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Wang J, Wang Y, Cai X, Xia W, Zhu J. A Review: Visuospatial Dysfunction in Patients with the Cerebral Small Vessel Disease. Neuroscience 2024; 552:47-53. [PMID: 38880241 DOI: 10.1016/j.neuroscience.2024.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 06/06/2024] [Accepted: 06/10/2024] [Indexed: 06/18/2024]
Abstract
Cerebral small vessel disease (CSVD) impairs visuospatial function, and this is one of the most obvious areas of cognitive impairment in CSVD. So, recognizing, monitoring, and treating visuospatial dysfunction are all important to the prognosis of CSVD. This review discussed the anatomical and pathological mechanisms, clinical recognition (scales, imaging, and biomarkers), and treatment of cognitive impairment especially visuospatial dysfunction in CSVD.
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Affiliation(s)
- Jiaxing Wang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Youmeng Wang
- Department of Neurology, Fuyang People's Hospital, Fuyang, China
| | - Xiuying Cai
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Wei Xia
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, China.
| | - Juehua Zhu
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China.
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Zhu F, Yao J, Feng M, Sun Z. Establishment and evaluation of a clinical prediction model for cognitive impairment in patients with cerebral small vessel disease. BMC Neurosci 2024; 25:35. [PMID: 39095700 PMCID: PMC11295716 DOI: 10.1186/s12868-024-00883-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 07/22/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND There are currently no effective prediction methods for evaluating the occurrence of cognitive impairment in patients with cerebral small vessel disease (CSVD). AIMS To investigate the risk factors for cognitive dysfunction in patients with CSVD and to construct a risk prediction model. METHODS A retrospective study was conducted on 227 patients with CSVD. All patients were assessed by brain magnetic resonance imaging (MRI), and the Montreal Cognitive Assessment (MoCA) was used to assess cognitive status. In addition, the patient's medical records were also recorded. The clinical data were divided into a normal cognitive function group and a cognitive impairment group. A MoCA score < 26 (an additional 1 point for education < 12 years) is defined as cognitive dysfunction. RESULTS A total of 227 patients (mean age 66.7 ± 6.99 years) with CSVD were included in this study, of whom 68.7% were male and 100 patients (44.1%) developed cognitive impairment. Age (OR = 1.070; 95% CI = 1.015 ~ 1.128, p < 0.05), hypertension (OR = 2.863; 95% CI = 1.438 ~ 5.699, p < 0.05), homocysteine(HCY) (OR = 1.065; 95% CI = 1.005 ~ 1.127, p < 0.05), lacunar infarct score(Lac_score) (OR = 2.732; 95% CI = 1.094 ~ 6.825, P < 0.05), and CSVD total burden (CSVD_score) (OR = 3.823; 95% CI = 1.496 ~ 9.768, P < 0.05) were found to be independent risk factors for cognitive decline in the present study. The above 5 variables were used to construct a nomogram, and the model was internally validated by using bootstrapping with a C-index of 0.839. The external model validation C-index was 0.867. CONCLUSIONS The nomogram model based on brain MR images and clinical data helps in individualizing the probability of cognitive impairment progression in patients with CSVD.
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Affiliation(s)
- Fangfang Zhu
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230000, China
- Department of Neurology, The Second Affiliated Hospital of Bengbu Medical University, Bengbu, 233000, China
| | - Jie Yao
- Department of Neurology, The Second Affiliated Hospital of Bengbu Medical University, Bengbu, 233000, China
| | - Min Feng
- Department of Neurology, The Second Affiliated Hospital of Bengbu Medical University, Bengbu, 233000, China
| | - Zhongwu Sun
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230000, China.
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Xu C, Xia J, Qiang Y, Wu Y. Relationship between burden of cerebral small vessel disease on imaging and cognitive impairment of COPD patients. J Neurosci Methods 2024; 410:110218. [PMID: 38996845 DOI: 10.1016/j.jneumeth.2024.110218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 06/18/2024] [Accepted: 07/09/2024] [Indexed: 07/14/2024]
Abstract
OBJECTIVE This study aims to explore the relationship between the burden of cerebral small vessel disease (CSVD) on imaging and cognitive impairment (CI) in patients with chronic obstructive pulmonary disease (COPD). METHODS The study included 118 COPD patients admitted to Changxing People's Hospital between July 2020 and July 2023. All patients received a 1.5 T MRI of the brain and pulmonary function tests. A cognitive function assessment was conducted via the Montreal Cognitive Assessment (MoCA) scale, and patients were divided into two groups. The relationship between the MoCA and CSVD burden score was analyzed by Pearson correlation, and to identify risk factors, multiple logistic regression analysis was performed. RESULTS The study showed a negative correlation between the MoCA and CSVD burden score in COPD patients (r=-0.479, P<0.001). Multiple logistic regression analysis found that age (OR=2.264, 95 % CI: 1.426-3.596, P<0.001), COPD grade (OR=3.139, 95 % CI: 2.012-4.898, P<0.001), as well as CSVD burden score (OR=5.336, 95 % CI: 1.191-23.900, P<0.001) were the independent risk factors for CI in COPD patients (P<0.05). CONCLUSION When screening for cognitive impairment in COPD patients, the CSVD burden score can be used in conjunction with cognitive assessment scales to make judgments.
