scholarly journals Visual dysfunction predicts cognitive impairment and white matter degeneration in Parkinson’s disease

2020 ◽  
Author(s):  
Angeliki Zarkali ◽  
Peter McColgan ◽  
Louise-Ann Leyland ◽  
Andrew J. Lees ◽  
Rimona S. Weil
Keyword(s):  
Cognitive Impairment ◽  
White Matter ◽  
Cross Section ◽  
Visual Function ◽  
Structural Changes ◽  
Intracranial Volume ◽  
Visual Dysfunction ◽  
Parkinsons Disease ◽  
Fibre Density

Visual dysfunction predicts dementia in Parkinsons disease (PD), but whether this translates to structural change is not known. We aimed to identify longitudinal white matter changes in patients with Parkinsons disease and low visual function and also in those who developed mild cognitive impairment (MCI). We used fixel-based analysis to examine longitudinal white matter change in PD. Diffusion MRI and clinical assessments were performed in 77 patients at baseline (22 low visual function /55 intact vision; and 13 MCI, 13 MCI converters /51 normal cognition) and 25 controls and again after 18 months. We compared micro-structural changes in fibre density, macro-structural changes in fibre bundle cross-section (FC) and combined fibre density and cross-section across white matter, adjusting for age, gender and intracranial volume. Patients with Parkinsons and visual dysfunction showed worse cognitive performance at follow up and were more likely to develop MCI compared with those with normal vision (p=0.008). Parkinsons with poor visual function showed diffuse micro-structural and macro-structural changes at baseline, whereas those with MCI showed fewer baseline changes. At follow-up, Parkinsons with low visual function showed widespread macrostructural changes, involving the fronto-occipital fasciculi, external capsules, and middle cerebellar peduncles bilaterally. No longitudinal change was seen in baseline MCI or in MCI converters, even when the two groups were combined. Parkinsons patients with poor visual function show increased white matter damage over time, providing further evidence for visual function as a marker of imminent cognitive decline.

scholarly journals Development of white matter fibre density and morphology over childhood: a longitudinal fixel-based analysis

2018 ◽  
Author(s):  
Sila Genc ◽  
Robert E Smith ◽  
Charles B Malpas ◽  
Vicki Anderson ◽  
Jan M Nicholson ◽  
...  
Keyword(s):  
White Matter ◽  
Cross Section ◽  
Repeated Measures ◽  
Pubertal Stage ◽  
Full Spectrum ◽  
Fibre Density ◽  
Fibre Development ◽  
Over Time ◽  
Time Point

AbstractPurposeWhite matter fibre development in childhood involves dynamic changes to microstructural organisation driven by increasing axon diameter, density, and myelination. However, there is a lack of longitudinal studies that have quantified advanced diffusion metrics to identify regions of accelerated fibre maturation, particularly across the early pubertal period. We applied a novel longitudinal fixel-based analysis (FBA) framework, in order to estimate microscopic and macroscopic white matter changes over time.MethodsDiffusion-weighted imaging (DWI) data were acquired for 59 typically developing children (27 female) aged 9 – 13 years at two time-points approximately 16 months apart (time-point 1: 10.4 ± 0.4 years, time-point 2: 11.7 ± 0.5 years). Whole brain FBA was performed using the connectivity-based fixel enhancement method, to assess longitudinal changes in fibre microscopic density and macroscopic morphological measures, and how these changes are affected by sex, pubertal stage, and pubertal progression. Follow-up analyses were performed in sub-regions of the corpus callosum to confirm the main findings using a Bayesian repeated measures approach.ResultsThere was a statistically significant increase in fibre density over time localised to medial and posterior commissural and association fibres, including the forceps major and bilateral superior longitudinal fasciculus. Increases in fibre cross-section were substantially more widespread. The rate of fibre development was not associated with age or sex. In addition, there was no significant relationship between pubertal stage or progression and longitudinal fibre development over time. Follow-up Bayesian analyses were performed to confirm the findings, which supported the null effect of the longitudinal pubertal comparison.ConclusionUsing a novel longitudinal fixel-based analysis framework, we demonstrate that white matter fibre density and fibre cross-section increased within a 16-month scan rescan period in specific regions. The observed increases might reflect increasing axonal diameter or axon count. Pubertal stage or progression did not influence the rate of fibre development in the early stages of puberty. Future work should focus on quantifying these measures across a wider age range to capture the full spectrum of fibre development across the pubertal period.

