Relationship between cognitive condition and neuroimaging features in patients with cerebral small vessel disease

CAO Wenwei; ZHAO Wei; YU Ling; CHAI Wen; WANG Yao; XU Qun

doi:10.12022/jnnr.2016-0069

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Journal of Neurology and Neurorehabilitation ›› 2017, Vol. 13 ›› Issue (1) : 17-24. DOI: 10.12022/jnnr.2016-0069

Original Research

Relationship between cognitive condition and neuroimaging features in patients with cerebral small vessel disease

CAO Wenwei, ZHAO Wei, YU Ling, CHAI Wen, WANG Yao, XU Qun

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Abstract

Objective: The purpose of this study is to investigate the relationship between the cognitive state of patients with cerebral small vessel disease (CSVD) and the location and number of lacunar infarcts, the white matter lesion (WML) and medial temporal lobe atrophy (MTA). Methods: This study recruited 59 patients with CSVD who had a recent symptomatic ischemic stroke history > 3 months and were registered in the secondary prevention clinic of cerebrovascular disease in Department of Neurology, Renji Hospital, Shanghai Jiao Tong University School of Medicine. According to the detailed neuropsychological assessment results, 59 patients were divided into no cognitive impairment (NCI) group (n = 24), mild cognitive impairment (MCI) group (n = 22) and vascular dementia (VaD) group (n = 13). The magnetic resonance imaging (MRI) of brain with multiple sequences and oblique coronal reconstruction was used for counting the number of lacunar infarcts and grading WML and MTA. Results: Cognitive impairment in patients with CSVD was associated with the number of lacunar infarcts (P = 0.004), and the number of lacunar infarcts in the subcortical white matter parts was significantly different among three groups (P = 0.001). The patients had more lacunar infarcts in thalamus in MCI and VaD groups than in NCI group, but it did not reach significant difference (P = 0.058). The majority of WLMs were located in the frontal and parietal occipital lobes, and there were less lesions in the temporal lobes and basal ganglia. There were significant differences in WML score of bilateral frontal lobes (P = 0.003) and basal ganglia (P = 0.009) among three groups. Of the 59 patients, MRI oblique coronal reconstruction was performed in 43 patients. It showed that MTA almost developed synchronously in both sides, and there were statistically significant differences in left and right MTA scores among three groups (both P < 0.001). In 13 patients whose left MTA scores were ≥2, 11 patients were in NCI and MCI groups. All the patients in VaD group had MTA, and the average left and right MTA scores of 6 patients were ≥2. The result of multivariate analysis showed that the number of subcortical WML [odds ratio: 2.39 (95% confidence interval: 1.19-5.80), P = 0.005] and the left MTA score [odds ratio: 10.21 (95% confidence interval: 2.02-51.75), P = 0.003] were the independent risk factors of cognitive impairment of patients with CSVD. Conclusion: The degree of cognitive impairment in patients with CSVD is associated with the number of subcortical WML and left MTA score.

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Cerebral small vessel diseases / Cognition disorders / Neuroimaging / Medial temporal lobe atrophy

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CAO Wenwei, ZHAO Wei, YU Ling, CHAI Wen, WANG Yao, XU Qun. Relationship between cognitive condition and neuroimaging features in patients with cerebral small vessel disease[J]. Journal of Neurology and Neurorehabilitation. 2017, 13(1): 17-24 https://doi.org/10.12022/jnnr.2016-0069

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