Cognitive impairments in sporadic cerebral small vessel disease (SVD): a systematic review and meta-analysis of cohorts with stroke, dementia and non-clinical presentations of SVD

AbstractBackgroundCognitive impairment is a key clinical feature of cerebral small vessel disease (SVD), but the full range of SVD-related cognitive impairments is unclear, and little is known about how they might vary across clinical and non-clinical manifestations of SVD.MethodsIn systematic searches of OVID MEDLINE, Embase, and PsychINFO from 1st January 1985 to 6th October 2019, we identified studies reporting cognitive test results for study participants with SVD and control participants without SVD. Using standardised group-level cognitive test data, we performed random effects meta-analyses in seven cognitive domains to test whether cognitive test scores differed between SVD and control groups. We conducted meta-regression analyses to test whether differences in age, education, or vascular risk factors between SVD and control groups, or whether different clinical manifestations of SVD (e.g. stroke, cognitive impairment, or non-clinical presentations) accounted for cognitive effect sizes.FindingsOf 8562 studies identified, we included 69 studies from six continents, published in four languages. These studies included 3229 participants with SVD and 3679 controls. Meta-analyses demonstrated that on average, control groups outperformed SVD cohorts on cognitive tests in all cognitive domains examined: executive function (estimate: -0.928; 95%CI: -1.08, -0.78); processing speed (-0.885; -1.17, -0.60); delayed memory (-0.898; -1.10, -0.69); language (-0.808; -1.01, -0.60); visuospatial ability (-0.720; -0.96, -0.48); reasoning (-0.634; -0.93, -0.34); and attention (-0.622; -0.94, -0.31; all p≤0.001). Meta-regression analyses suggested that differences in years of education between SVD and control groups may account for a proportion of the differences in performance on tests of executive function, visuospatial ability and language, and that cohorts with cognitive impairments performed more poorly on tests of executive function, delayed memory and visuospatial ability than cohorts with stroke or non-clinical presentations of SVD.InterpretationParticipants with SVD demonstrated poorer cognitive performance relative to control groups in all cognitive domains we examined. This effect was present for all presentations of SVD, reinforcing the need to test a range of cognitive domains in both clinical and research settings. Lower levels of education in SVD versus control participants may contribute to these effects, highlighting the need to account for educational level in the assessment of SVD-related cognitive impairment.FundingNone.

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Corpus callosal atrophy and associations with cognitive impairment in Parkinson disease

Neurology ◽

10.1212/wnl.0000000000003764 ◽

2017 ◽

Vol 88 (13) ◽

pp. 1265-1272 ◽

Cited By ~ 37

Author(s):

Jennifer G. Goldman ◽

Ian O. Bledsoe ◽

Doug Merkitch ◽

Vy Dinh ◽

Bryan Bernard ◽

...

Keyword(s):

Working Memory ◽

Cognitive Impairment ◽

Executive Function ◽

Corpus Callosum ◽

Parkinson Disease ◽

Clinical Manifestations ◽

Cognitive Domain ◽

Intracranial Volume ◽

Volume Loss ◽

Cognitive Domains

Objective:To investigate atrophy of the corpus callosum on MRI in Parkinson disease (PD) and its relationship to cognitive impairment.Methods:One hundred patients with PD and 24 healthy control participants underwent clinical and neuropsychological evaluations and structural MRI brain scans. Participants with PD were classified as cognitively normal (PD-NC; n = 28), having mild cognitive impairment (PD-MCI; n = 47), or having dementia (PDD; n = 25) by Movement Disorder Society criteria. Cognitive domain (attention/working memory, executive function, memory, language, visuospatial function) z scores were calculated. With the use of FreeSurfer image processing, volumes for total corpus callosum and its subsections (anterior, midanterior, central, midposterior, posterior) were computed and normalized by total intracranial volume. Callosal volumes were compared between participants with PD and controls and among PD cognitive groups, covarying for age, sex, and PD duration and with multiple comparison corrections. Regression analyses were performed to evaluate relationships between callosal volumes and performance in cognitive domains.Results:Participants with PD had reduced corpus callosum volumes in midanterior and central regions compared to healthy controls. Participants with PDD demonstrated decreased callosal volumes involving multiple subsections spanning anterior to posterior compared to participants with PD-MCI and PD-NC. Regional callosal atrophy predicted cognitive domain performance such that central volumes were associated with the attention/working memory domain; midposterior volumes with executive function, language, and memory domains; and posterior volumes with memory and visuospatial domains.Conclusions:Notable volume loss occurs in the corpus callosum in PD, with specific neuroanatomic distributions in PDD and relationships of regional atrophy to different cognitive domains. Callosal volume loss may contribute to clinical manifestations of PD cognitive impairment.