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Affiliation(s)
- Chentao Xu
- Department of Radiology, Changxing People's Hospital, Huzhou, Zhejiang 313100, China.
| | - Jinjin Xia
- Department of Neurology, Changxing People's Hospital, Huzhou, Zhejiang 313100, China.
| | - Yanfei Qiang
- Department of Respiration, Changxing People's Hospital, Huzhou, Zhejiang 313100, China.
| | - Yingzhe Wu
- Department of Radiology, Changxing People's Hospital, Huzhou, Zhejiang 313100, China.
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Wu H, Xu L, Zheng X, Gu C, Zhou X, Sun Y, Li X. Association of pulsatility index with total burden of cerebral small vessel disease and cognitive impairment. Brain Behav 2024; 14:e3526. [PMID: 38783554 PMCID: PMC11116751 DOI: 10.1002/brb3.3526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 04/16/2024] [Accepted: 04/19/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE This study investigated the correlation between the pulsatility index (PI) of the middle cerebral artery with the total burden of cerebral small vessel disease and cognitive impairment. METHOD Information on patients hospitalized in the Department of Neurology was collected retrospectively. These patients had complete clinical and laboratory data. The middle cerebral artery PI was measured using transcranial Doppler, a Mini-Mental State Examination (MMSE) was used to assess cognitive function, and the total cerebral small vessel disease burden was assessed using magnetic resonance imaging. Patients were grouped according to their scores for total imaging burden of cerebral small vessel disease and cognitive function. Logistic regression analysis assessed the association between the PI, total imaging burden, and cognitive impairment. Spearman analysis was used to evaluate the correlation between the PI and total imaging burden and cognitive impairment, and receiver operating characteristic (ROC) curves were used to determine the predictive value of the PI for cognitive function. RESULTS The PI was higher in the cognitive impairment (CI) group than in the no-CI group. Binary logistic regression analysis showed that increased PI was an independent risk factor for CI (OR = 1.582; 95% CI: 1.043-2.401; p = .031) and total imaging burden (OR = 1.842; 95% CI: 1.274-2.663; p = .001). Spearman analysis found that the PI correlated negatively with the MMSE score (r = -.627, p < .001). ROC curve analysis showed the PI predicted CI with an area under the curve of 0.784. The PI combined with the total imaging burden predicted CI in cerebral small vessel disease with an area under the curve of 0.832. CONCLUSION An increased PI was associated with CI and a high imaging burden in cerebral small vessel disease patients. The PI combined with the total burden score shows a high predictive value for CI.
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Affiliation(s)
- Huijuan Wu
- Department of NeurologyJinzhou Medical UniversityJinzhouChina
| | - Liaoyang Xu
- Department of NeurologyThe Affiliated Lianyungang Hospital of Xuzhou Medical UniversityLianyungangChina
| | - Xingyongpei Zheng
- Department of NeurologyThe Affiliated Lianyungang Hospital of Xuzhou Medical UniversityLianyungangChina
| | - Caihong Gu
- Department of Critical Care MedicineThe First Affiliated Hospital of Kangda College of Nanjing Medical UniversityLianyungangChina
| | - Xinyu Zhou
- Department of NeurologyLianyungang Clinical College of Nanjing Medical University, The First People's Hospital of Lianyungang CityLianyungangChina
- Department of NeurologyThe First Affiliated Hospital of Kangda College of Nanjing Medical UniversityLianyungangChina
- Department of NeurologyThe Affiliated Lianyungang Hospital of Xuzhou Medical UniversityLianyungangChina
| | - Yong Sun
- Department of NeurosurgeryThe Affiliated Lianyungang Hospital of Xuzhou Medical UniversityThe First People's Hospital of Lianyungang CityLianyungangChina
| | - Xiaomin Li
- Department of Emergency MedicineLianyungang Clinical College of Nanjing Medical UniversityThe First People's Hospital of LianyungangLianyungangChina
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Månsson T, Rosso A, Ellström K, Abul-Kasim K, Elmståhl S. Chronic kidney disease and its association with cerebral small vessel disease in the general older hypertensive population. BMC Nephrol 2024; 25:93. [PMID: 38481159 PMCID: PMC10936027 DOI: 10.1186/s12882-024-03528-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 02/28/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Cerebral small vessel disease can be identified using magnetic resonance imaging, and includes white matter hyperintensities, lacunar infarcts, cerebral microbleeds, and brain atrophy. Cerebral small vessel disease and chronic kidney disease share many risk factors, including hypertension. This study aims to explore an association between chronic kidney disease and cerebral small vessel disease, and also to explore the role of hypertension in this relationship. METHODS With a cross sectional study design, data from 390 older adults was retrieved from the general population study Good Aging in Skåne. Chronic kidney disease was defined as glomerular filtration rate < 60 ml/min/1,73m2. Associations between chronic kidney disease and magnetic resonance imaging markers of cerebral small vessel disease were explored using logistic regression models adjusted for age and sex. In a secondary analysis, the same calculations were performed with the study sample stratified based on hypertension status. RESULTS In the whole group, adjusted for age and sex, chronic kidney disease was not associated with any markers of cerebral small vessel disease. After stratification by hypertension status and adjusted for age and sex, we observed that chronic kidney disease was associated with cerebral microbleeds (OR 1.93, CI 1.04-3.59, p-value 0.037), as well as with cortical atrophy (OR 2.45, CI 1.34-4.48, p-value 0.004) only in the hypertensive group. In the non-hypertensive group, no associations were observed. CONCLUSIONS In this exploratory cross-sectional study, we observed that chronic kidney disease was associated with markers of cerebral small vessel disease only in the hypertensive subgroup of a general population of older adults. This might indicate that hypertension is an important link between chronic kidney disease and cerebral small vessel disease. Further studies investigating the relationship between CKD, CSVD, and hypertension are warranted.
