Neuroimaging Characteristics of Small-Vessel Disease in Older Adults with Normal Cognition, Mild Cognitive Impairment, and Alzheimer Disease

Alberto Mimenza-Alvarado, Sara G Aguilar-Navarro, Sara Yeverino-Castro, César Mendoza-Franco, José Alberto Ávila-Funes, Gustavo C Román, Alberto Mimenza-Alvarado, Sara G Aguilar-Navarro, Sara Yeverino-Castro, César Mendoza-Franco, José Alberto Ávila-Funes, Gustavo C Román

Abstract

Introduction: Cerebral small-vessel disease (SVD) represents the most frequent type of vascular brain lesions, often coexisting with Alzheimer disease (AD). By quantifying white matter hyperintensities (WMH) and hippocampal and parietal atrophy, we aimed to describe the prevalence and severity of SVD among older adults with normal cognition (NC), mild cognitive impairment (MCI), and probable AD and to describe associated risk factors.

Methods: This study included 105 older adults evaluated with magnetic resonance imaging and clinical and neuropsychological tests. We used the Fazekas scale (FS) for quantification of WMH, the Scheltens scale (SS) for hippocampal atrophy, and the Koedam scale (KS) for parietal atrophy. Logistic regression models were performed to determine the association between FS, SS, and KS scores and the presence of NC, MCI, or probable AD.

Results: Compared to NC subjects, SVD was more prevalent in MCI and probable AD subjects. After adjusting for confounding factors, logistic regression showed a positive association between higher scores on the FS and probable AD (OR = 7.6, 95% CI 2.7-20, p < 0.001). With the use of the SS and KS (OR = 4.5, 95% CI 3.5-58, p = 0.003 and OR = 8.9, 95% CI 1-72, p = 0.04, respectively), the risk also remained significant for probable AD.

Conclusions: These results suggest an association between severity of vascular brain lesions and neurodegeneration.

Keywords: Alzheimer disease; Mild cognitive impairment; Small-vessel disease.

