Aberrant White Matter Networks Mediate Cognitive Impairment in Patients with Silent Lacunar Infarcts in Basal Ganglia Territory

Tang, Jinfu; Zhong, Shaobo; Chen, Yaojing; Chen, Kewei; Zhang, Junying; Gong, Gaolang; Fleisher, Adam; He, Yong; Zhang, Zhanjun

doi:10.1038/jcbfm.2015.67

Cited by 18 publications

(15 citation statements)

References 45 publications

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“…As predicted, the presence of silent brain infarcts was associated with significantly worse cognitive performance. Significant deficits were detected in memory and other cognitive domains, reinforcing the view that covert vascular lesions in elderly populations are related to deficits in several cognitive domains 31 , 32 . Cohen’s d values were moderate (approximately 0.5) for the total and memory SKT scores and greater than 0.40 for the COGSCORE and the SKT attention subscore.…”

Section: Discussionsupporting

confidence: 64%

“…The preferential location of silent brain infarcts in the basal ganglia in our study is highly consistent with the findings of previous studies 3 and supports the hypothesis that this brain region exhibits greater vulnerability to cerebrovascular-related damage and the associated cognitive deficits in multiple domains 34 . Based on recent tractography MRI studies using diffusion tension imaging, even small silent vascular basal ganglia lesions may affect the function of large-scale cortical white matter networks, providing a potential explanation for the emergence of the association between cognitive deficits in multiple domains with silent basal ganglia infarcts 32 . Moreover, resting-state functional MRI investigations have revealed aberrant patterns of functional connectivity in both intra- and between brain networks in patients with vascular basal ganglia lesions, which are directly proportional to the degree of cognitive impairment 31 .…”

Section: Discussionmentioning

confidence: 99%

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High frequency of silent brain infarcts associated with cognitive deficits in an economically disadvantaged population

Squarzoni¹,

Tamashiro-Duran²,

Duran³

et al. 2017

Clinics

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OBJECTIVE:Using magnetic resonance imaging, we aimed to assess the presence of silent brain vascular lesions in a sample of apparently healthy elderly individuals who were recruited from an economically disadvantaged urban region (São Paulo, Brazil). We also wished to investigate whether the findings were associated with worse cognitive performance.METHODS:A sample of 250 elderly subjects (66-75 years) without dementia or neuropsychiatric disorders were recruited from predefined census sectors of an economically disadvantaged area of Sao Paulo and received structural magnetic resonance imaging scans and cognitive testing. A high proportion of individuals had very low levels of education (4 years or less, n=185; 21 with no formal education).RESULTS:The prevalence of at least one silent vascular-related cortical or subcortical lesion was 22.8% (95% confidence interval, 17.7–28.5), and the basal ganglia was the most frequently affected site (63.14% of cases). The subgroup with brain infarcts presented significantly lower levels of education than the subgroup with no brain lesions as well as significantly worse current performance in cognitive test domains, including memory and attention (p<0.002).CONCLUSIONS:Silent brain infarcts were present at a substantially high frequency in our elderly sample from an economically disadvantaged urban region and were significantly more prevalent in subjects with lower levels of education. Covert cerebrovascular disease significantly contributes to cognitive deficits, and in the absence of magnetic resonance imaging data, this cognitive impairment may be considered simply related to ageing. Emphatic attention should be paid to potentially deleterious effects of vascular brain lesions in poorly educated elderly individuals from economically disadvantaged environments.

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Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

High frequency of silent brain infarcts associated with cognitive deficits in an economically disadvantaged population

Squarzoni¹,

Tamashiro-Duran²,

Duran³

et al. 2017

Clinics

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“…The association of network efficiency with cognition persisted after controlling for the SVD, but it was not stated how it compared to a simple FA value [48]. A similar association with cognition was found in 27 patients with a lacune on neuroimaging where global and local network efficiencies were reduced compared to control and memory, attention, executive function and verbal fluency were all associated with nodal efficiency [49]. …”

Section: Methods For This Reviewmentioning

confidence: 99%

Advanced Neuroimaging of Cerebral Small Vessel Disease

Blair

Hernandez

Thrippleton

et al. 2017

Curr Treat Options Cardio Med

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Opinion statementCerebral small vessel disease (SVD) is characterised by damage to deep grey and white matter structures of the brain and is responsible for a diverse range of clinical problems that include stroke and dementia. In this review, we describe advances in neuroimaging published since January 2015, mainly with magnetic resonance imaging (MRI), that, in general, are improving quantification, observation and investigation of SVD focussing on three areas: quantifying the total SVD burden, imaging brain microstructural integrity and imaging vascular malfunction. Methods to capture ‘whole brain SVD burden’ across the spectrum of SVD imaging changes will be useful for patient stratification in clinical trials, an approach that we are already testing. More sophisticated imaging measures of SVD microstructural damage are allowing the disease to be studied at earlier stages, will help identify specific factors that are important in development of overt SVD imaging features and in understanding why specific clinical consequences may occur. Imaging vascular function will help establish the precise blood vessel and blood flow alterations at early disease stages and, together with microstructural integrity measures, may provide important surrogate endpoints in clinical trials testing new interventions. Better knowledge of SVD pathophysiology will help identify new treatment targets, improve patient stratification and may in future increase efficiency of clinical trials through smaller sample sizes or shorter follow-up periods. However, most of these methods are not yet sufficiently mature to use with confidence in clinical trials, although rapid advances in the field suggest that reliable quantification of SVD lesion burden, tissue microstructural integrity and vascular dysfunction are imminent.Electronic supplementary materialThe online version of this article (doi:10.1007/s11936-017-0555-1) contains supplementary material, which is available to authorized users.

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“…项目组后续的研究发现, 遗忘型MCI功能连接的改变可能与扣带束的纤维损伤有关 [26] . [27,28] , 白质纤维完整性 [29] 构的广泛损伤 [31] , 而高血压患者的白质损伤则主要在上纵束 [32] , 隐匿性梗死灶则主要影响大脑前部及深部白质区域 [33,34] . 项目组进一步的功能fMRI研究表明,…”

Section: 情绪情感测查主要针对抑郁和孤独感的测评具体包unclassified