Investigation of hypertensive arteriopathy-related and cerebral amyloid angiopathy-related small vessel disease scores in patients from a memory clinic: a prospective single-centre study

Matsumoto, Kana; Shindo, Akihiro; Yuichiro,; Tabei, Ken-ichi; Ueda, Yukito; Ishikawa, Hidehiro; Matsuura, Keita; Yoshimaru, Kimiko; Taniguchi, Akira; Kato, Natsuko; Satoh, Masayuki; Maeda, Masayuki; Tomimoto, Hidekazu

doi:10.1136/bmjopen-2020-042550

Cited by 7 publications

(14 citation statements)

References 36 publications

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“…Only C 1 score significantly correlated with impairment in global cognition, recall memory, orientation, language, and visuoexecutive function as compared with CAA-SVD score (representative of entire CAA co-pathological burden) and C 2 score (indicative of global SVD imaging burden). Unlike previous study showing an association of CAA-SVD score with cognitive functions, the discrepant finding may be attributed to varying population characteristics ( 74 ). Combining measures of total CMBs and WMHs (i.e., C 1 score) added further correlation coefficients in the cognitive correlation analysis in contrast to regional and total imaging scores of CMBs or WMHs alone.…”

Section: Discussioncontrasting

confidence: 93%

Imaging Markers of Subcortical Vascular Dementia in Patients With Multiple-Lobar Cerebral Microbleeds

et al. 2021

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Background and Purpose: Small vessel disease (SVD) imaging markers are related to ischemic and hemorrhage stroke and to cognitive dysfunction. This study aimed to clarify the relationship between SVD imaging markers and subcortical vascular dementia in severe SVD burden.Methods: A total of 57 subjects with multiple lobar cerebral microbleeds (CMBs) and four established SVD imaging markers were enrolled from the dementia and stroke registries of a single center. Visual rating scales that are used to semi-quantify SVD imaging changes were analyzed individually and compositely to make correlations with cognitive domains and subcortical vascular dementia.Results: Dementia group had higher subcortical and total white matter hyperintensities (WMHs) and SVD composite scores than non-dementia group. Individual imaging markers correlated differently with one another and had distinct cognitive correlations. After adjusting for demographic factors, multivariate logistic regression indicated associations of subcortical WMHs (odds ratio [OR] 2.03, CI 1.24–3.32), total WMHs (OR 1.43, CI 1.09–1.89), lacunes (OR 1.18, CI 1.02–1.35), cerebral amyloid angiopathy-SVD scores (OR 2.33, CI 1.01–5.40), C1 scores (imaging composite scores of CMB and WMH) (OR 1.41, CI 1.09–1.83), and C2 scores (imaging composite scores of CMB, WMH, perivascular space, and lacune) (OR 1.38, CI 1.08–1.76) with dementia.Conclusions: SVD imaging markers might have differing associations with cognitive domains and dementia. They may provide valuable complementary information in support of personalized treatment planning against cognitive impairment, particularly in patients with a heavy SVD load.

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Section: Discussioncontrasting

confidence: 93%

Imaging Markers of Subcortical Vascular Dementia in Patients With Multiple-Lobar Cerebral Microbleeds

et al. 2021

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“…A previous report revealed that ePVS was detected in temporal pole lesions in patients with CADASIL (Yamamoto et al, 2009). Although cSS has not been found in CADASIL (Wollenweber et al, 2017), SVD scores including ePVS and cSS have been reported to influence neuropsychological tests in memory clinic patients (Matsuda et al, 2021). Moreover, the ePVS burden has also been associated with cognitive impairment (Bown et al, 2021).…”

Section: Discussionmentioning

confidence: 98%

Imaging Characteristics for Predicting Cognitive Impairment in Patients With Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy

Taniguchi

Shindo

Tabei

et al. 2022

Front. Aging Neurosci.

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ObjectivesPatients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) show various clinical symptoms, including migraine, recurrent stroke, and cognitive impairment. We investigated the associations between magnetic resonance imaging (MRI) markers of small vessel disease and neuropsychological tests and identified the MRI characteristics for predicting cognitive impairment in patients with CADASIL.MethodsSubjects included 60 CADASIL patients diagnosed with genetic tests and registered in the Japanese CADASIL REDCap database between June 2016 and December 2020. Patient information including clinical data, modified Rankin Scale (mRS); MRI findings of small vessel disease including periventricular and deep white matter lesions (WML), lacunar infarcts, and cerebral microbleeds (CMBs); and neuropsychological tests, including the Japanese version of the Mini-Mental State Examination (MMSE), the Japanese version of the Montreal Cognitive Assessment (MoCA-J), and the Frontal Assessment Battery (FAB), were evaluated.ResultsData from 44 CADASIL patients were eligible for this study, compared between patients with and without dementia. Regarding the neuroimaging findings, the Fazekas score of periventricular and deep WML was higher in patients with dementia (periventricular, p = 0.003; deep, p = 0.009). The number of lacunar infarcts was higher in patients with dementia (p = 0.001). The standardized partial regression coefficient (SPRC) in MoCA-J was 0.826 (95% CI, 0.723–0.942; p = 0.005) for the number of CMBs. The SPRC in MMSE was 0.826 (95% CI, 0.719–0.949; p = 0.007) for the number of CMBs. The SPRC for FAB decreased significantly to 0.728 (95% CI, 0.551–0.960; p = 0.024) for the number of lacunar infarcts. Receiver operating characteristic (ROC) curves for dementia showed that in the number of lacunar infarcts, a cut-off score of 5.5 showed 90.9% sensitivity and 61.1% specificity. For the number of CMBs, a cut-off score of 18.5 showed 45.5% sensitivity and 100% specificity.ConclusionThe characteristic MRI findings were that CADASIL patients with dementia had severe WML, both periventricular and deep, and a larger number of lacunar infarcts than those without dementia. The risk of dementia may be associated with ≥ 6 lacunar infarcts, ≥19 CMBs, or a Fazekas scale score of 3 in periventricular and deep WML.