References

    1. Mortamais M, Artero S, Ritchie K. White matter hyperintensities as early and independent predictors of Alzheimer's disease risk. J Alzheimers Dis. 2014;42((suppl 4)):S393–S400.
    1. Bilello M, Doshi J, Nabavizadeh SA, Toledo JB, Erus G, Xie SX, Trojanowski JQ, Han X, Davatzikos C. Correlating cognitive decline with white matter lesion and brain atrophy MRI measurements in Alzheimer's disease. J Alzheimers Dis. 2015;48:987–994.
    1. Toledo JB, Arnold SE, Raible K, Brettschneider J, Xie SX, Grossman M, Monsell SE, Kukull WA, Trojanowski JQ. Contribution of cerebrovascular disease in autopsy confirmed neurodegenerative disease cases in the National Alzheimer's Coordinating Centre. Brain. 2013;136:2697–2706.
    1. Wardlaw JM, Smith EE, Biessels GJ, Cordonnier C, Fazekas F, Frayne R, Lindley RI, O´Brien JT, Barkhof F, Benavente OR, Black SE, Brayne C, Breteler M, Chabriat H, DeCarli C, De Leeuw FE, Doubal F, Duering M, Fox NC, Greenberg S, Hachinski V, Kilimann I, Mok V, van Oostenbrugge R, Pantoni L, Speck O, Stephan B, Teipel S, Viswanathan A, Werring D, Chen C, Smith C, van Buchern M, Norrving B, Gorelick PB, Dichgans M. Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration. Lancet Neurol. 2013;12:822–838.
    1. Fazekas F, Kleinert R, Offenbacher H, Schmidt R, Kleinert G, Payer F, Radner H, Lechner H. Pathologic correlates of incidental MRI white matter signal hyperintensities. Neurology. 1993;43:1683–1689.
    1. Scheltens P, Launer LJ, Barkhof F, Weinstein HC, van Gool WA. Visual assessment of medial temporal lobe atrophy on magnetic resonance imaging: interobserver reliability. J Neurol. 1995;242:557–560.
    1. Koedam EL, Lehmann M, van der Flier WM, Scheltens P, Pijnenburg YA, Fox N, Barkhof F, Wattjes MP. Visual assessment of posterior atrophy development of a MRI rating scale. Eur Radiol. 2011:2618–2625.
    1. Warren MW, Weiner MF, Rosetti HC, McColl R, Peshock R, King KS. Cognitive impact of lacunar infarcts and white matter hyperintensity volume. Dement Geriatr Cogn Disord Extra. 2015;5:170–175.
    1. Benedictus MR, van Harten AC, Leeuwis AE, Koene T, Scheltens P, Barkhof F, Prins ND, van der Flier WM. White matter hyperintensities relate to clinical progression in subjective cognitive decline. Stroke. 2015;46:2661–2664.
    1. Folstein MF, Folstein SE, McHugh PR. “Mini-Mental State”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–198.
    1. Morris JC. The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology. 1993;43:2412–2414.
    1. Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychological function. JAMA. 1963;185:914–919.
    1. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9:179–186.
    1. Ostrosky-Solís F, Ardila A, Roselli M. NEUROPSI: a brief neuropsychological test battery in Spanish with norms by age and educational level. J Int Neuropsychol Soc. 1999;5:413–433.
    1. Petersen RC. Clinical practice. Mild cognitive impairment. N Engl J Med. 2011;364:2227–2234.
    1. Fourth Edition. Barcelona, Masson: American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders; 2002. Text Revision (DSM-IV-TR)
    1. McKhann GM, Knopman DS, Chertkow H, Hyman BT, Jack CR, Jr, Kawas CH, Klunk WE, Koroshetz WJ, Manly JJ, Mayeux R, Mohs RC, Morris JC, Rossor MN, Scheltens P, Carrillo MC, Thies B, Weintraub S, Phelps CH. The diagnosis of dementia due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement. 2011;7:263–269.
    1. Keefover RW. Aging and cognition. Neurol Clin. 1998;16:635–648.
    1. Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1982;17:34–37.
    1. Mok V, Kim JS. Prevention and management of cerebral small vessel disease. J Stroke. 2015;17:111–122.
    1. Kerber KA, Whitman GT, Brown DL, Baloh RW. Increased risk of death in community-dwelling older people with white matter hyperintensities on MRI. J Neurol Sci. 2006;250:33–38.
    1. Wardlaw JM, Smith C, Dichgans M. Mechanisms underlying sporadic cerebral small vessel disease: insights from neuroimaging. Lancet Neurol. 2013 DOI: 10.1016/S1474-4422(13)70060-7.
    1. Appelman AP, Exalto LG, van der Graaf Y, Biessels GJ, Mali WP, Geerlings MI. White matter lesions and brain atrophy: more than shared risk factors? A systematic review. Cerebrovasc Dis. 2009;28:227–242.
    1. Aribisala BS, Valdés Hernández MC, Royle NA, Morris Z, Muñoz Maniega S, Bastin ME, Deary IJ, Wardlaw JM. Brain atrophy associations with white matter lesions in the ageing brain: the Lothian Birth Cohort 1936. Eur Radiol. 2013;23:1084–1092.
    1. Vernooij MW, van der Lugt A, Ikram MA, Wielpolski PA, Niessen WJ, Hofman A, Krestin GP, Breteler MM. Prevalence and risk factors of cerebral microbleeds: the Rotterdam Scan Study. Neurology. 2008;70:1208.
    1. Cordonnier C, Al-Shahi Salman R, Wardlaw J. Spontaneous brain microbleeds: systematic review, subgroup analyses and standards for study design and reporting. Brain. 2007;130((Pt 8)):1988–2003.
    1. Wang M, Norman JE, Srinivasan VJ, Rutledge JC. Metabolic, inflammatory, and microvascular determinants of white matter disease and cognitive decline. Am J Neurodegener Dis. 2016;5:171–177.
    1. Erten-Lyons D, Woltjer R, Kaye J, Mattek N, Dodge HH, Green S, Tran H, Howieson DB, Wild K, Silbert LC. Neuropathologic basis of white matter hyperintensity accumulation with advanced age. Neurology. 2013;81:977–983.
    1. Provenzano FA, Muraskin J, Tosto G, Narkhede A, Wasserman BT, Griffith EY, Guzman VA, Meier IB, Zimmerman ME, Brickman AM. Alzheimer's Disease Neuroimaging Initiative White matter hyperintensities and cerebral amyloidosis: necessary and sufficient for clinical expression of Alzheimer disease? JAMA Neurol. 2013;70:455–461.
    1. van der Flier WM, van Straaten EC, Barkhof F, Verdelho A, Madureira S, Pantoni L, Inzitari D, Erkinjuntti T, Crisby M, Waldemar G, Schmidt R, Fazekas F, Scheltens P. Small vessel disease and general cognitive function in nondisabled elderly: the LADIS study. Stroke. 2005;36:2116–2120.
    1. Au R, Massaro JM, Wolf PA, Young ME, Beiser A, Seshadri S, D'Agostino RB, DeCarli C. Association of white matter hyperintensity volume with decreased cognitive functioning: the Framingham Heart Study. Arch Neurol. 2006;63:246–250.
    1. Mosley TH, Jr, Knopman DS, Catellier DJ, Bryan N, Hutchinson RG, Grothues CA, Folsom AR, Cooper LS, Burke GL, Liao D, Szklo M. Cerebral MRI findings and cognitive functioning: the Atherosclerosis Risk in Communities Study. Neurology. 2005;64:2056–2062.
    1. Baker JG, Williams AJ, Ionita CC, Lee-Kwen P, Ching M, Miletich RS. Cerebral small vessel disease: cognition, mood, daily functioning, and imaging findings from a small pilot sample. Dement Geriatr Cogn Dis Extra. 2012;2:169–179.

Source: PubMed

Sponsoren und Mitarbeiter

Krankheiten

Drogeninterventionen

3
Abonnieren