Effects of Lacunar Infarctions on Cognitive Impairment in Patients with Cerebral Autosomal-Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy
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Background and Purpose Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an inherited microangiopathy caused by mutations in the Notch3 gene. Although previous studies have shown an association between lacunar infarction and cognitive impairment, the relationship between MRI parameters and cognition remains unclear. In this study we investigated the influence of MRI parameters on cognitive impairment in CADASIL. Methods We applied a prospective protocol to 40 patients. MRI analysis included the normalized volume of white-matter hyperintensities (nWMHs), number of lacunes, and number of cerebral microbleeds. Cognition was assessed with the aid of psychometric tests [Mini-Mental State Examination (MMSE), Alzheimer’s Disease Assessment Scale-cognition (ADAS-cog), Trail-Making Test, and Stroop interference (Stroop IF)]. Results A multivariate regression analysis revealed that the total number of lacunes influenced the performance in the MMSE, ADAS-cog, and Stroop IF, while nWMHs had a strong univariate association with ADAS-cog and Stroop IF scores. However, this association disappeared in the multivariate analysis. Conclusions These findings demonstrate that the number of lacunes is the main predictive factor of cognitive impairment in CADASIL.
Abstract
Background and Purpose Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an inherited microangiopathy caused by mutations in the Notch3 gene. Although previous studies have shown an association between lacunar infarction and cognitive impairment, the relationship between MRI parameters and cognition remains unclear. In this study we investigated the influence of MRI parameters on cognitive impairment in CADASIL. Methods We applied a prospective protocol to 40 patients. MRI analysis included the normalized volume of white-matter hyperintensities (nWMHs), number of lacunes, and number of cerebral microbleeds. Cognition was assessed with the aid of psychometric tests [Mini-Mental State Examination (MMSE), Alzheimer’s Disease Assessment Scale-cognition (ADAS-cog), Trail-Making Test, and Stroop interference (Stroop IF)]. Results A multivariate regression analysis revealed that the total number of lacunes influenced the performance in the MMSE, ADAS-cog, and Stroop IF, while nWMHs had a strong univariate association with ADAS-cog and Stroop IF scores. However, this association disappeared in the multivariate analysis. Conclusions These findings demonstrate that the number of lacunes is the main predictive factor of cognitive impairment in CADASIL.
참고문헌 (22)
- Joutel A, "Notch3 mutations in CADASIL, a hereditary adult-onset condition causing stroke and dementia", Nature, 383, pp.707~710 (1996)
- Chabriat H, "Clinical spectrum of CADASIL: a study of 7 families. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy", Lancet, 346, pp.934~939 (1995)
- Peters N, "The pattern of cognitive performance in CADASIL: a monogenic condition leading to subcortical ischemic vascular dementia", Am J Psychiatry, 162, pp.2078~2085 (2005)
- Benisty S, "Diagnostic criteria of vascular dementia in CADASIL", Stroke, 39, pp.838~844 (2008)
- O’Sullivan M, "MRI hyperintensities of the temporal lobe and external capsule in patients with CADASIL", Neurology, 56, pp.628~634 (2001)
- Viswanathan A, "Lacunar lesions are independently associated with disability and cognitive impairment in CADASIL", Neurology, 69, pp.172~179 (2007)
- Liem MK, "Lacunar infarcts are the main correlate with cognitive dysfunction in CADASIL", Stroke, 38, pp.923~928 (2007)
- Liem MK, "MRI correlates of cognitive decline in CADASIL: a 7-year follow-up study", Neurology, 72, pp.143~148 (2009)
- Viswanathan A, "Impact of MRI markers in subcortical vascular dementia: a multi-modal analysis in CADASIL", Neurobiol Aging, 31, pp.1629~1636 (2010)
- Viswanathan A, "Blood pressure and haemoglobin A1c are associated with microhaemorrhage in CADASIL: a two-centre cohort study", Brain, 129, pp.2375~2383 (2006)
- Jouvent E, "Brain atrophy is related to lacunar lesions and tissue microstructural changes in CADASIL", Stroke, 38, pp.1786~1790 (2007)
- Kang Y, "A validity study on the Korean mini-mental state examination (K-MMSE) in dementia patients", J Korean Neurol Assoc, 15, pp.300~308 (1997)
- Rosen WG, "A new rating scale for Alzheimer’s disease", Am J Psychiatry, 141, pp.1356~1364 (1984)
- Suh GH, "Development of the Korean version of Alzheimers Disease Assessment Scale (ADAS-K) to assess cognition in dementia", J Korean Geriatr Soc, 7, pp.269~277 (2003)
- Reitan RM, "Trail Making Test. Manual for Administration and Scoring" (1959), Indiana University
- 이한승, "한국판 노인형 기호잇기검사의 개발과 타당화 연구", Dementia and Neurocognitive Disorders(대한치매학회지), 6(2), pp.54~67 (2007), 대한치매학회
- Madureira S, "Development of a neuropsychological battery for the Leukoaraiosis and Disability in the Elderly Study (LADIS): experience and baseline data", Neuroepidemiology, 27, pp.101~116 (2006)
- Golden C, "Stroop Color and Word Test" (2002), Stoelting
- Bokura H, "Distinguishing silent lacunar infarction from enlarged Virchow-Robin spaces: a magnetic resonance imaging and pathological study", J Neurol, 245, pp.116~122 (1998)
- Koennecke HC, "Cerebral microbleeds on MRI: prevalence, associations, and potential clinical implications", Neurology, 66, pp.165~171 (2006)
- Kang SY, "Nerve conduction studies in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy", J Neurol, 256, pp.1724~1727 (2009)
- Lee JS, "Olfactory identification deficits in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy", Eur Neurol, 64, pp.280~285 (2010)