Higher Total Cerebral Small Vessel Disease Burden Was Associated With Mild Cognitive Impairment and Overall Cognitive Dysfunction: A Propensity Score-Matched Case–Control Study

Li, Xuanting; Yuan, Junliang; Qin, Wei; Yang, Lei; Yang, Shuna; Li, Yue; Hu, Wenli

doi:10.3389/fnagi.2021.695732

Cited by 22 publications

(16 citation statements)

References 34 publications

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“…Other CSVD features such as LIs and CMBs were also associated with executive function in this study; whether these features were associated with cognitive dysfunction remains debatable. Although some meta-analyses have failed to uncover such an association [30,31], our results were in line with previous studies [32][33][34], even at the very early stages of cognitive decline. Taken together, we confirmed that each CSVD feature has its own contribution to executive dysfunction.…”

Section: Discussionsupporting

confidence: 93%

Neuropsychological Profile of Early Cognitive Impairment in Cerebral Small Vessel Disease

Seki¹,

Yamada²,

Hosoya³

et al. 2022

Cerebrovasc Dis

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Introduction: The neuropsychological feature of vascular mild cognitive impairment is a deficit of the frontal-subcortical circuit; however, the features in the early stage are not consistent. In the present study, we aimed to investigate the neuropsychological features of the very early stage of cognitive impairment with cerebral small vessel disease (CSVD) and to elucidate the cognitive differences among CSVD subtypes. Methods: A comprehensive neuropsychological test battery was applied to nondemented subjects scoring below the cutoff point 26 of the Japanese version of the Montreal Cognitive Assessment. After factor analysis was conducted to identify covert cognitive factors in the battery, correlation analyses were performed between the factors and CSVD subtypes: white matter hyperintensity (WMH), lacunar infarcts (LIs), cerebral microbleeds (CMBs), perivascular spaces, and cortical atrophy. Results: Among the 465 recruited patients, 139 underwent a full neuropsychological test battery. Through factor analysis, the following three factors were extracted: executive function, memory, and attention. Of the CSVD features, total WMH was correlated with executive function and memory, whereas deep WMH was correlated with memory alone. Of the CSVD subtypes, LIs and CMBs were correlated only with executive function. Frontal and posterior atrophy were correlated with memory and attention, whereas medial temporal atrophy was correlated with memory alone. Conclusions: Executive dysfunction accompanied by subtle impairment of memory and processing speed was the main feature of neuropsychological profiles in the subjects with CSVD, even in the very early stage. Furthermore, each CSVD feature and focal cerebral atrophy are associated with cognitive impairment.

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Section: Discussionsupporting

confidence: 93%

Neuropsychological Profile of Early Cognitive Impairment in Cerebral Small Vessel Disease

Seki¹,

Yamada²,

Hosoya³

et al. 2022

Cerebrovasc Dis

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“… 12 , 21 Additionally, lines of evidence suggest that the total CSVD burden score may be a pragmatic and useful predictor of cognitive impairment in older people. 11 , 21 In the present study, we observed the severity of total CSVD burden was associated with MCI after adjustment for potential confounders, which suggested that total CSVD burden score may be a potential biomarker of MCI in patients with T2DM. In addition, we also found the severity of total CSVD burden was negatively associated with MoCA scores, which suggested that increased total CSVD burden may accelerate the progression of cognitive impairment, but this association requires more longitudinal studies to verify.…”

Section: Discussionsupporting

confidence: 56%

“… 10 CSVD is a prominent cause of cognitive impairment and an independent risk factor for MCI. 10 , 11 Total CSVD burden score, calculated by integrating above imaging markers, might better represent the severity of CSVD and predict cognitive impairment. 12 In addition, the presence of brain abnormalities on magnetic resonance imaging (MRI), particularly markers of CSVD, are more common in people with T2DM.…”

Section: Introductionmentioning

confidence: 99%

Cerebral Small Vessel Disease is Associated with Mild Cognitive Impairment in Type 2 Diabetes Mellitus

