Infratentorial Abnormalities in Vascular Dementia

Bastos-Leite, António J.; Flier, Wiesje M. van der; Straaten, E.C.W. van; Scheltens, Philip; Barkhof, Frederik

doi:10.1161/01.str.0000196984.90718.8a

Cited by 32 publications

(25 citation statements)

References 34 publications

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“…In patients with VP, brainstem and cerebellar involvement have been previously reported on MRI [3], and degenerative changes in the ipsilateral substantia nigra could occur 2 weeks after a striatal stroke [26]. Second, the midbrain atrophy could be related to global cortical atrophy, most probably attributable to axonal degeneration secondary to supratentorial pathology [10]. The association of midbrain atrophy and cognitive performance, in VaD patients, supports this hypothesis [10].…”

Section: Discussionmentioning

confidence: 80%

“…Second, the midbrain atrophy could be related to global cortical atrophy, most probably attributable to axonal degeneration secondary to supratentorial pathology [10]. The association of midbrain atrophy and cognitive performance, in VaD patients, supports this hypothesis [10]. We are not able to conclude whether midbrain atrophy is related to parkinsonism or to axonal degeneration.…”

Section: Discussionmentioning

confidence: 85%

“…A lot of previous reports have suggested that measurements for diameters and areas of midbrain and pons on routine MRIs are valuable in discriminating PSP from either IPD or multiple system atrophy [5,6,8,9]. In addition to PSP, some studies have shown that patients with vascular dementia (VaD) also had midbrain atrophy on MRIs [10,11]. Some of the characteristics of VP and VaD overlap – both have the frequent occurrence of brain atrophy, white matter lesions and a predominance of motor symptoms such as gait disturbances [12].…”

Section: Introductionmentioning

confidence: 99%

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Midbrain Atrophy in Vascular Parkinsonism

et al. 2011

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Background: Midbrain atrophy is a well-known feature of progressive supranuclear palsy (PSP). Some clinical features of vascular parkinsonism (VP) such as pseudobulbar phenomena, lower body predominance and early postural instability suggest that the brainstem could be associated with VP. The aim of this study was to determine whether midbrain atrophy was present in patients with VP. Methods: We measured the midbrain (Amd) and pons area (Apn) of 20 patients with VP, 15 patients with probable PSP and 30 patients with idiopathic Parkinson’s disease (IPD). The Amd and Apn were measured on mid-sagittal T₁-weighted MRI scans using a computerized image analysis system. Results: For the Amd, the patients with VP (99.86 mm²) and PSP (87.30 mm²) had significantly smaller areas than the patients with IPD (130.52 mm²). For the Apn, there was a significant difference only between the VP (407.23 mm²) and the IPD (445.05 mm²) patients. The Amd/Apn ratios of the patients with VP (0.245) and PSP (0.208) were significantly smaller than in the patients with IPD (0.292). Conclusions: Our study shows that brainstem atrophy often occurs in patients with VP and the midbrain is more vulnerable than the pons to atrophic changes.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

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Midbrain Atrophy in Vascular Parkinsonism

et al. 2011

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“…In a recent report on infratentorial abnormalities in vascular dementia, 11% of patients were found to have midbrain atrophy, as determined by an AP diameter of the mesencephalon less than 15 mm. Moreover, vascular dementia patients with midbrain atrophy are reported to have worse general cognitive and executive functions than those without midbrain atrophy; the midbrain was found to contribute to cognition independently of supratentorial structures [2]. Senile plaques, with or without neurofibrillary tangles in the periaqueductal gray and dorsal raphe nucleus of the midbrain was reported in Alzheimer's disease [15].…”

Section: Discussionmentioning

confidence: 99%

“…A number of reports have suggested that a low midbrain diameter on routine MRIs may be valuable in discriminating PSP from either Parkinson's disease or multiple system atrophy [6,14,17,24,27,28,35]. Recently, midbrain atrophy on MRIs, along with infratentorial vascular lesions, cerebellar atrophy, and changes in basilar artery diameter, have been reported for vascular dementia [2]. In particular, 11% of vascular dementia patients were found to have midbrain atrophy, which was determined by an anteroposterior diameter of the mesencephalon of less than 15 mm.…”