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COGNITIVE IMPAIRMENT DETECTION IN ADULT THALASSEMIA PATIENT USING MOCA-INA

MNJ (Malang Neurology Journal) ◽

10.21776/ub.mnj.2021.007.01.6 ◽

2021 ◽

Vol 7 (1) ◽

pp. 24-29

Author(s):

Chandra Calista Wardoyo ◽

Uni Gamayani ◽

Anam Ong ◽

Ahmad Rizal ◽

Yusuf Wibisono ◽

...

Keyword(s):

Cognitive Impairment ◽

Healthy Subjects ◽

Screening Tools ◽

Case Group ◽

Control Groups ◽

Thalassemia Patient ◽

Cognitive Domains ◽

A Value ◽

Healthy Control ◽

And Control

Background: Cognitive impairment in thalassemia patients are prevalent, therefore early detection of cognitive impairment in adult thalassemia patients is crucial for prevention. Montreal Cognitive Assessment (MoCA) is a public domain cognition screening tools that covers all cognitive domains in detecting mild cognitive impairments. Objective: To compare cognitive function between adult thalassemia patients and healty control by using Indonesia version of MoCA test (MoCA-Ina) Methods: This prospective observational analytic with case control study, compared the total scores and scores of each domain of cognition between adult thalassemia patients and healthy subjects at the Medical Hematology Oncology Clinic of Dr. Hasan Sadikin General Hospital, Bandung, Indonesia using MoCA-Ina from August to October 2018. Results: A total of 32 thalassemia subjects and 50 healthy subjects were conducted. A total of 16(50%) subjects in the case group had a value of MoCA-Ina <26, while only 1(2%) healthy control had a value of MoCA-Ina <26. The median total MoCA-Ina score in case and control groups were 25.5 and 27.50 (p <0.001). The median score of memory domains, executive functions and visuospatial of the case and control groups were 3 versus 4 (p <0.001), 3 versus 3.5 (p <0.001) and 3.53 ± 0.671 versus 3.88 ± 0.385 (p <0.003), respectively. Conclusion: Adults thalassemia patients have lower score in total MoCA-Ina, domains of memory, executive function and visuospatial score compared to healthy control.

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Abstract P268: Greater Cognitive Impairment Among Older Adults With Type 1 Diabetes as Compared to Non-diabetic Controls: Results From the Study of Longevity in Diabetes (SOLID)

Circulation ◽

10.1161/circ.141.suppl_1.p268 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Mary E Lacy ◽

Paola Gilsanz ◽

Chloe Eng ◽

Michal S Beeri ◽

Andrew J Karter ◽

...

Keyword(s):