scholarly journals Structural changes in white matter lesion patients and their correlation with cognitive impairment

2019 ◽  
Vol Volume 15 ◽  
pp. 1355-1363 ◽  
Author(s):  
Jinfang Wang ◽  
Yi Liang ◽  
Hongyan Chen ◽  
Wanming Wang ◽  
Yanwen Wang ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
White Matter ◽  
Structural Changes ◽  
White Matter Lesion

White Matter Changes and Cognitive Decline in a Ten-Year Follow-Up Period: A Pilot Study on a Single-Center Cohort from the Leukoaraiosis and Disability Study

2016 ◽  
Vol 41 (5-6) ◽  
pp. 303-313
Author(s):  
Sofia Madureira ◽  
Ana Verdelho ◽  
Carla Moleiro ◽  
Catarina Santos ◽  
Philip Scheltens ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
White Matter ◽  
Verbal Learning ◽  
White Matter Lesions ◽  
Disease Assessment ◽  
California Verbal Learning Test ◽  
Clinical Diagnoses ◽  
Neuropsychological Predictors ◽  
Learning Test

Aims: To describe the contribution of white matter lesions to the long-term neuropsychological profiles of different groups of clinical diagnoses, and to identify neuropsychological predictors of cognitive impairment in a 10-year follow-up. Methods: The Lisbon subcohort of the Leukoaraiosis and Disability (LADIS) study was re-evaluated performing a clinical, functional and cognitive evaluation [including Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale - Cognition (ADAS-Cog) and ADAS-Cog with the extension for vascular impairment (VADAS-Cog), the 9-word version of the California Verbal Learning Test (CVLT-9), the Trail-Making test and the Stroop test] as well as an MRI scan. Using clinical diagnostic criteria, participants were identified as having no cognitive impairment (NI), cognitive impairment but no dementia (CIND) or dementia (DEM), and the effect of time on clinical diagnosis and neuropsychological profiles was analyzed. Results: From the initial group of 66 participants, 37 out of 41 survivors (90%) were re-evaluated (mean age 81.40 years, 57% women). Fifteen patients (41%) had DEM, 12 (32%) CIND and 10 (27%) NI. Over time, the three groups presented distinct profiles in the MMSE [F2, 62 = 15.85, p = 0.000], ADAS [F2, 62 = 15.85, p = 0.000] and VADAS [F2, 48 = 5.87, p = 0.008]. Logistic regression analysis identified higher scores on MMSE (β = 1.14, p = 0.03, OR = 3.13, 95% CI 1.09-8.97) as predictors of NI after 10 years of follow-up. Conclusion: Higher scores on baseline MMSE were the only neuropsychological predictors of NI after 10 years.

White matter hyperintensities predict dementia in poststroke patients with cognitive impairment no dementia (CIND)

2011 ◽  
Vol 26 (S2) ◽  
pp. 490-490
Author(s):  
Y.K. Chen ◽  
E. Lee ◽  
J.Y. Lu ◽  
W.C.W. Chu ◽  
V.C.T. Mok ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cognitive Impairment ◽  
White Matter ◽  
White Matter Hyperintensities ◽  
Hippocampal Volume ◽  
Cognitive Domain ◽  
Nihss Score ◽  
One Year ◽  
Cognitive Impairment No Dementia

IntroductionLongitudinal studies of predicting dementia conversion of poststroke cognitive impairment no dementia (CIND) are limited.ObjectiveTo investigate the clinical and imaging predictors of dementia conversion in poststroke patients with CIND.AimTo understand dementia conversion of CIND.Methods143 patients with CIND (defined as impairment in at least one cognitive domain without meeting the criteria of dementia) at three months after stroke were recruited and followed up for one year. Dementia was diagnosed using the criteria of Diagnostic and Statistical Manual of Mental Disorders (4th edition, DSM-IV). MRI measurements including infarction, microbleeds, white matter hyperintensities (WMHs) and hippocampal volume were conducted. Logistic regression was performed to find the predictors of dementia at follow-up.Results16 (11.2%) out of the 143 patients developed dementia 15 months after stroke. In univariate comparisons, subjects with dementia at follow-up had older age (78.0 ± 5.3 vs.71.5 ± 8.5 years, p = 0.003) and higher NIHSS score (7.1 ± 3.5 vs.4.7 ± 3.3, p = 0.005) on admission. They also had higher frequency of old infarcts in the thalamus (31.3% vs. 11.0%, p = 0.025), larger volume of old infarcts (4.2 ± 11.2 vs. 0.7 ± 2.6 cm3, p < 0.001) and WMHs volume (33.2 ± 34.0 vs. 14.2 ± 14.1 cm3, p = 0.016). In logistic regression, age (odds ratio [OR] =1.203, 95%C.I.=1.054-1.373, p = 0.006), NIHSS score on admission (OR = 1.324, 95%C.I.=1.082-1.619, p = 0.006) and WMHs volume (OR = 1.045, 95%C.I.=1.007-1.084, p = 0.019) were significant predictors of dementia at follow-up.ConclusionsWMHs volume predicts dementia in poststroke patients with CIND, suggesting subcortical ischemic vascular disease was an important origin of poststroke delayed dementia.

