Diffusion tensor imaging of thalamus correlates with cognition in CADASIL without dementia

O’Sullivan, Michael; Singhal, Sumeet; Charlton, Rebecca A.; Markus, Hugh S.

doi:10.1212/01.wnl.0000113760.72706.d2

Cited by 91 publications

(80 citation statements)

References 17 publications

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“…The current findings specifically implicate the thalamus as a critical neural structure in the disruption of cognitive functioning in unilateral TLE. This finding is consistent with an extensive literature implicating the importance of thalamic integrity in cognition in both normal and clinical populations (Johnson & Ojemann, 2000;O'Sullivan et al, 2004;Schwartz & Black, 2006;Sherman & Guillery, 2002). Furthermore, these findings may have relevance for pre-post surgical outcome in cognition.…”

Section: Cognitive Functioningsupporting

confidence: 91%

Thalamic atrophy and cognition in unilateral temporal lobe epilepsy

Seidenberg

Hermann

Pulsipher

et al. 2008

J Inter Neuropsych Soc

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This study examined quantitative magnetic resonance volumes of the thalamus and hippocampus and determined their relationship with cognitive function and clinical seizure characteristics in a sample of 46 unilateral temporal lobe epilepsy (TLE) subjects (20 left and 26 right) and 29 controls. The hippocampus and thalamus exhibited different patterns of volume abnormality, different associations with clinical seizure characteristics, and different patterns of relationship with cognitive measures. Hippocampal volume reduction was primarily ipsilateral to the seizure focus, and thalamic volume reduction was bilateral. Ipsilateral hippocampal volume was significantly correlated with both early neurodevelopmental features (age of seizure onset) and disease characteristics (duration of epilepsy), whereas thalamus integrity was related only to disease variables. Hippocampal volume showed a selective association with verbal memory performance. In contrast, both left and right thalamic volumes were significantly correlated with performance on both memory and nonmemory cognitive domains. These findings underscore the importance of thalamic atrophy in chronic TLE and its potential implications for cognition. (JINS, 2008, 14, 384-393.)

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Section: Cognitive Functioningsupporting

confidence: 91%

Thalamic atrophy and cognition in unilateral temporal lobe epilepsy

Seidenberg

Hermann

Pulsipher

et al. 2008

J Inter Neuropsych Soc

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“…The severity of MRI structural changes, extensively evaluated in volumetric, regional blood volume and anisotropy (diffusion tensor imaging) studies is also correlated to cognitive changes. Specifically, variables such as the specific location of white matter lesions (eg the cingulate pathway and frontal regions), the number and total volume of ischemic lesions, the degree of diffuse cortical atrophy or the presence of atrophy in specific areas such as hippocampus and thalamus, correlate (with marked variations between studies) to the evolution of cognitive impairment and progression of secondary functional limitations [95][96][97][98][99][100] . The extension of white matter lesions per se and the presence and extent of microhemorrhages exhibit lower correlation with cognitive disorders.…”

Section: Cognitive Decline and Dementiamentioning

confidence: 99%

CADASIL: pathogenesis, clinical and radiological findings and treatment

André

2010

Arq. Neuro-Psiquiatr.

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Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common genetic cause of ischemic strokes and a most important model for the study of subcortical vascular dementia. This unrelentlessly progressive disease affects many hundreds of families all over the world but is not well studied in Brazil. This manuscript reviews pathogenetic, clinical, radiological and therapeutic features of CADASIL. The causal mutations are now very well known, but the same can not be said about its intimate pathogenetic mechanisms. The variable clinical presentation should lead physicians to actively pursue the diagnosis in many settings and to more thouroughly investigate family history in first degree relatives. A rational approach to genetic testing is however needed. Treatment of CADASIL is still largely empiric. Highquality therapeutic studies involving medications and cognitive interventions are strongly needed in CADASIL. Key words: CADASIL, etiology, genetics, diagnosis, therapeutics.cADAsIL: patogênese, achados clínicos e radiológicos e tratamento resumo CADASIL é a causa genética mais freqüente de infartos cerebrais e constitui modelo importante de estudo de demências vasculares subcorticais. De natureza inexoravelmente progressiva, afeta milhares de pessoas em todo o mundo. Sua importância é pouco reconhecida entre nós, o que nos levou à presente revisão dos principais aspectos patogenéticos, clínicos, neuroradiológicos e terapêuticos da doença. As mutações causais são hoje bem conhecidas, mas os mecanismos patogenéticos íntimos ainda permanecem misteriosos. A apresentação clínica variável deve fazer com que os médicos considerem o diagnóstico em vários contextos clínicos e investiguem de forma mais extensa que o usual a história familial deparentes de primeiro grau. Além disso, uma abordagem racional é necessária para reduzir custos e aumentar a eficiência do diagnóstico genético. O tratamento atual de pacientes com CADASIL é basicamente empírico. Estudos clínicos sobre medicamentos e intervenções cognitivas de alto nível metodológico constituem uma necessidade urgente.

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“…15 Diffusion tensor imaging (DTI) describes the properties of water diffusion in vivo, thus disclosing important details of fiber tract orientation and providing information regarding microstructural integrity of the tissue. [20][21][22][23] Few studies have used DTI 9,10,24 to investigate thalamic changes in MS. However, results have been conflicting, and the relationship between DTI-derived metrics pointing to thalamic involvement and functional disability remains unclear.…”

mentioning

confidence: 99%

“…37 The thalamus was inspected for the presence of lesions on both the registered and unregistered T1WI and T2WI images. In each hemisphere, 2 symmetric circular regions of interest (area ϭ 68 pixels, including mainly the centromedian, dorsoventral, and dorsolateral regions of the thalami) 22,24 were placed in the normal-appearing thalamus on 3 consecutive axial sections (above the plane of the anterior commissure) on the (bϭ0) image and examined in all 3 planes by 1 investigator. Care was taken to ensure that the thalamus could be identified bilaterally on at least 1 section dorsally and 1 section caudally from the target sections so that no adjacent structures were included (Fig 1).…”

mentioning

confidence: 99%