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Affiliation(s)
- Tomas Månsson
- Department of Clinical Sciences in Malmö, Division of Geriatric Medicine, Lund University and Skåne University Hospital, Jan Waldenströms gata 35, pl 13, 205 02, Malmö, Sweden.
| | - Aldana Rosso
- Department of Clinical Sciences in Malmö, Division of Geriatric Medicine, Lund University and Skåne University Hospital, Jan Waldenströms gata 35, pl 13, 205 02, Malmö, Sweden
| | - Katarina Ellström
- Department of Clinical Sciences in Malmö, Division of Geriatric Medicine, Lund University and Skåne University Hospital, Jan Waldenströms gata 35, pl 13, 205 02, Malmö, Sweden
| | - Kasim Abul-Kasim
- Department of Clinical Sciences in Lund, Division of Diagnostic Radiology, Lund University, 221 85, Lund, Sweden
| | - Sölve Elmståhl
- Department of Clinical Sciences in Malmö, Division of Geriatric Medicine, Lund University and Skåne University Hospital, Jan Waldenströms gata 35, pl 13, 205 02, Malmö, Sweden
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Yu M, Feng L, Zhao X, Huang Q, Xia N, Xia H, Wen C, Wang M, Zhu Z, Yang Y. The interaction of global small vessel disease burden and Alzheimer's disease pathologies do not change the independent association of amyloid-beta with hippocampal volume: A longitudinal study on mild cognitive impairment subjects. Hippocampus 2023; 33:1197-1207. [PMID: 37638636 DOI: 10.1002/hipo.23573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 08/04/2023] [Accepted: 08/13/2023] [Indexed: 08/29/2023]
Abstract
The purpose of this study was to investigate whether the co-existence of global small vessel disease (SVD) burdens and Alzheimer's disease (AD) pathologies change hippocampal volume (HV) and cognitive function of mild cognitive impairment (MCI) subjects. We obtained MRI images, cerebrospinal fluid biomarkers (Aβ1-42 and p-tau), and neuropsychological tests of 310 MCI subjects from ADNI. The global SVD score was assessed. We used linear regression and linear mixing effect to analyze the effects of global SVD burdens, AD pathologies, and their interactions (SVD*AD) on baseline and longitudinal HV and cognition respectively. We used simple mediation effect to analyze the influencing pathways. After adjusting for global SVD and SVD*AD, Aβ remained independently correlated with baseline and longitudinal HV (std β = 0.294, p = .007; std β = 0.292, p < .001), indicating that global SVD did not affect the correlation between Aβ and HV. Global SVD score was correlated with longitudinal but not baseline HV (std β = 0.470, p = .050), suggesting that global SVD may be more representative of long-term permanent impairment. Global SVD, AD pathologies, and SVD*AD were independently correlated with baseline and longitudinal cognitions, in which the association of Aβ (B = 0.005, 95% CI: 0.005; 0.024) and p-tau (B = -0.002, 95% CI: -0.004; -0.000) with cognition were mediated by HV, suggesting that HV is more likely to explain the progression caused by AD pathology than SVD. The co-existence of global SVD and AD pathologies did not affect the individual association of Aβ on HV; HV played a more important role in the influence of AD pathology on cognition than in SVD.
