Hippocampal and cortical atrophy predict dementia in subcortical ischemic vascular disease

被引:365
|
作者
Fein, G
Di Sclafani, V
Tanabe, J
Cardenas, V
Weiner, MW
Jagust, WJ
Reed, BR
Norman, D
Schuff, N
Kusdra, L
Greenfield, T
Chui, H
机构
[1] Neurobehav Res Inc, San Francisco, CA USA
[2] Dept Vet Affairs Med Ctr, Magnet Resonance Unit, San Francisco, CA USA
[3] Univ Calif San Francisco, Dept Radiol, San Francisco, CA 94143 USA
[4] Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94143 USA
[5] Univ Calif Davis, Dept Neurol, Davis, CA 95616 USA
[6] Univ So Calif, Dept Neurol, Los Angeles, CA 90033 USA
[7] Univ Calif Davis, Lawrence Berkeley Lab, Dept Neurol, Davis, CA 95616 USA
[8] Univ Calif Davis, Ctr Funct Imaging, Davis, CA 95616 USA
关键词
D O I
10.1212/WNL.55.11.1626
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: The cause of dementia in subcortical ischemic vascular disease (SIVD) is controversial. Objectives: To determine whether cognitive impairment in SIVD 1) correlates with measures of ischemic brain injury or brain atrophy, and/or 2) is due to concomitant AD. Methods: Volumetric MRI of the brain was performed in 1) elderly subjects with lacunes (L) and a spectrum of cognitive impairment-normal cognition (NC+L, n = 32), mild cognitive impairment (CI+L, n = 26), and dementia (D+L, n = 29); 2) a comparison group with probable AD (n = 28); and 3) a control group with normal cognition and no lacunes (NC). The authors examined the relationship between the severity of cognitive impairment and 1) volume, number, and location of lacunes; 2) volume of white matter signal hyperintensities (WMSH); and 3) measures of brain atrophy (i.e., hippocampal, cortical gray matter, and CSF volumes). Results: Among the three lacune groups, severity of cognitive impairment correlated with atrophy of the hippocampus and cortical gray matter, but not with any lacune measure. Although hippocampal atrophy was the best predictor of severity of cognitive impairment, there was evidence for a second, partially independent, atrophic process associated with ventricular dilation, cortical gray matter atrophy, and increase in WMSH. Eight autopsied SIVD cases showed variable severity of ischemic and neurofibrillary degeneration in the hippocampus, but no significant AD pathology in neocortex. The probable AD group gave evidence of only one atrophic process, reflected in the severity of hippocampal atrophy, Comparison of regional neocortical gray matter volumes showed sparing of the primary motor and visual cortices in the probable AD group, but relatively uniform atrophy in the D+L group. Conclusions: Dementia in SIVD, as in AD, correlates best with hippocampal and cortical atrophy, rather than any measure of lacunes. In SIVD, unlike AD, there is evidence for partial independence between these two atrophic processes. Hippocampal atrophy may result from a mixture of ischemic and degenerative pathologies. The cause of diffuse cortical atrophy is not known, but may be partially indexed by the severity of WMSH.
引用
收藏
页码:1626 / 1635
页数:10
相关论文
共 50 条
  • [1] Subcortical ischemic lesions in dementia are associated with hippocampal and cortical atrophy
    Chui, H
    DiSclafani, V
    Weiner, M
    Norman, D
    Jagust, W
    Ellis, W
    Vinters, H
    Fein, G
    [J]. NEUROLOGY, 1999, 52 (06) : A98 - A99
  • [2] Hippocampal Atrophy in Subcortical Vascular Dementia
    van de Pol, Laura
    Gertz, Hermann-Josef
    Scheltens, Philip
    Wolf, Henrike
    [J]. NEURODEGENERATIVE DISEASES, 2011, 8 (06) : 465 - 469
  • [3] Midbrain atrophy in subcortical ischemic vascular dementia
    Sung, Young-Hee
    Park, Ki-Hyung
    Lee, Yeung-Bae
    Park, Hyeon-Mi
    Shin, Dong Jin
    Park, Jea-Sul
    Oh, Mi-Sun
    Ma, Hyeo-Il
    Yu, Kyung-Ho
    Kang, Suk-Yun
    Kim, Yun Joong
    Lee, Byung-Chul
    [J]. JOURNAL OF NEUROLOGY, 2009, 256 (12) : 1997 - 2002
  • [4] Midbrain atrophy in subcortical ischemic vascular dementia
    Young-Hee Sung
    Ki-Hyung Park
    Yeung-Bae Lee
    Hyeon-Mi Park
    Dong Jin Shin
    Jea-Sul Park
    Mi-Sun Oh
    Hyeo-Il Ma
    Kyung-Ho Yu
    Suk-Yun Kang
    Yun Joong Kim
    Byung-Chul Lee
    [J]. Journal of Neurology, 2009, 256 : 1997 - 2002
  • [5] Subcortical ischemic vascular disease and dementia
    Erkinjuntti, T
    [J]. INTERNATIONAL PSYCHOGERIATRICS, 2003, 15 : 23 - 26
  • [6] Dementia attributable to subcortical ischemic vascular disease
    Chui, H
    [J]. NEUROLOGIST, 2001, 7 (04) : 208 - 219
  • [7] The role of brain infarcts and hippocampal atrophy in subcortical ischaemic vascular dementia
    G. Gainotti
    A. Acciarri
    A. Bizzarro
    C. Marra
    C. Masullo
    S. Misciagna
    T. Tartaglione
    A. Valenza
    C. Colosimo
    [J]. Neurological Sciences, 2004, 25 : 192 - 197
  • [8] The role of brain infarcts and hippocampal atrophy in subcortical ischaemic vascular dementia
    Gainotti, G
    Acciarri, A
    Bizzarro, A
    Marra, C
    Masullo, C
    Misciagna, S
    Tartaglione, T
    Valenza, A
    Colosimo, C
    [J]. NEUROLOGICAL SCIENCES, 2004, 25 (04) : 192 - 197
  • [9] Subcortical ischemic vascular dementia
    Chui, Helena C.
    [J]. NEUROLOGIC CLINICS, 2007, 25 (03) : 717 - +
  • [10] Progression of subcortical ischemic disease from vascular depression to vascular dementia
    Steffens, DC
    Taylor, WD
    Krishnan, KRR
    [J]. AMERICAN JOURNAL OF PSYCHIATRY, 2003, 160 (10): : 1751 - 1756