Older Adults ◽

Type 1 Diabetes ◽

Cognitive Impairment ◽

Executive Function ◽

Cognitive Function ◽

Episodic Memory ◽

Regression Models ◽

Cognitive Test ◽

Race Ethnicity

Introduction: Studies have shown poorer cognitive function in children and adolescents with type 1 diabetes (T1D) as compared to non-diabetic peers. However, little is known about cognitive function in older adults with T1D. Hypothesis: We hypothesized that older adults with T1D and type 2 diabetes (T2D) would have greater cognitive impairment than age, sex, race/ethnicity, and education-matched controls without diabetes. Methods: We compared baseline cognitive impairment among older adults (aged ≥60) from the Study of Longevity in Diabetes (SOLID) with T1D (n=771), T2D (=234) and no diabetes (n=253). Cognitive tests assessed three cognitive domains identified via factor analysis (language, executive function, episodic memory). All cognitive test scores were standardized and cognitive impairment was defined as 1.5 SD below the mean. In logistic regression models adjusted for age, sex, education, and race/ethnicity, we examined the association between diabetes status (T1D, T2D or no diabetes) and cognition on each cognitive domain and on global cognition (average of scores on the 3 domains). Results: In adjusted regression models, compared to older adults without diabetes, those with T1D were more likely to have impaired cognitive function on the language (OR=2.13, 95% CI: 1.08, 4.17) and executive function domains (OR=2.66, 95% CI: 1.36, 5.22). No significant differences in global cognitive impairment or impairment on the episodic memory domain were observed for T1D and no significant differences on any domain were observed for T2D. Conclusions: Our findings suggest that older adults with T1D have greater cognitive impairment than their peers without diabetes; findings were specific to the language and executive function domains, with episodic memory being unaffected. No increase in cognitive impairment was observed for older adults with T2D. Additional research is needed to understand the causes and potentially modifiable factors associated with impaired cognition among older adults with T1D.

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Vascular cognitive impairment (VCI): Progress towards knowledge and treatment

Dementia & Neuropsychologia ◽

10.1590/s1980-57642010dn40100002 ◽

2010 ◽

Vol 4 (1) ◽

pp. 4-13 ◽

Cited By ~ 8

Author(s):

Silvia Di Legge ◽

Vladimir Hachinski

Keyword(s):

Cognitive Impairment ◽

Clinical Manifestations ◽

Vascular Cognitive Impairment ◽

Cognitive Outcome ◽

Cognitive Domains ◽

Mitochondrial Dna Damage ◽

Complex Interactions ◽

Dementia Syndrome ◽

Data Elements ◽

The Impact

Abstract Until recently, the study of cognitive impairment as a manifestation of cerebrovascular disease (CVD) has been hampered by the lack of common standards for assessment. The term vascular cognitive impairment (VCI) encompasses all levels of cognitive decline associated with CVD from mild deficits in one or more cognitive domains to crude dementia syndrome. VCI incorporates the complex interactions among classic vascular risk factors (i.e. arterial hypertension, high cholesterol, and diabetes), CVD subtypes, and Alzheimer's Disease (AD) pathology. VCI may be the earliest, commonest, and subtlest manifestation of CVD and can be regarded as a highly prevalent and preventable syndrome. However, cognition is not a standardized outcome measure in clinical trials assessing functional ability after stroke. Furthermore, with the exception of anti-hypertensive medications, the impact of either preventive or acute stroke treatments on cognitive outcome is not known. Although clinical, epidemiological, neuroimaging, and experimental data support the VCI concept, there is a lack of integrated knowledge on the role played by the most relevant pathophysiological mechanisms involved in several neurological conditions including stroke and cognitive impairment such as excitotoxicity, apoptosis, mitochondrial DNA damage, oxidative stress, disturbed neurotransmitter release, and inflammation. For this reason, in 2006 the National Institute of Neurological Disorders and Stroke (NINDS) and the Canadian Stroke Network (CSN) defined a set of data elements to be collected in future studies aimed at defining VCI etiology, clinical manifestations, predictive factors, and treatment. These recommendations represent the first step toward developing diagnostic criteria for VCI based on sound knowledge rather than on hypotheses. The second step will be to integrate all studies using the agreed methodologies. This is likely to accelerate the search for answers.

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A community-based case–control study of prevalence and pattern of cognitive impairments in patients with epilepsy residing in South-Eastern Nigeria

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.181488 ◽

2016 ◽

Vol 07 (03) ◽

pp. 405-411 ◽

Cited By ~ 2

Author(s):

Eugene O. Arinzechi ◽

Olubunmi A. Ogunrin ◽

Cosmas M. Nwosu ◽

Paul O. Nwani ◽

Kelechi O. Enwereji ◽

...