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Affiliation(s)
- Mengying Yu
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Zhejiang, China
| | - Lufei Feng
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Zhejiang, China
- Department of Radiology, Zhuji Central Hospital, Zhejiang, China
| | - Xuemiao Zhao
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Zhejiang, China
| | - Qun Huang
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Zhejiang, China
| | - Nengzhi Xia
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Zhejiang, China
| | - Huwei Xia
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Zhejiang, China
| | - Caiyun Wen
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Zhejiang, China
| | - Meihao Wang
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Zhejiang, China
| | - Zili Zhu
- Department of Imaging, Ningbo City First Hospital, Zhejiang, China
| | - Yunjun Yang
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Zhejiang, China
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Hua M, Ma AJ, Liu ZQ, Ji LL, Zhang J, Xu YF, Chen WY, Mao LL. Arteriolosclerosis CSVD: a common cause of dementia and stroke and its association with cognitive function and total MRI burden. Front Aging Neurosci 2023; 15:1163349. [PMID: 37520130 PMCID: PMC10375409 DOI: 10.3389/fnagi.2023.1163349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 06/26/2023] [Indexed: 08/01/2023] Open
Abstract
Objective Arteriolosclerosis cerebral small vessel disease (CSVD) is a common type of CSVD. This study aimed to explore the factors associated with cognitive function and total MRI burden related to the disease. Methods The demographic characteristics, clinical manifestations, cognitive function score, Barthel Index (BI), blood test index, and follow-up results of arteriolosclerosis CSVD patients treated for the first time in our hospital from January 2014 to August 2022 were collected. White matter hyperintensity (WMH) Fazekas score, total MRI burden, and cerebral atrophy grade were evaluated according to brain MRI findings. Factors associated with CSVD cognitive function were analyzed by binary logistic regression. The correlative factors related to the total MRI burden of CSVD were analyzed by ordered multiple logistic regression. Results A total of 146 patients were included in this study, of which 132 cases (90.4%) had hypertension. There were 108 patients (74.0%) with cognitive dysfunction, 97 patients (66.4%) with balance and gait disorders, and 83 patients (56.8%) with moderate-to-severe dependence in daily life (BI ≤ 60 points). Of 146 patients, 79 (54.1%) completed clinical and imaging follow-ups for a median of 3 years. The number of patients with cognitive impairment and BI ≤ 60 points after follow-up significantly increased compared with the first admission (P < 0.001). There were also significant differences in total MRI burden (P = 0.001), WMH Fazekas score, and cerebral atrophy grade (P < 0.001). Mean age (P = 0.012), median deep WMH Fazekas score (P = 0.028), and median deep (P < 0.001) and superficial (P =0.002) cerebral atrophy grade of patients with cognitive impairment at first admission were all higher than those with non-cognitive impairment. Multivariate analysis showed that deep cerebral atrophy was independently and significantly associated with cognitive impairment of CSVD (P = 0.024), and hypertension was significantly and independently associated with total MRI burden (P = 0.001). Conclusion The disease course of arteriolosclerosis CSVD may be related to cognitive function and total MRI burden. Deep cerebral atrophy was an independent risk factor for cognitive dysfunction in arteriolosclerosis CSVD, and hypertension was an independent risk factor for total MRI burden.
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Affiliation(s)
| | | | | | | | | | | | - Wen-Ya Chen
- Department of Neurology, Wujin Hospital Affiliated to Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
| | - Lun-Lin Mao
- Department of Neurology, Wujin Hospital Affiliated to Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
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Zhang X, Liang C, Wang N, Wang Y, Gao Y, Sui C, Xin H, Feng M, Guo L, Wen H. Abnormal whole-brain voxelwise structure-function coupling and its association with cognitive dysfunction in patients with different cerebral small vessel disease burdens. Front Aging Neurosci 2023; 15:1148738. [PMID: 37455935 PMCID: PMC10347527 DOI: 10.3389/fnagi.2023.1148738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 06/13/2023] [Indexed: 07/18/2023] Open
Abstract
Cerebral small vessel disease (CSVD) is a universal neurological disorder in older adults that occurs in connection with cognitive dysfunction and is a chief risk factor for dementia and stroke. While whole-brain voxelwise structural and functional abnormalities in CSVD have been heavily explored, the degree of structure-function coupling abnormality possible in patients with different CSVD burdens remains largely unknown. This study included 53 patients with severe CSVD burden (CSVD-s), 108 patients with mild CSVD burden (CSVD-m) and 76 healthy controls. A voxelwise coupling metric of low frequency fluctuations (ALFF) and voxel-based morphometry (VBM) was used to research the important differences in whole-brain structure-function coupling among groups. The correlations between ALFF/VBM decoupling and cognitive parameters in CSVD patients were then investigated. We found that compared with healthy controls, CSVD-s patients presented notably decreased ALFF/VBM coupling in the bilateral caudate nuclei and increased coupling in the right inferior temporal gyrus (ITG). In addition, compared with the CSVD-m group, the CSVD-s group demonstrated significantly decreased coupling in the bilateral caudate nuclei, right putamen and inferior frontal gyrus (IFG) and increased coupling in the left middle frontal gyrus and medial superior frontal gyrus. Notably, the ALFF/VBM decoupling values in the caudate, IFG and ITG not only showed significant correlations with attention and executive functions in CSVD patients but also prominently distinguished CSVD-s patients from CSVD-m patients and healthy controls in receiver operating characteristic curve research. Our discoveries demonstrated that decreased ALFF/VBM coupling in the basal ganglia and increased coupling in the frontotemporal lobes were connected with more severe burden and worse cognitive decline in CSVD patients. ALFF/VBM coupling might serve as a novel effective neuroimaging biomarker of CSVD burden and provide new insights into the pathophysiological mechanisms of the clinical development of CSVD.