Section: Introductionmentioning

confidence: 99%

Midbrain atrophy in subcortical ischemic vascular dementia

et al. 2009

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Magnetic resonance imaging (MRI) has revealed age-related changes in midbrain volume in normal subjects. Atrophy of the midbrain in patients with progressive supranuclear palsy (PSP) has been demonstrated using conventional brain MRI, and it was recently reported that some patients with vascular dementia also have midbrain atrophy. The aim of the present study was to investigate if the patients with subcortical ischemic vascular dementia (SIVD) have atrophic changes in the midbrain. MRIs of 23 SIVD patients, 18 probable PSP patients, and 96 controls were retrospectively analyzed. Differences in the distances between midbrain structures were compared across the patient groups and controls. We measured the anteroposterior diameter (AP), and the distance between the interpeduncular fossa and the aqueduct (IF–AQ), the aqueduct and posterior margin of the superior colliculi (AQ–SC), and the peduncular prominence and the interpeduncular fossa (PP–IF) of the midbrain. The AP diameter and IF–AQ were negatively correlated with age in normal controls (r = -0.21, p < 0.005 for AP; r = -0.14, p < 0.0001 for IF–AQ). In SIVD patients, the AP diameter and IF–AQ were both significantly smaller than in controls (p < 0.001). Changes in the midbrain found for SIVD patients were similar to those seen in PSP patients. Our results suggest that the midbrain decreases in size with normal aging, especially around the tegmental region. This change is more pronounced in patients with SIVD and in patients with PSP. Prospective functional studies are needed to ascertain the clinical relevance of midbrain atrophy in SIVD.

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Medial positioning of the hippocampus and hippocampal fissure volume in developmental topographical disorientation

Fragueiro,

Cury,

Santacroce

et al. 2024

Hippocampus

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Developmental topographical disorientation (DTD) refers to the lifelong inability to orient by means of cognitive maps in familiar surroundings despite otherwise well‐preserved general cognitive functions, and the absence of any acquired brain injury or neurological condition. While reduced functional connectivity between the hippocampus and other brain regions has been reported in DTD individuals, no structural differences in gray matter tissue for the whole brain neither for the hippocampus were detected. Considering that the human hippocampus is the main structure associated with cognitive map‐based navigation, here, we investigated differences in morphological and morphometric hippocampal features between individuals affected by DTD (N = 20) and healthy controls (N = 238). Specifically, we focused on a developmental anomaly of the hippocampus that is characterized by the incomplete infolding of hippocampal subfields during fetal development, giving the hippocampus a more round or pyramidal shape, called incomplete hippocampal inversion (IHI). We rated IHI according to standard criteria and extracted hippocampal subfield volumes after FreeSurfer's automatic segmentation. We observed similar IHI prevalence in the group of individuals with DTD with respect to the control population. Neither differences in whole hippocampal nor major hippocampal subfield volumes have been observed between groups. However, when assessing the IHI independent criteria, we observed that the hippocampus in the DTD group is more medially positioned comparing to the control group. In addition, we observed bigger hippocampal fissure volume for the DTD comparing to the control group. Both of these findings were stronger for the right hippocampus comparing to the left. Our results provide new insights regarding the hippocampal morphology of individuals affected by DTD, highlighting the role of structural anomalies during early prenatal development in line with the developmental nature of the spatial disorientation deficit.

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Infratentorial Abnormalities in Vascular Dementia

Cited by 32 publications

References 34 publications

Midbrain Atrophy in Vascular Parkinsonism

Midbrain Atrophy in Vascular Parkinsonism

Midbrain atrophy in subcortical ischemic vascular dementia

Medial positioning of the hippocampus and hippocampal fissure volume in developmental topographical disorientation

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