Keyword(s):

Cognitive Impairment ◽

Prevalence Rate ◽

Cognitive Impairments ◽

Sub Saharan Africa ◽

Cognitive Test ◽

Computer Assisted ◽

Healthy Controls ◽

Community Screening ◽

South Eastern ◽

Patients With Epilepsy

ABSTRACT Background: Epilepsy is the commonest neurological disorder encountered in Sub-Saharan Africa. The quality of life of patients with epilepsy (PWEs) is adversely affected by cognitive impairments. Aim: This study investigated the prevalence and pattern of cognitive impairments in PWE in Ukpo community located in a South-Eastern state in Nigeria using Community Screening Interview for Dementia (CSID) and a computer-assisted cognitive test battery (FePsy). Methods and Patients: Fifty-one PWEs were studied and compared with 51 age-, sex-and level of education-matched healthy controls. Diagnosis of epilepsy was confirmed clinically with eye-witness corroboration. Sociodemographic data and information on epilepsy variables were obtained with the aid of a questionnaire. Cognitive domains assessed include language, memory, orientation, attention, psychomotor speed and constructional praxis. Results: The prevalence rate of cognitive impairment using total CSID score was 19.6%. Analysis of CSID scores revealed significant impairment in language (17.6%), memory (29.4%), orientation (15.7%), attention (7.8%) and constructional praxis (15.7%) compared to healthy controls. A similar pattern was observed with FePsy but with better sensitivity indices for detecting cognitive impairment. Conclusion: This study indicated significant prevalence rate of cognitive impairment among treatment-naïve PWE with profound affectation of memory, mental speed and language. In addition, the FePsy was found to be more sensitive and specific in assessment of cognitive function in PWE.

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A Pilot Study of Neurocognitive Function and Brain Structures in Adolescents With Alcohol Use Disorders: Does Maltreatment History Matter?

Child Maltreatment ◽

10.1177/1077559518810525 ◽

2019 ◽

Vol 24 (4) ◽

pp. 374-388 ◽

Cited By ~ 3

Author(s):

Michael D. De Bellis ◽

Rajendra A. Morey ◽

Kate B. Nooner ◽

Donald P. Woolley ◽

Courtney C. Haswell ◽

...

Keyword(s):

Executive Function ◽

Alcohol Use ◽

Inferior Frontal Gyrus ◽

Alcohol Use Disorders ◽

Inverse Correlation ◽

Fine Motor ◽

Control Groups ◽

Lower Performance ◽

Visual Spatial ◽

And Control

Neurocognitive and brain structural differences are associated with adolescent onset alcohol use disorders (AUDs). Maltreatment histories may contribute to current results. To examine these issues, healthy adolescents ( n = 31), adolescents without maltreatment and AUD (AUD − MAL, n = 28), and adolescents with AUDs with maltreatment (AUD + MAL, n = 17) underwent comprehensive neurocognitive assessments and MRI structural scans. Controls performed significantly better than the two AUD groups in math and language. The AUD + MAL group performed significantly lower in sustained attention compared to the AUD − MAL and control groups and lower in reading compared to controls. The AUD + MAL group had larger left pars triangularis, a region of the inferior frontal gyrus, compared to the AUD-MAL and control groups, and smaller anterior corpus callosum volumes versus the AUD − MAL group. There were no group differences in other prefrontal cortex, amygdala, hippocampus, and parahippocampal volumes. The AUD + MAL group showed an inverse correlation between hippocampal volumes and age. AUD variables were associated with lower performance in fine-motor and executive function. Cannabis use variables were associated with lower performance in fine-motor, language, visual-spatial, memory, and executive function. Parahippocampal volumes positively correlated with abstinence. The preliminary results suggest adolescent AUD studies should consider examinations of maltreatment history, comorbid substance use disorders, and recovery during abstinence in their analyses.