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“…In total, 42 patients consulted with our hospital memory clinic between February 2017 and July 2019 (Matsuda et al, 2021). All procedures followed the Clinical Study Guidelines of the Ethics Committee of Mie University Hospital and were approved by the internal review board (registration number: 1596).…”

Section: Patientsmentioning

confidence: 99%

“…In the category verbal fluency task, participants were asked to name as many animals as possible in 1 min. In the letter verbal fluency task, participants were asked to name as many objects as possible in 1 min, beginning with each of the following four phonemes: ka, sa, ta, and te (Matsuda et al, 2021). The average scores for these four phonemes were used for statistical analyses.…”

Section: Neuropsychological Assessmentsmentioning

confidence: 99%

“…Other CAA-specific imaging features include posterior-dominant anteroposterior distribution of WMH (Thanprasertsuk et al, 2014) and CMIs <5 mm in diameter localized within the cortex, predominantly in the occipital lobe (Ishikawa et al, 2020). We previously developed the modified CAA-SVD score based on these imaging features, and found that the scores significantly correlated with cognitive function in memory clinic patients (Matsuda et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

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Association between behavioral and psychological symptoms and cerebral small vessel disease MRI findings in memory clinic patients

Shinohara

Matsumoto

et al. 2023

Front. Aging Neurosci.

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ObjectivesCerebral small vessel disease (SVD) is commonly observed among elderly individuals with cognitive impairment and has been recognized as a vascular contributor to dementia and behavioral and psychological symptoms (BPS), however, the relationship between BPS and SVD burden remains unclear.MethodsWe prospectively recruited 42 patients with mild cognitive impairment (MCI) or mild dementia from the memory clinic in our hospital, who were assigned to either a clinical dementia rating (CDR) of 0.5 or 1.0, respectively. The presence of BPS was determined through interviews with caregivers. The patients underwent brain MRI and three types of SVD scores, total, cerebral amyloid angiopathy (CAA), and modified CAA, were assigned. Patients were also evaluated through various neuropsychological assessments.ResultsThe CDR was significantly higher in patients with BPS (p = 0.001). The use of antihypertensive agents was significantly higher in patients without BPS (p = 0.038). The time taken to complete trail making test set-A was also significantly longer in patients with BPS (p = 0.037). There was no significant difference in total SVD and CAA-SVD score (p = 0.745, and 0.096) and the modified CAA-SVD score was significantly higher in patients with BPS (p = 0.046). In addition, the number of total CMBs and lobar CMBs was significantly higher in patients with BPS (p = 0.001 and 0.001). Receiver operating characteristic curves for BPS showed that for modified CAA-SVD, a cutoff score of 3.5 showed 46.7% sensitivity and 81.5% specificity. Meanwhile, for the total number of cerebral microbleeds (CMBs), a cut-off score of 2.5 showed 80.0% sensitivity and 77.8% specificity and for the number of lobar CMBs, a cut-off score of 2.5 showed 73.3% sensitivity and 77.8% specificity.ConclusionOverall, patients with BPS showed worse CDRs, reduced psychomotor speed, higher modified CAA-SVD scores, larger numbers of total and lobar CMBs. We propose that severe modified CAA scores and higher numbers of total and lobar CMBs are potential risk factors for BPS in patients with mild dementia or MCI. Therefore, by preventing these MRI lesions, the risk of BPS may be mitigated.

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Investigation of hypertensive arteriopathy-related and cerebral amyloid angiopathy-related small vessel disease scores in patients from a memory clinic: a prospective single-centre study

Cited by 7 publications

References 36 publications

Imaging Markers of Subcortical Vascular Dementia in Patients With Multiple-Lobar Cerebral Microbleeds

Imaging Markers of Subcortical Vascular Dementia in Patients With Multiple-Lobar Cerebral Microbleeds

Imaging Characteristics for Predicting Cognitive Impairment in Patients With Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy

Association between behavioral and psychological symptoms and cerebral small vessel disease MRI findings in memory clinic patients

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