scholarly journals Cognitive Correlates of MRI-defined Cerebral Vascular Injury and Atrophy in Elderly American Indians: The Strong Heart Study

2019 ◽  
Vol 26 (3) ◽  
pp. 263-275 ◽  
Author(s):  
Astrid Suchy-Dicey ◽  
Dean Shibata ◽  
Brenna Cholerton ◽  
Lonnie Nelson ◽  
Darren Calhoun ◽  
...  
Keyword(s):  
Executive Function ◽  
White Matter ◽  
Magnetic Resonance ◽  
Cerebrovascular Disease ◽  
Cognitive Functioning ◽  
American Indians ◽  
Processing Speed ◽  
Brain Volume ◽  
Hippocampal Volume ◽  
White Matter Disease

AbstractObjective:American Indians experience substantial health disparities relative to the US population, including vascular brain aging. Poorer cognitive test performance has been associated with cranial magnetic resonance imaging findings in aging community populations, but no study has investigated these associations in elderly American Indians.Methods:We examined 786 American Indians aged 64 years and older from the Cerebrovascular Disease and its Consequences in American Indians study (2010–2013). Cranial magnetic resonance images were scored for cortical and subcortical infarcts, hemorrhages, severity of white matter disease, sulcal widening, ventricle enlargement, and volumetric estimates for white matter hyperintensities (WMHs), hippocampus, and brain. Participants completed demographic, medical history, and neuropsychological assessments including testing for general cognitive functioning, verbal learning and memory, processing speed, phonemic fluency, and executive function.Results:Processing speed was independently associated with the presence of any infarcts, white matter disease, and hippocampal and brain volumes, independent of socioeconomic, language, education, and clinical factors. Other significant associations included general cognitive functioning with hippocampal volume. Nonsignificant, marginal associations included general cognition with WMH and brain volume; verbal memory with hippocampal volume; verbal fluency and executive function with brain volume; and processing speed with ventricle enlargement.Conclusions:Brain-cognition associations found in this study of elderly American Indians are similar to those found in other racial/ethnic populations, with processing speed comprising an especially strong correlate of cerebrovascular disease. These findings may assist future efforts to define opportunities for disease prevention, to conduct research on diagnostic and normative standards, and to guide clinical evaluation of this underserved and overburdened population.

scholarly journals Processing speed in normal aging: Effects of white matter hyperintensities and hippocampal volume loss

2013 ◽  
Vol 21 (2) ◽  
pp. 197-213 ◽  
Author(s):  
Kathryn V. Papp ◽  
Richard F. Kaplan ◽  
Beth Springate ◽  
Nicola Moscufo ◽  
Dorothy B. Wakefield ◽  
...  
Keyword(s):  
White Matter ◽  
Processing Speed ◽  
White Matter Hyperintensities ◽  
Hippocampal Volume ◽  
Normal Aging ◽  
Volume Loss ◽  
Aging Effects

scholarly journals Spongiform leukoencephalopathy: A unique case of biopsy confirmed leukoencephalopathy secondary to toxic, non-inflammatory exposure

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110429
Author(s):  
Kristen Zemina ◽  
Yolanda Piña ◽  
Patrick Malafronte ◽  
Niraja Suresh ◽  
Rebeca Hurst
Keyword(s):  
Magnetic Resonance Imaging ◽  
White Matter ◽  
Magnetic Resonance ◽  
Clinical Presentation ◽  
Brain Biopsy ◽  
Disease Diagnosis ◽  
High Dose ◽  
White Matter Disease ◽  
Resonance Imaging ◽  
Chemotherapy Drugs

Toxin-induced leukoencephalopathy is a rare neurological condition that has been previously associated with intracranial radiation, chemotherapy, drugs of abuse, and environmental exposures. Herein, we present a patient with brain-biopsy proven toxin-induced leukoencephalopathy, likely secondary to multiple environmental offenders including insecticides and non-Food and Drug Administration approved anabolic steroids, opioids, and benzodiazepines. A 60-year-old man presented to our service as a direct transfer from an outside facility for evaluation of a rapidly progressive neuropsychiatric decline. Extensive workup with blood work, cerebrospinal fluid analysis, paraneoplastic panel, serial magnetic resonance imaging brain with and without contrast, and electroencephalograms were unrevealing. Magnetic resonance imaging brain showed diffuse confluent white matter disease, which was non-specific. The patient was treated with high-dose methylprednisolone and trials of intravenous immunoglobulin without any significant improvement. Finally, a brain biopsy was performed, and pathology confirmed a spongiform leukoencephalopathy, favoring a toxin-related etiology. The diagnosis of toxin-induced leukoencephalopathy should be considered in patients with steep neuropsychiatric decline and associated diffuse white matter disease. Diagnosis relies heavily on history of exposure, clinical presentation, imaging findings, and ultimately, histopathology from brain biopsy. The recognition of the clinical presentation is important to pursue the appropriate diagnostic workup and treatment.