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THE RELATIONSHIP BETWEEN CLOCK DRAWING AND COGNITION IN PARKINSON'S

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2015-312379.172 ◽

2015 ◽

Vol 86 (11) ◽

pp. e4.82-e4

Author(s):

Jeremy Cosgrove ◽

Stuart Jamieson ◽

Stephen Smith ◽

Jane Alty

Keyword(s):

Cognitive Impairment ◽

Executive Function ◽

Cognitive Assessment ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Montreal Cognitive Assessment ◽

Visuospatial Ability ◽

Clock Drawing ◽

The Relationship ◽

Normal Cognition

IntroductionClock drawing (CD) requires executive function, attention and visuospatial ability. Our objective was to investigate CD in Parkinson's subjects with and without cognitive impairment.Methods107 subjects completed the Montreal Cognitive Assessment (MoCA), classifying into normal cognition (PD-NC – MoCA ≥26) and cognitive impairment (PD-CI–MoCA <26). CD was scored using MoCA criteria; a maximum of 3 points, one each for correct contour, clock face and clock hands.ResultsPD-CI (n=57) and PD-NC were matched for all demographics except age (PD-CI were older, P 0.032). 35% of PD-CI scored full marks compared to 90% of PD-NC (sensitivity 0.64, specificity 0.9, age adjusted-odds ratio for predicting PD-CI 15.63, 95% CI 5.18 – 47.62, P<0.001). 88% of PD-CI scored points for contour and 60% scored points for clock face. In contrast, all PD-NC scored points for contour and clock face (P <0.001). 42% of PD-CI and 90% of PD-NC correctly drew clock hands (P<0.001).ConclusionsIn this cohort, inability to score maximum points for CD was associated with PD-CI. Correctly drawing clock hands was the hardest component for both groups. Incorrect contour or clock face was highly specific for PD-CI.

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Fibrinogen Levels and Cognitive Profile Differences in Patients with Mild Cognitive Impairment

Dementia and Geriatric Cognitive Disorders ◽

10.1159/000510420 ◽

2020 ◽

pp. 1-8

Author(s):

Jung-Min Pyun ◽

Nayoung Ryoo ◽

Young Ho Park ◽

SangYun Kim

Keyword(s):

Risk Factors ◽

Cognitive Impairment ◽

Executive Function ◽

Mild Cognitive Impairment ◽

Disease Progression ◽

Vascular Risk Factors ◽

Plasma Fibrinogen ◽

Cognitive Test ◽

Vascular Risk ◽

Confrontation Naming

Background: Fibrinogen is considered a marker of vascular pathology, indicating a weakened blood-brain barrier, and has a causative role in neuroinflammation and neurodegeneration. Little is known about the relationship between fibrinogen levels and cognitive function in patients with mild cognitive impairment (MCI). We aimed to investigate differences in cognitive profiles according to plasma fibrinogen levels in patients with MCI and the influence of plasma fibrinogen levels on cognitive decline. Methods: This retrospective cohort study included 643 patients with MCI: 323 patients in the high fibrinogen (high fib) group and 320 patients in the low fibrinogen (low fib) group. A multiple linear regression model was performed to compare cognitive test performance between groups. The Cox proportional hazard model was used to analyze the hazard ratio of fibrinogen level for disease progression. Results: The high fib group demonstrated poorer performance in attention, executive function, and confrontation naming than the low fib group. After adjustment for APOE genotype, the high fib group was associated with poor attention and executive function. After adjustment for vascular risk factors including body mass index, hypertension, diabetes mellitus, dyslipidemia, and smoking history, the high fib group showed declined attention and confrontation naming ability. High fibrinogen levels did not predict disease progression to CDR 1. Conclusion: High plasma fibrinogen levels were associated with poor performance in attention in patients with MCI, regardless of APOE genotype or vascular risk factors.

