed in clinical practice. Regression analysis was performed to elucidate the relationship between a decrease of the cortical mantle and increase in ventricular width with aging. RESULTS Cortical thickness decreases with age (r = -0.49, P < 0.01; r = -0.502 in male and r = -0.461 in female subjects). Regarding the ventricular indices, we found a significant correlation with age for both the whole sample and the subdivision by gender. Cortical thickness and ventricular width are closely correlated (r = -0.43 in women, r = -0.468 in men, P < 0.001 each). The bandwidth of variance scales up with aging in all parameters. The results are discussed in terms of the underlying mechanisms of normal aging. CONCLUSION Our findings suggest that a decrease in cortical thickness and increase in ventricular width occur with normal aging. The enlargement of the third ventricle correlates the most strongly with age.
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Affiliation(s)
- Christoph Preul
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
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Scheid R, Preul C, Lincke T, Matthes G, Schroeter ML, Guthke T, Yves von Cramon D, Sabri O. Correlation of cognitive status, MRI- and SPECT-imaging in CADASIL patients. Eur J Neurol 2006; 13:363-70. [PMID: 16643314 DOI: 10.1111/j.1468-1331.2006.01245.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Although there is evidence for correlations between disability and magnetic resonance imaging (MRI) total lesion volume in autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), the significance of structural MRI abnormalities for cognitive dysfunction remains controversial. We performed detailed neuropsychological testing, high resolution MRI, and Tc-99m-ethyl cysteinate-dimer SPECT in three CADASIL patients. MR-images were rated independently by two investigators for the presence of white matter lesions, lacunar infarcts, microbleeds, and ventricular enlargement. Cortical atrophy was quantified by the use of automatic morphometric assessment of the cortical thickness. In addition, laboratory and patients' history data were collected in order to assess the individual vascular risk factor profile. The differences in cognitive performance between the three patients are neither explained by structural-, or functional neuroimaging, nor by the patient-specific vascular risk factor profiles. The neuroradiologically least affected patient met criteria for dementia, whereas the most severely affected patient was in the best clinical and cognitive state. Conventional structural and functional neuroimaging is important for the diagnosis of CADASIL, but it is no sufficient surrogate marker for the associated cognitive decline. Detailed neuropsychological assessment seems to be more useful, particularly with respect to the implementation of reliable outcome parameters in possible therapeutic trials.
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Affiliation(s)
- R Scheid
- Day Clinic of Cognitive Neurology, University of Leipzig, Germany.
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