Teng¹,

Feng²,

Liu³

et al. 2022

DMSO

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Objective Type 2 diabetes mellitus (T2DM) is associated with cognitive impairment, but the underlying cerebral small vessel disease (CSVD)-related structural brain correlates are unclear. The aim of this study was to investigate the relationship between various imaging markers of CSVD and mild cognitive impairment (MCI) in patients with T2DM. Methods A total of 228 eligible participants with T2DM who were divided into MCI group and normal cognitive group based on neuropsychological assessment were enrolled in this retrospective study. White matter hyperintensity (WMH), lacunes, cerebral microbleeds (CMBs) and enlarged perivascular spaces (EPVS) were evaluated based on brain magnetic resonance imaging (MRI). The total CSVD burden score was calculated by combining the above four markers of CSVD. Binary logistic regression analysis was used to evaluate the relationship between different imaging markers of CSVD and MCI in patients with T2DM. Kruskal–Wallis test and Jonckheere–Terpstra test were used to compare mean MoCA scores among individuals with varying CSVD markers. Results In the multivariate binary logistic regression analyses, moderate or severe total CSVD burden (OR: 3.29, 95% CI: 1.63–7.38, P =0.004; OR: 10.97, 95% CI: 4.94–24.34, P <0.001, respectively), moderate dWMH (OR: 3.26, 95% CI: 1.43–7.41, P =0.005), extensive lacunes (OR: 4.97, 95% CI: 1.79–13.81, P =0.002), and moderate BG-EPVS (OR: 3.84, 95% CI: 1.81–8.13, P <0.001) were associated with MCI in patients with T2DM related to MCI after adjusting for potential confounders. There was a trend for significant decrease in MoCA scores with increase severity of dWMH, pWMH, lacunes, BG-EPVS, deep CMBs, or total CSVD burden ( P for trend <0.05). Conclusion Different imaging markers of CSVD, particularly total CSVD burden, were associated with an increased risk of MCI and decline in MoCA scores in patients with T2DM. These findings may provide clues for future studies to explore early diagnostic imaging markers of cognitive impairment in relation to T2DM.

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“…Also, Liang et al (2019) have confirmed that total CSVD burden is correlated with reduced MMSE subscores for thought orientation, word recall, and calculation in a post-stroke population. Li et al (2021) have also shown that memory, executive function, speed, and motor control were correlated with a higher total CSVD burden in a propensity score-matched case-control study. The overlap of affected cognitive domains in PD and CSVD may be due to the impairment of similar signaling networks despite the involvement of multiple pathogeneses.…”

Section: Discussionmentioning

confidence: 79%

Characteristics of Cognitive Impairment and Their Relationship With Total Cerebral Small Vascular Disease Score in Parkinson’s Disease

Hou¹,

Hou²,

Qiu³

et al. 2022

Front. Aging Neurosci.

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BackgroundThis study aimed to investigate the characteristics of cognitive dysfunctions and their relationship with total cerebral small vascular disease (CSVD) in Parkinson’s disease (PD).MethodsA total of 174 idiopathic PD patients who underwent brain magnetic resonance imaging (MRI) were recruited. Demographic information, vascular disease risk factors, motor function (MDS-UPDRS III score), and cognitive level (MoCA, MMSE) were collected for these patients. The total CSVD burden was scored based on lacunes, enlarged perivascular spaces (EPVS), high-grade white matter hyperintensities (WMH), and cerebral microbleeds (CMBs) for each subject.ResultsCognitive scores on MoCA for language, delayed recall, and orientation were significantly reduced in PD patients with CSVD burden ≥ 1 than in those with CSVD burden = 0. Educational level, PDQ 39, and CSVD burden were significantly associated with MoCA scores in individuals with PD. For the whole group, the full model accounted for 33.6% variation in total MoCA scores. In which, CSVD burden explained 2.7% of the results, and the detection of lacunes, WMH, EPVS, and strictly lobar CMBs were significantly correlated with MoCA scores. The stability of the outcomes was confirmed by sensitivity analysis.ConclusionCSVD can independently contribute to cognitive decline in PD and cause damage in specific cognitive domains. Promoting neurovascular health may help preserve cognitive functions in PD.

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Higher Total Cerebral Small Vessel Disease Burden Was Associated With Mild Cognitive Impairment and Overall Cognitive Dysfunction: A Propensity Score-Matched Case–Control Study

Cited by 22 publications

References 34 publications

Neuropsychological Profile of Early Cognitive Impairment in Cerebral Small Vessel Disease

Neuropsychological Profile of Early Cognitive Impairment in Cerebral Small Vessel Disease

Cerebral Small Vessel Disease is Associated with Mild Cognitive Impairment in Type 2 Diabetes Mellitus

Characteristics of Cognitive Impairment and Their Relationship With Total Cerebral Small Vascular Disease Score in Parkinson’s Disease

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