scholarly journals Associations of the Lifestyle for Brain Health Index With Structural Brain Changes and Cognition: Results From the Maastricht Study

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012572
Author(s):  
Irene S Heger ◽  
Kay Deckers ◽  
Miranda T Schram ◽  
Coen DA Stehouwer ◽  
Pieter C Dagnelie ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Information Processing ◽  
Executive Function ◽  
White Matter ◽  
Processing Speed ◽  
Grey Matter ◽  
White Matter Hyperintensities ◽  
Information Processing Speed ◽  
Brain Health ◽  
Dementia Risk

Background and Objectives:Observational research has shown that a substantial proportion of all dementia cases worldwide is attributable to modifiable risk factors. Dementia risk scores might be useful to identify high-risk individuals and monitor treatment adherence. The objective of this study was to investigate whether a dementia risk score, the LIfestyle for BRAin health (LIBRA) index, is associated with MRI markers and cognitive functioning/impairment in the general population.Methods:Cross-sectional data was used from the observational population-based cohort of The Maastricht Study.. The weighted compound score of LIBRA (including twelve dementia risk and protective factors, e.g. hypertension, physical inactivity) was calculated, with higher scores indicating higher dementia risk. Standardized volumes of white matter, grey matter, CSF (as proxy for general brain atrophy), white matter hyperintensities, and presence of cerebral small vessel disease were derived from 3T MRI. Cognitive functioning was tested in three domains: memory, information processing speed, and executive function and attention. Values ≤1.5 SD below the average were defined as cognitive impairment. Multiple regression analyses and structural equation modelling were used, adjusted for age, sex, education, intracranial volume and type-2 diabetes.Results:Participants (n=4,164; mean age 59y; 49.7% men) with higher LIBRA scores (mean=1.19, range=-2.7 to +9.2), denoting higher dementia risk, had higher volumes of white matter hyperintensities (β=0.051, p=.002), and lower scores on information processing speed (β=-0.067, p=.001) and executive function and attention (β=-0.065, p=.004). Only in men, associations between LIBRA and volumes of grey matter (β=-0.093, p<.001), CSF (β=0.104, p<.001) and memory (β=-0.054, p=.026) were found. White matter hyperintensities and CSF volume partly mediated the association between LIBRA and cognition.Discussion:Higher health- and lifestyle-based dementia risk is associated with markers of general brain atrophy, cerebrovascular pathology and worse cognition, suggesting that LIBRA meaningfully summarizes individual lifestyle-related brain health. Improving LIBRA factors on an individual level might improve population brain health. Sex differences in lifestyle-related pathology and cognition need to be further explored.Classification of Evidence:This study provides Class II evidence that higher LIBRA scores are significantly associated with lower scores on some cognitive domains and a higher risk of cognitive impairment.

Abstract TP462: Cognitive Profile of Non-demented Cerebral Amlyoid Angiopathy Patients

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Li Xiong ◽  
Sigurros Davidsdottir ◽  
Roongpiboonsopit Duangnapa ◽  
Sekh Thanprasertsuk ◽  
Panagiotis Fotiadis ◽  
...  
Keyword(s):  
Executive Function ◽  
Processing Speed ◽  
Brain Volume ◽  
Cognitive Profile ◽  
Superficial Siderosis ◽  
Amyloid Angiopathy ◽  
Z Score ◽  
Total Brain Volume ◽  
Neuropsychological Profile ◽  
Total Brain

Objective: To characterize the neuropsychological profile of sporadic cerebral amyloid angiopathy (CAA) patients without dementia and to determine the association between cognitive performance in different domains and neuroimaging lesions characteristic of CAA. Methods: Forty-eight CAA patients were compared to 138 cognitively normal subjects (CN) using a standard neuropsychological test battery designed to assess the cognitive profile in CAA patients without dementia. Total brain volume (TBV), white matter hyperintensities (WMH), number of cerebral microbleeds (CMBs), hippocampal volume (HV) and the presence of cerebral superficial siderosis (cSS) of all CAA patients were measured. The association between these neuroimaging markers and neuropsychological performance in different cognitive domains in the CAA group were analyzed. Results: Patients with CAA had significantly worse performance on all individual neuropsychological domain tested when compared to the CN group. The cognitive decline of CAA patients was most noticeable in tests for processing speed (Z score -1.84±1.50), then followed by executive function (Z score -1.03±1.04), semantic fluency (Z score -0.71±1.07), episodic memory (Z score -0.68±1.08), and attention (Z score -0.48±1.00). Total brain volume of the CAA patients was correlated with processing speed (β=0.358, P=0.034) and executive function (β=0.507, P=0.002). Conclusion: Non-demented patients with CAA had cognitive deficits in multiple areas. Lower total brain volume was related to slower processing speed and worse executive function.

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