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Affiliation(s)
- Xinyue Zhang
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education, Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Changhu Liang
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education, Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Na Wang
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education, Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Yuanyuan Wang
- Department of Medical Imaging, Binzhou Medical University, Yantai, Shandong, China
| | - Yian Gao
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education, Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Chaofan Sui
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education, Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Haotian Xin
- Department of Radiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Mengmeng Feng
- Department of Radiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Lingfei Guo
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education, Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Hongwei Wen
- Key Laboratory of Cognition and Personality (Ministry of Education), Faculty of Psychology, Southwest University, Chongqing, China
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Singh MV, Uddin MN, Vidalle MC, Sutton KR, Boodoo ZD, Peterson AN, Tyrell A, Brenner R, Tivarus ME, Wang HZ, Sahin B, Zhong J, Weber M, Wang L, Qiu X, Maggiwar SB, Schifitto G. Role of non-classical monocytes in HIV-associated vascular cognitive impairment. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.03.24.23287660. [PMID: 37034744 PMCID: PMC10081378 DOI: 10.1101/2023.03.24.23287660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Despite antiretroviral treatment (cART), people living with HIV (PLWH) are more susceptible to neurocognitive impairment (NCI), probably due to synergistic/additive contribution of traditional cerebrovascular risk factors. Specifically, altered blood brain barrier (BBB) and transmigration of inflammatory monocytes are risk factors for developing cerebral small vessel disease (CSVD). In order to investigate if inflammatory monocytes exacerbate CSVD and cognitive impairment, 110 PLWH on cART and 110 age-, sex- and Reynold’s cardiovascular risk score-matched uninfected individuals were enrolled. Neuropsychological testing, brain magnetic resonance imaging and whole blood analyses to measure platelet-monocyte interaction and monocyte, endothelial activation were performed. Results demonstrated that PLWH exhibited increased levels of platelet-monocyte complexes (PMCs) and higher expression of activation molecules on PMCs. PLWH with CSVD had the poorest cognitive performance and the highest circulating levels of non-classical monocytes which exhibited significant inverse correlation with each other. Furthermore, markers of monocyte and endothelium activation were significantly positively correlated indicating BBB impairment. Our results confirm that interaction with platelets activates and drives monocytes towards an inflammatory phenotype in PLWH. In particular, elevated levels of non-classical monocytes may represent a common pathway to neuroinflammation, CSVD and subsequent cognitive impairment, warranting further longitudinal studies to evaluate responsiveness of this potential biomarker.
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Xiao Y, Teng Z, Xu J, Qi Q, Guan T, Jiang X, Chen H, Xie X, Dong Y, Lv P. Systemic Immune-Inflammation Index is Associated with Cerebral Small Vessel Disease Burden and Cognitive Impairment. Neuropsychiatr Dis Treat 2023; 19:403-413. [PMID: 36852257 PMCID: PMC9960781 DOI: 10.2147/ndt.s401098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 02/15/2023] [Indexed: 02/23/2023] Open
Abstract
OBJECTIVE This study sought to explore the associations of the systemic immune-inflammation index (SII) with total cerebral small vessel disease (CSVD) burden and cognitive impairment. METHODS We enrolled 201 patients in the retrospective study with complete clinical and laboratory data. The SII was calculated as platelet count × neutrophil count/lymphocyte count. Cognitive function was evaluated by the Mini-Mental State Examination (MMSE). Total CSVD burden was assessed based on magnetic resonance imaging. We performed logistic regression models, Spearman correlation, and mediation analysis to evaluate the associations of SII with CSVD burden and cognitive impairment. RESULTS After adjustment for confounding factors in the multivariate binary logistic regression model, elevated SII (odds ratio [OR], 3.263; 95% confidence interval [CI], 1.577-6.752; P = 0.001) or severe CSVD burden (OR, 2.794; 95% CI, 1.342-5.817; P = 0.006) was significantly associated with the risk of cognitive impairment. Correlation analyses revealed that SII levels were negatively associated with MMSE scores (rs = -0.391, P < 0.001), and positively associated with the total CSVD burden score (rs = 0.361, P < 0.001). Moreover, SII was significantly related to the severity of the CSVD burden (OR, 2.674; 95% CI, 1.359-5.263; P = 0.004). The multivariable-adjusted odds ratios (95% CI) in highest tertile versus lowest tertile of SII were 8.947 (3.315-24.145) for cognitive impairment and 4.945 (2.063-11.854) for severe CSVD burden, respectively. The effect of higher SII on cognitive impairment development was partly mediated by severe CSVD burden. CONCLUSION Elevated SII is associated with severe CSVD burden and cognitive impairment. The mediating role of severe CSVD burden suggests that higher SII may contribute to cognitive impairment through aggravating CSVD burden.