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33 Cognitive Domain Associations with Balance Performance in Community – Dwelling Older People with Cognitive Impairment

Age and Ageing ◽

10.1093/ageing/afz164.33 ◽

2019 ◽

Vol 48 (Supplement_4) ◽

pp. iv9-iv12

Author(s):

Morag Taylor ◽

Stephen Lord ◽

Annika Toots ◽

Close Jacqueline

Keyword(s):

Cognitive Impairment ◽

Executive Function ◽

Older People ◽

Verbal Fluency ◽

Community Dwelling ◽

Cognitive Domain ◽

Balance Performance ◽

Visuospatial Ability ◽

Community Dwelling Older People ◽

Attention Memory

Abstract Aims Investigate the relationship between global cognition and cognitive domain function and balance performance in a large sample of older people with cognitive impairment. Methods Three hundred and nine community-dwelling older people (mean age=82 years; 47% female) with cognitive impairment were recruited for the iFOCIS fall prevention randomised controlled trial. Baseline assessments completed before randomisation were used for analyses and included the Addenbrooke’s Cognitive Examination-III (ACE-III; global cognitive function) and its individual cognitive domains (attention; memory; verbal fluency; language; visuospatial ability) and executive function, further examined using the Frontal Assessment Battery (FAB). Balance performance was derived by averaging postural sway on floor and foam, maximal balance range (reverse z-score) and co-ordinated stability z-scores. With balance performance as the dependent variable, global cognition and each cognitive domain were entered into multivariate linear regression models. Results Mean (± standard deviation) ACE-III and FAB scores were 62.8±19.2 and 11.4±4.6 respectively. In linear regression analyses adjusted for covariates, global cognitive function and each cognitive domain were significantly associated with balance performance. Executive function (verbal fluency; β=-.248, p<0.001, adjusted R2=0.376) and visuospatial ability (β=-.250, p<0.001, adjusted R2=0.381) had the strongest and memory the weakest (β=-.119, p=0.018, adjusted R2=0.334) association with balance. Visuospatial ability remained significantly associated with balance performance when adjusted for attention, memory, language, verbal fluency and the FAB. Executive function (verbal fluency) remained significantly associated with balance when adjusted for attention, memory, language and visuospatial ability. Conversely, attention, memory, and language did not withstand adjustment for visuospatial ability or executive function. Conclusions Poorer global cognition and performance in each cognitive domain were associated with poorer balance performance in this large sample of community-dwelling older people with cognitive impairment. Visuospatial ability and executive function were independently associated with balance, highlighting the role higher-level cognitive processes and spatial perception and processing play in postural control.

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Absence of Correlation between IL-28B Gene Polymorphisms and the Clinical Presentation of Chronic Hepatitis B in an Amazon Brazilian Population

Disease Markers ◽

10.1155/2014/534534 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Simone Regina Souza da Silva Conde ◽

Luciana L. Rocha ◽

Vanessa M. Ferreira ◽

Julius Caesar Mendes Soares Monteiro ◽

Nathália Karla Fonseca Filgueiras ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis B ◽

Chronic Hepatitis B ◽

Clinical Manifestations ◽

Positive Control ◽

Control Group ◽

Similar Distribution ◽

Control Groups ◽

And Control

Objective. The present study investigated the prevalence of the IL-28B polymorphisms rs12979860 and rs8099917 in chronic hepatitis B patients from a case study in Eastern Amazonia.Methods. In total, 65 chronically infected HBV patients and 97 healthy subjects who were anti-HBc and anti-HBs positive (control group) were evaluated between May 2011 and December 2012. The groups of patients were designated as inactive carriers, chronic hepatitis without cirrhosis, and chronic hepatitis with cirrhosis based on clinical, pathological, biochemical, hematological, and virological variables. The patients were genotyped using quantitative real-time PCR.Results. The frequencies of the rs12979860 polymorphism were similar between the infected group (32.3% CC, 41.5% CT, and 26.2 TT) and the control population (35% CC, 47.4% CT, and 17.6% TT), and the frequencies of the rs8099917 polymorphism (7.7% GG, 35.4% GT, and 56.9% TT versus 7.2% GG, 35.1% GT, and 57.7% TT) were also similar in both groups. The associations between the rs12979860 and rs8099917 polymorphisms and the clinical manifestations were not statistically significant.Conclusion. In conclusion, these polymorphisms had a similar distribution between infected and control groups, indicating that they were not associated with susceptibility and the clinical evolution of hepatitis B in the examined population.

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