A quantitative MRI study of vascular dementia

Abstract

We studied the MRI and clinical factors associated with dementia following stroke by quantifying ventricle-to-brain ratio (VBR), anatomic region of infarction, and cortical, subcortical, and white matter areas of infarction in 24 stroke patients with dementia and 29 nondemented stroke patients. The factors that most strongly correlated with dementia were total white matter lesion (WML) area, left WML, VBR, right WML, age, left cortical infarction area, left parietal infarction area, and total infarction area. Using discriminant analysis, these factors correctly classified 28 of 29 nondemented patients and 18 of 24 demented patients. Both cortical and white matter total infarction area measurements were strongly associated with dementia in stroke patients, suggesting that these factors strongly influenced the development of dementia following stroke. There was a strong association between dementia and left- but not right-hemisphere infarction area. The only demographic factor that strongly associated with dementia was age.

Hippocampal and cortical atrophy predict dementia in subcortical ischemic vascular disease

“…Our data also confirm the association between dementia and ventricular enlargement, noted by other investigators studying heterogeneous samples of large-and small-artery type VaD. 3,14,15 MRI and computerized segmentation methods used in the current study enable demonstration of a stronger association between dementia in SIVD and specifically neocortical as well as hippocampal atrophy.…”

“…Atrophy of the hippocampus and medial temporal lobe, anatomic regions highly susceptible to neurofibrillary degeneration, are characteristically observed in AD. [10][11][12] Previous investigators have correlated dementia in SIVD with the severity of ventricular enlargement, 3,[13][14][15] white matter lesions, 14,[16][17][18] cerebral hypoperfusion, 13,18,19 and number, but not necessarily volume, of lacunes. 3,16,19 One group has noted the presence of hippocampal atrophy in VaD, as well as AD.…”

Frequency and Determinants of Poststroke Dementia in Chinese

“…Stroke severity and level of education are well-known risk factors. 9 -11,13,16 Similarly, an association between the extent of white matter lesions and PSDE has been reported, 10,33 although not consistently. 15 For instance, Miyao et al 34 have demonstrated that, after the first lacunar infarction, the prevalence of dementia is higher in patients with leukoaraiosis.…”

Vascular Dementia Prevention: A Risk Factor Analysis

“…The left-sided predominance of lesions in demented patients with large-vessel stroke in territories of the anterior and posterior cerebral arteries has been repeatedly demonstrated [20]. Other risk factors include current smoking, lower blood pressure, orthostatic hypotension, and larger periventricular white matter ischemic lesions by brain CT or MRI [21, 22]. Hypoxic and ischemic complications of acute stroke (e.g., seizures, cardiac arrhythmias, aspiration pneumonia, etc.)…”