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Affiliation(s)
- Yining Xiao
- Department of Neurology, Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.,Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, People's Republic of China.,Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, Shijiazhuang, Hebei, People's Republic of China
| | - Zhenjie Teng
- Department of Neurology, Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.,Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, People's Republic of China.,Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, Shijiazhuang, Hebei, People's Republic of China
| | - Jing Xu
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, People's Republic of China.,Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, Shijiazhuang, Hebei, People's Republic of China
| | - Qianqian Qi
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, People's Republic of China
| | - Tianyuan Guan
- Department of Neurology, Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.,Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, People's Republic of China
| | - Xin Jiang
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, People's Republic of China.,Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, Shijiazhuang, Hebei, People's Republic of China
| | - Huifang Chen
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, People's Republic of China
| | - Xiaohua Xie
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, People's Republic of China
| | - Yanhong Dong
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, People's Republic of China.,Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, Shijiazhuang, Hebei, People's Republic of China
| | - Peiyuan Lv
- Department of Neurology, Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.,Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, People's Republic of China.,Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, Shijiazhuang, Hebei, People's Republic of China
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11
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Zhang L, Gao F, Zhang Y, Hu P, Yao Y, Zhang Q, He Y, Shang Q, Zhang Y. Analysis of risk factors for the development of cognitive dysfunction in patients with cerebral small vessel disease and the construction of a predictive model. Front Neurol 2022; 13:944205. [PMID: 36034271 PMCID: PMC9403715 DOI: 10.3389/fneur.2022.944205] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 07/22/2022] [Indexed: 12/18/2022] Open
Abstract
Background Cognitive dysfunction in cerebral small vessel disease (CSVD) is a common cause of vascular dementia. The purpose of this study was to find independent risk factors for the development of cognitive dysfunction in patients with CSVD and establish a risk prediction model, in order to provide a reference for clinical diagnosis and treatment of such patients. Methods In this study, clinical data of patients with CSVD admitted to the Department of Neurology in Gansu Provincial Hospital from December 2019 to December 2021 were collected, and 159 patients were finally included after strict screening according to the inclusion and exclusion criteria. There were 43 patients with normal function and 116 patients with cerebral small vessel disease cognitive impairment (CSVDCI). The logistic multivariable regression model was used to screen out the independent risk factors of cognitive dysfunction in patients with CSVD, and the nomogram of cognitive dysfunction in patients with CSVD was constructed based on the results of the logistic multivariable regression analysis. Finally, the accuracy of the prediction model was evaluated by C-index, calibration curve, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA). Results The results of multivariable logistic regression analysis showed that hypertension (OR = 2.683, 95% CI 1.119–6.432, P = 0.027), homocysteine (Hcy) (OR = 1.083, 95% CI 1.026–1.143, P = 0.004), total CSVD MRI Score (OR = 1.593, 95% CI 1.025–2.475, P = 0.039) and years of schooling (OR = 0.883, 95% CI 0.798–0.978, P = 0.017) were independent risk factors for the development of cognitive dysfunction in patients with CSVD. The C-index of this prediction model was 0.806 (95% CI 0.735–0.877), and the calibration curve, ROC curve, and DCA curve all showed good predictive power in the nomogram. Conclusions The nomogram constructed in this study has high accuracy and clinical utility in predicting the occurrence of cognitive dysfunction in patients with CSVD. For patients with CSVD with the above risk factors, active clinical intervention and prevention are required during clinical consultation and disease management to avoid cognitive impairment as much as possible.
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Affiliation(s)
- Le Zhang
- The First Clinical Medical College of Gansu University of Chinese Medicine (Gansu Provincial Hospital), Lanzhou, China
- The Department of Neurology, Gansu Provincial Hospital, Lanzhou, China
| | - Fulin Gao
- The Department of Neurology, Gansu Provincial Hospital, Lanzhou, China
| | - Yamin Zhang
- The Department of Neurology, Gansu Provincial Hospital, Lanzhou, China
| | - Pengjuan Hu
- The First Clinical Medical College of Gansu University of Chinese Medicine (Gansu Provincial Hospital), Lanzhou, China
- The Department of Neurology, Gansu Provincial Hospital, Lanzhou, China
| | - Yuping Yao
- The Department of Neurology, Gansu Provincial Hospital, Lanzhou, China
| | - Qingzhen Zhang
- The First Clinical Medical College of Gansu University of Chinese Medicine (Gansu Provincial Hospital), Lanzhou, China
- The Department of Neurology, Gansu Provincial Hospital, Lanzhou, China
| | - Yan He
- The First Clinical Medical College of Gansu University of Chinese Medicine (Gansu Provincial Hospital), Lanzhou, China
- The Department of Neurology, Gansu Provincial Hospital, Lanzhou, China
| | - Qianlan Shang
- The First Clinical Medical College of Gansu University of Chinese Medicine (Gansu Provincial Hospital), Lanzhou, China
- The Department of Neurology, Gansu Provincial Hospital, Lanzhou, China
| | - Yi Zhang
- The Department of Neurology, Gansu Provincial Hospital, Lanzhou, China
- *Correspondence: Yi Zhang
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12
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Hou M, Hou X, Qiu Y, Wang J, Zhang M, Mao X, Wu X. Characteristics of Cognitive Impairment and Their Relationship With Total Cerebral Small Vascular Disease Score in Parkinson's Disease. Front Aging Neurosci 2022; 14:884506. [PMID: 35875803 PMCID: PMC9301002 DOI: 10.3389/fnagi.2022.884506] [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: 02/26/2022] [Accepted: 06/16/2022] [Indexed: 11/21/2022] Open
Abstract
Background This study aimed to investigate the characteristics of cognitive dysfunctions and their relationship with total cerebral small vascular disease (CSVD) in Parkinson’s disease (PD). Methods A total of 174 idiopathic PD patients who underwent brain magnetic resonance imaging (MRI) were recruited. Demographic information, vascular disease risk factors, motor function (MDS-UPDRS III score), and cognitive level (MoCA, MMSE) were collected for these patients. The total CSVD burden was scored based on lacunes, enlarged perivascular spaces (EPVS), high-grade white matter hyperintensities (WMH), and cerebral microbleeds (CMBs) for each subject. Results Cognitive scores on MoCA for language, delayed recall, and orientation were significantly reduced in PD patients with CSVD burden ≥ 1 than in those with CSVD burden = 0. Educational level, PDQ 39, and CSVD burden were significantly associated with MoCA scores in individuals with PD. For the whole group, the full model accounted for 33.6% variation in total MoCA scores. In which, CSVD burden explained 2.7% of the results, and the detection of lacunes, WMH, EPVS, and strictly lobar CMBs were significantly correlated with MoCA scores. The stability of the outcomes was confirmed by sensitivity analysis. Conclusion CSVD can independently contribute to cognitive decline in PD and cause damage in specific cognitive domains. Promoting neurovascular health may help preserve cognitive functions in PD.
