Accumulation of MRI markers of cerebral small vessel disease is associated with decreased cognitive function. A study in first-ever lacunar stroke and hypertensive patients

被引:165
作者
Huijts, Marjolein [1 ,2 ,3 ]
Duits, Annelien [2 ,4 ]
van Oostenbrugge, Robert J. [1 ,2 ,3 ]
Kroon, Abraham A. [2 ,3 ,5 ]
de Leeuw, Peter W. [3 ,5 ]
Staals, Julie [1 ,3 ]
机构
[1] Maastricht Univ, Dept Neurol, NL-6202 AZ Maastricht, Netherlands
[2] Maastricht Univ, Sch Mental Hth & Neurosci MHeNS, NL-6202 AZ Maastricht, Netherlands
[3] Maastricht Univ, CARIM, NL-6202 AZ Maastricht, Netherlands
[4] Maastricht Univ, Dept Psychiat & Psychol, NL-6202 AZ Maastricht, Netherlands
[5] Maastricht Univ, Maastricht Univ Med Ctr, Dept Internal Med, NL-6202 AZ Maastricht, Netherlands
来源
FRONTIERS IN AGING NEUROSCIENCE | 2013年 / 5卷
关键词
cerebral small vessel disease; cognition; white matter lesions; brain microbleeds; lacunar infarcts; enlarged perivascular spaces; VIRCHOW-ROBIN SPACES; PROCESSING SPEED; MICROBLEEDS; DYSFUNCTION; INFARCTS; DECLINE; DEMENTIA; RISK;
D O I
10.3389/fnagi.2013.00072
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Background: White matter lesions (WMLs), asymptomatic lacunar infarcts, brain microbleeds (BMBs), and enlarged perivascular spaces (EPVS) have been identified as silent lesions due to cerebral small vessel disease (cSVD). All these markers have been individually linked to cognitive functioning, but are also strongly correlated with each other. The combined effect of these markers on cognitive function has never been studied and would possibly provide more useful information on the effect on cognitive function. Methods: Brain MRI and extensive neuropsychological assessment were performed in 189 patients at risk for cSVD (112 hypertensive patients and 77 first-ever lacunar stroke patients). We rated the presence of any asymptomatic lacunar infarct, extensive WMLs, any deep BMB, and moderate to extensive EPVS in the basal ganglia. The presence of each marker was summed to an ordinal score between 0 and 4. Associations with domains of cognitive function (memory, executive function, information processing speed, and overall cognition) were analyzed with correlation analyses. Results: Correlation analyses revealed significant associations between accumulating cSVD burden and decreased performance on all cognitive domains (all p <= 0.001). Results remained significant for information processing speed (r = -0.181, p = 0.013) and overall cognition (r = -0.178, p = 0.017), after correction for age and sex. Testing of trend using linear regression analyses revealed the same results. Discussion: We tested a new approach to capture total brain damage resulting from cSVD and found that accumulation of MRI burden of cSVD is associated with decreased performance on tests of information processing speed and overall cognition, implying that accumulating brain damage is accompanied by worse cognitive functioning.
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