Strategic role of frontal white matter tracts in vascular cognitive impairment: a voxel-based lesion-symptom mapping study in CADASIL
| Autor: | Sonia Reyes, Christian Opherk, Dominique Hervé, Marco Duering, Martin Dichgans, Nikola Zieren, Eric Jouvent, Chahin Pachai, Nils Peters, Hugues Chabriat |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty Genu of the corpus callosum Internal capsule CADASIL Neuropsychological Tests Nerve Fibers Myelinated Cohort Studies White matter Leukoencephalopathy Lesion Imaging Three-Dimensional Corona radiata medicine Humans Brain Mapping Middle Aged medicine.disease Magnetic Resonance Imaging Hyperintensity Frontal Lobe medicine.anatomical_structure Regression Analysis Female Neurology (clinical) Radiology medicine.symptom Cognition Disorders Psychology |
| Zdroj: | Brain. 134:2366-2375 |
| ISSN: | 1460-2156 0006-8950 |
| Popis: | Cerebral small vessel disease is the most common cause of vascular cognitive impairment. It typically manifests with lacunar infarcts and ischaemic white matter lesions. However, little is known about how these lesions relate to the cognitive symptoms. Previous studies have found a poor correlation between the burden of ischaemic lesions and cognitive symptoms, thus leaving much of the variance in cognitive performance unexplained. The objective of the current study was to investigate the relationship between the location of subcortical ischaemic lesions and cognitive symptoms in small vessel disease. We applied a voxel-based lesion-symptom mapping approach to data from 215 patients with CADASIL, a genetically defined small vessel disease with mutations in the NOTCH3 gene. All patients were examined by magnetic resonance imaging and comprehensive neuropsychological testing. Lacunar lesions and white matter lesions were segmented on three-dimensional T1 and fluid-attenuated inversion recovery sequences, respectively. One hundred and forty-five subjects had a total of 854 lacunar lesions (range 1–13 per individual). The normalized volume of white matter hyperintensities ranged from 0.0425% to 21.5% of the intracranial cavity. Significant clusters for cognitive performance were detected for both lacunar lesions and white matter hyperintensities. The most prominent results were obtained on a compound score for processing speed, the predominantly affected cognitive domain in this group of patients. Strategic locations included the anterior parts of the thalamus, the genu and anterior limb of the internal capsule, the anterior corona radiata and the genu of the corpus callosum. By combining the lesion-symptom mapping data with information from a probabilistic white matter atlas we found that the majority of the processing speed clusters projected on the anterior thalamic radiation and the forceps minor. In multivariate models that included demographic parameters, brain atrophy and the volume of ischaemic lesions, regional volumes of lacunar lesions and white matter hyperintensities in the anterior thalamic radiation predicted performance in processing speed tasks, whereas there was no independent contribution of the global volume of ischaemic lesions. These observations emphasize the importance of lesion location for both lacunar and ischaemic white matter lesions. Our findings further highlight the anterior thalamic radiation as a major anatomical structure impacting on processing speed. Together these findings provide strong support for a central role of frontal-subcortical circuits in cerebral small vessel disease and vascular cognitive impairment. * Abbreviations : CADASIL : cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy |
| Databáze: | OpenAIRE |
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