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Affiliation(s)
- Miaomiao Hou
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaojun Hou
- Department of Neurology, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Yiqing Qiu
- Department of Neurosurgery, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Jiali Wang
- Department of Neurosurgery, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Mingyang Zhang
- Department of Chemistry, University of Utah, Salt Lake City, UT, United States
| | - Xiaowei Mao
- Department of Neurology, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Xi Wu
- Department of Neurosurgery, The First Affiliated Hospital of Naval Medical University, Shanghai, China
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13
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Zheng BK, Niu PP. Higher Coffee Consumption Is Associated With Reduced Cerebral Gray Matter Volume: A Mendelian Randomization Study. Front Nutr 2022; 9:850004. [PMID: 35369049 PMCID: PMC8969755 DOI: 10.3389/fnut.2022.850004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 02/15/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundRecently published two-sample Mendelian randomization (MR) studies showed that genetically predicted coffee consumption may be associated with increased risk of Alzheimer’s disease and intracerebral hemorrhage but associated with a decreased risk of small vessel ischemic stroke. We aimed to investigate the effects of genetically predicted coffee consumption on magnetic resonance imaging (MRI) markers of cerebral small vessel disease and brain volume using the two-sample MR method.MethodsTwelve single nucleotide polymorphisms (SNPs) in up to 375,833 individuals were used as genetic instruments for cups consumed per day of coffee. Another four SNPs from an independent sample were used to perform the replication analysis. Three SNPs in up to 45,821 individuals were used as genetic instruments for high coffee consumption vs. low/no coffee consumption.ResultsMendelian randomization analysis showed that coffee consumption (cups/day) was inversely associated with gray matter volume (beta = −0.371, 95% CI = −0.596 to −0.147, p = 0.001). Replication analysis and multivariable analyses after adjusting for other risk factors confirmed the effect. High coffee consumption was also suggestively associated with decreased gray matter volume (beta = −0.061, 95% CI = −0.109 to −0.013, p = 0.013) compared with low/no coffee consumption. All analyses did not find an effect of coffee consumption on other outcomes including white matter hyperintensity volume, mean diffusivity, fractional anisotropy, brain microbleed, total brain volume, white matter volume, and hippocampus volume.ConclusionThis two-sample MR study showed that genetically predicted higher coffee consumption is causally associated with reduced gray matter volume of the brain.
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Affiliation(s)
- Bing-Kun Zheng
- Neonatal Intensive Care Unit (NICU), The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Bing-Kun Zheng,
| | - Peng-Peng Niu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Peng-Peng Niu,
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14
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Zhu Z, Zeng Q, Zhang R, Luo X, Li K, Xu X, Zhang M, Yang Y, Huang P. White Matter Free Water Outperforms Cerebral Small Vessel Disease Total Score in Predicting Cognitive Decline in Persons with Mild Cognitive Impairment. J Alzheimers Dis 2022; 86:741-751. [PMID: 35124653 DOI: 10.3233/jad-215541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Vascular pathology is an important partner of Alzheimer's disease (AD). Both total cerebral small vessel disease (CSVD) score and white matter free water (FW) are useful markers that could reflect cerebral vascular injury. OBJECTIVE We aim to investigate the efficacy of these two metrics in predicting cognitive declines in patients with mild cognitive impairment (MCI). METHODS We enrolled 126 MCI subjects with 3D T1-weighted images, fluid-attenuated inversion recovery images, T2 * images, diffusion tensor imaging images, cerebrospinal fluid biomarkers and neuropsychological tests from the Alzheimer's Disease Neuroimaging Initiative database. The total CSVD score and FW values were calculated. Simple and multiple linear regression analyses were applied to explore the association between vascular and cognitive impairments. Linear mixed effect models were constructed to investigate the efficacy of total CSVD score and FW on predicting cognitive decline. RESULTS FW was associated with baseline cognition and could predict the decline of executive and language functions in MCI subjects, while no association was found between total CSVD score and cognitive declines. CONCLUSION FW is a promising imaging marker for investigating the effect of CSVD on AD progression.
