scholarly journals Heterogeneity in mild cognitive impairment: Differences in neuropsychological profile and associated white matter lesion pathology

2009 ◽  
Vol 15 (6) ◽  
pp. 906-914 ◽  
Author(s):  
LISA DELANO-WOOD ◽  
MARK W. BONDI ◽  
JOSHUA SACCO ◽  
NORM ABELES ◽  
AMY J. JAK ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
White Matter ◽  
Processing Speed ◽  
White Matter Lesion ◽  
Clinical Sample ◽  
Neuropsychological Profile ◽  
Executive Processing ◽  
Fluid Attenuated Inversion Recovery ◽  
Periventricular Lesion

AbstractThis study examined whether distinct neuropsychological profiles could be delineated in a sample with Mild Cognitive Impairment (MCI) and whether white matter lesion (WML) burden contributed to MCI group differences. A heterogeneous, clinical sample of 70 older adults diagnosed with MCI was assessed using cognitive scores, and WML was quantified using a semi-automated, volumetric approach on T2-weighted fluid-attenuated inversion recovery (FLAIR) images. Using cluster and discriminant analyses, three distinct groups (Memory/Language, Executive/Processing Speed, and Pure Memory) were empirically derived based on cognitive scores. Results also showed a dose dependent relationship of WML burden to MCI subgroup, with the Executive/Processing Speed subgroup demonstrating significantly higher levels of WML pathology when compared to the other subgroups. In addition, there was a dissociation of lesion type by the two most impaired subgroups (Memory/Language and Executive/Processing Speed) such that the Memory/Language subgroup showed higher periventricular lesion (PVL) and lower deep white matter lesion (DWML) volumes, whereas the Executive/Processing Speed demonstrated higher DWML and lower PVL volumes. Results demonstrate that distinct MCI subgroups can be empirically derived and reliably differentiated from a heterogeneous MCI sample, and that these profiles differ according to WML burden. Overall, findings suggest different underlying pathologies within MCI and contribute to our understanding of MCI subtypes. (JINS, 2009, 15, 906–914.)

scholarly journals Neuropsychological Impairments and Their Cognitive Architecture in Mild Cognitive Impairment (MCI) with Lewy Bodies and MCI-Alzheimer’s Disease

2021 ◽  
pp. 1-11
Author(s):  
Joanna Ciafone ◽  
Alan Thomas ◽  
Rory Durcan ◽  
Paul C Donaghy ◽  
Calum A Hamilton ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Executive Function ◽  
Mild Cognitive Impairment ◽  
Processing Speed ◽  
Lewy Bodies ◽  
Trail Making Test ◽  
Neuropsychological Profile ◽  
Trail Making

Abstract Objective: The present study aimed to clarify the neuropsychological profile of the emergent diagnostic category of Mild Cognitive Impairment with Lewy bodies (MCI-LB) and determine whether domain-specific impairments such as in memory were related to deficits in domain-general cognitive processes (executive function or processing speed). Method: Patients (n = 83) and healthy age- and sex-matched controls (n = 34) underwent clinical and imaging assessments. Probable MCI-LB (n = 44) and MCI-Alzheimer’s disease (AD) (n = 39) were diagnosed following National Institute on Aging-Alzheimer’s Association (NIA-AA) and dementia with Lewy bodies (DLB) consortium criteria. Neuropsychological measures included cognitive and psychomotor speed, executive function, working memory, and verbal and visuospatial recall. Results: MCI-LB scored significantly lower than MCI-AD on processing speed [Trail Making Test B: p = .03, g = .45; Digit Symbol Substitution Test (DSST): p = .04, g = .47; DSST Error Check: p < .001, g = .68] and executive function [Trail Making Test Ratio (A/B): p = .04, g = .52] tasks. MCI-AD performed worse than MCI-LB on memory tasks, specifically visuospatial (Modified Taylor Complex Figure: p = .01, g = .46) and verbal (Rey Auditory Verbal Learning Test: p = .04, g = .42) delayed recall measures. Stepwise discriminant analysis correctly classified the subtype in 65.1% of MCI patients (72.7% specificity, 56.4% sensitivity). Processing speed accounted for more group-associated variance in visuospatial and verbal memory in both MCI subtypes than executive function, while no significant relationships between measures were observed in controls (all ps > .05) Conclusions: MCI-LB was characterized by executive dysfunction and slowed processing speed but did not show the visuospatial dysfunction expected, while MCI-AD displayed an amnestic profile. However, there was considerable neuropsychological profile overlap and processing speed mediated performance in both MCI subtypes.

High White Matter Lesion Load Is Associated with Hippocampal Atrophy in Mild Cognitive Impairment

2011 ◽  
Vol 31 (2) ◽  
pp. 132-138 ◽  
Author(s):  
C. Eckerström ◽  
E. Olsson ◽  
N. Klasson ◽  
M. Bjerke ◽  
M. Göthlin ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
White Matter ◽  
White Matter Lesion ◽  
Hippocampal Atrophy ◽  
Lesion Load

scholarly journals A ketogenic supplement improves white matter energy supply and processing speed in mild cognitive impairment

2021 ◽  
Author(s):  
Maggie Roy ◽  
Melanie Fortier ◽  
Francois Rheault ◽  
Manon Edde ◽  
Etienne Croteau ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
White Matter ◽  
Processing Speed ◽  
Energy Supply ◽  
Medium Chain Triglyceride ◽  
Energy Deficit ◽  
Post Intervention ◽  
Significant Positive Association ◽  
The Brain

INTRODUCTION: White matter (WM) energy supply is crucial for axonal function and myelin maintenance. Providing ketones, the brain s alternative fuel to glucose, is a therapeutic strategy to bypass the brain s glucose-specific energy deficit in mild cognitive impairment (MCI). How an additional supply of ketones affects glucose or ketone uptake in specific WM fascicles in MCI has not previously been described. METHODS: This 6-month interventional study included MCI participants randomized to a placebo (n = 16) or ketogenic medium chain triglyceride (kMCT; n = 17) drink. A neurocognitive battery and brain imaging were performed pre- and post-intervention. WM fascicle uptake of ketone and glucose and structural properties were assessed using positron emission tomography and diffusion imaging, respectively. RESULTS: Ketone uptake was increased by 2.5 to 3.2-fold in nine fascicles of interest (P < 0.001) only in the kMCT group, an effect seen both in deep WM and in fascicle cortical endpoints. Improvement in processing speed was associated with WM ketone uptake globally and in individual fascicles, most importantly the fornix (r = +0.61; P = 0.014). DISCUSSION: A 6-month ketogenic supplementation in MCI improved WM energy supply globally. The significant positive association with processing speed suggests that ketones may have a role in myelin integrity in MCI.

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