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Affiliation(s)
- Zili Zhu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China.,Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, China
| | - Qingze Zeng
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China
| | - Ruiting Zhang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China
| | - Xiao Luo
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China
| | - Kaicheng Li
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China
| | - Xiaopei Xu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China
| | - Minming Zhang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China
| | - Yunjun Yang
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, China
| | - Peiyu Huang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China.,Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, China
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Li X, Yang S, Qin W, Yang L, Li Y, Hou Y, Huang Q, Hu W. Cerebral Microbleeds Were Related With Poor Cognitive Performances on the Dual Task Condition in Older Adults. Front Aging Neurosci 2022; 13:807753. [PMID: 35082660 PMCID: PMC8784411 DOI: 10.3389/fnagi.2021.807753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/17/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The dual task (DT) was commonly used to assess the risk of falls in older adults and patients with neurological disorders. However, the performance on DT conditions has not been well investigated in patients with cerebral microbleed (CMB). This study is aimed to compare the performance in DT tests between older adults with and without CMB, and to explore the association between CMB and cognitive performances of DT.Methods: This is a cross-sectional study. A total of 211 old adults participated, involving 68 CMB patients. The task protocol involved two global cognition tests, two single cognitive tests (serial 7 subtraction and semantic fluency), two single motor tasks [8-m walking and timed up and go test (TUG)], and three DT tests [walking and serial subtraction (WSS), walking and semantic fluency (WSF), and TUG and serial subtraction (TUGSS)]. The time taken to complete each task and the number of correct responses were recorded. For each DT condition, the correct response rate (CRR) and the dual-task effect (DTE) for the correct number were calculated.Results: Compared with subjects without CMB, CMB patients had worse cognitive performances on DT condition in CRR of WSS (p = 0.003), WSF (p = 0.030) and TUGSS (p = 0.006), and DTE of WSS (p = 0.017). Binary logistic regression analysis showed that the presence of CMB was an independent risk factor for the impairment group for CRR of TUGSS (OR, 2.54; 95% CI, 1.11–5.82; p = 0.027) with the adjustment for confounders, rather than CRR of WSS and WSF, or DTE of WSS. Multiple linear regression analysis showed that CRR of TUGSS decreased with the increase of CMB number grades (β, −0.144; 95% CI, −0.027, −0.002; p = 0.028).Conclusion: The present study indicated that CMBs were closely associated with poor cognitive performances on DT in the elderly. Strongest effect size was seen for CRR of TUGSS, where performance deficits increased in proportion to the degree of CMB burden.
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Teng Z, Feng J, Liu R, Dong Y, Chen H, Xu J, Jiang X, Li R, Lv P. Cerebral Small Vessel Disease is Associated with Mild Cognitive Impairment in Type 2 Diabetes Mellitus. Diabetes Metab Syndr Obes 2022; 15:1985-1994. [PMID: 35814027 PMCID: PMC9259063 DOI: 10.2147/dmso.s368725] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/29/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Type 2 diabetes mellitus (T2DM) is associated with cognitive impairment, but the underlying cerebral small vessel disease (CSVD)-related structural brain correlates are unclear. The aim of this study was to investigate the relationship between various imaging markers of CSVD and mild cognitive impairment (MCI) in patients with T2DM. METHODS A total of 228 eligible participants with T2DM who were divided into MCI group and normal cognitive group based on neuropsychological assessment were enrolled in this retrospective study. White matter hyperintensity (WMH), lacunes, cerebral microbleeds (CMBs) and enlarged perivascular spaces (EPVS) were evaluated based on brain magnetic resonance imaging (MRI). The total CSVD burden score was calculated by combining the above four markers of CSVD. Binary logistic regression analysis was used to evaluate the relationship between different imaging markers of CSVD and MCI in patients with T2DM. Kruskal-Wallis test and Jonckheere-Terpstra test were used to compare mean MoCA scores among individuals with varying CSVD markers. RESULTS In the multivariate binary logistic regression analyses, moderate or severe total CSVD burden (OR: 3.29, 95% CI: 1.63-7.38, P=0.004; OR: 10.97, 95% CI: 4.94-24.34, P<0.001, respectively), moderate dWMH (OR: 3.26, 95% CI: 1.43-7.41, P=0.005), extensive lacunes (OR: 4.97, 95% CI: 1.79-13.81, P=0.002), and moderate BG-EPVS (OR: 3.84, 95% CI: 1.81-8.13, P<0.001) were associated with MCI in patients with T2DM related to MCI after adjusting for potential confounders. There was a trend for significant decrease in MoCA scores with increase severity of dWMH, pWMH, lacunes, BG-EPVS, deep CMBs, or total CSVD burden (P for trend <0.05). CONCLUSION Different imaging markers of CSVD, particularly total CSVD burden, were associated with an increased risk of MCI and decline in MoCA scores in patients with T2DM. These findings may provide clues for future studies to explore early diagnostic imaging markers of cognitive impairment in relation to T2DM.
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Affiliation(s)
- Zhenjie Teng
- Department of Neurology, Hebei Medical University, Shijiazhuang, Hebei Province, People’s Republic of China
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei Province, People’s Republic of China
| | - Jing Feng
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei Province, People’s Republic of China
| | - Ronghui Liu
- Department of Radiology, Hebei General Hospital, Shijiazhuang, Hebei Province, People’s Republic of China
| | - Yanhong Dong
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei Province, People’s Republic of China
| | - Huifang Chen
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei Province, People’s Republic of China
| | - Jing Xu
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei Province, People’s Republic of China
| | - Xin Jiang
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei Province, People’s Republic of China
| | - Rui Li
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei Province, People’s Republic of China
| | - Peiyuan Lv
- Department of Neurology, Hebei Medical University, Shijiazhuang, Hebei Province, People’s Republic of China
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei Province, People’s Republic of China
- Correspondence: Peiyuan Lv, Department of Neurology, Hebei General Hospital, 348 Heping West Road, Shijiazhuang, Hebei Province, 050051, People’s Republic of China, Tel/Fax +86 31185988906, Email
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