scholarly journals Do cerebral white matter lesions influence the rate of progression from mild cognitive impairment to dementia?

2012 ◽  
Vol 25 (1) ◽  
pp. 120-127 ◽  
Author(s):  
Michael E. Devine ◽  
J. Andres Saez Fonseca ◽  
Zuzana Walker
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
White Matter ◽  
White Matter Lesions ◽  
Cerebral White Matter ◽  
Brain Scans ◽  
Mri Brain ◽  
Cerebral White Matter Lesions ◽  
Ct And Mri

ABSTRACTBackground: Cerebral white matter lesions (WML), evident on CT and MRI brain scans, are histopathologically heterogeneous but associated with vascular risk factors and thought mainly to indicate ischemic damage. There has been disagreement over their clinical prognostic value in predicting conversion from mild cognitive impairment (MCI) to dementia.Methods: We scrutinised and rated CT and MRI brain scans for degree of WML in a memory clinic cohort of 129 patients with at least 1 year of follow-up. We examined the relationship between WML severity and time until conversion to dementia for all MCI patients and for amnestic (aMCI) and non-amnestic (naMCI) subgroups separately.Results: Five-year outcome data were available for 87 (67%) of the 129 patients. The proportion of patients converting to dementia was 25% at 1 year and 76% at 5 years. Patients with aMCI converted to dementia significantly earlier than those with naMCI. WML severity was not associated with time to conversion to dementia for either MCI patients in general or aMCI patients in particular. Among naMCI patients, there was a tendency for those with a low degree of WML to survive without dementia for longer than those with a high degree of WML. However, this was not statistically significant.Conclusions: MCI subtype is a significant independent predictor of conversion to dementia, with aMCI patients having higher risk than naMCI for conversion throughout the 5-year follow-up period. WML severity does not influence conversion to dementia for aMCI but might accelerate progression in naMCI.

scholarly journals Race/Ethnic Disparities in Mild Cognitive Impairment and Dementia: The Northern Manhattan Study

2020 ◽  
Author(s):  
Clinton B. Wright ◽  
Janet T. DeRosa ◽  
Michelle P. Moon ◽  
Kevin Strobino ◽  
Charles DeCarli ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
White Matter ◽  
White Matter Hyperintensity ◽  
Prevalence Rates ◽  
Vascular Risk ◽  
Community Based ◽  
Diverse Community ◽  
Race Ethnicity

ABSTRACTOBJECTIVEEstimate the prevalence of mild cognitive impairment (MCI) and probable dementia in the racially and ethnically diverse community-based Northern Manhattan Study cohort and examine sociodemographic, vascular risk factor, and brain imaging correlates.METHODSCases of MCI and probable dementia were adjudicated by a team of neuropsychologists and neurologists and prevalence was estimated across race/ethnic groups. Ordinal proportional odds models were used to estimate race/ethnic differences in prevalence rates for MCI or probable dementia adjusting for sociodemographic variables (model 1), model 1 plus potentially modifiable vascular risk factors (model 2), and model 1 plus structural imaging markers of brain integrity (model 3).RESULTSThere were 989 participants with cognitive outcome determinations (mean age 69 ± 9 years; 68% Hispanic, 16% Black, 14% White; 62% women; mean (±SD) follow-up five (±0.6) years). Prevalence rates for MCI (20%) and probable dementia (5%) were significantly different by race/ethnicity even after accounting for age and education difference across race-ethnic groups; Hispanic and Black participants had greater prevalence rates than Whites. Adjusting for sociodemographic and brain imaging factors explained the most variance in the race/ethnicity associations. White matter hyperintensity burden explained much of the disparity between Black and White, but not between Hispanic and White, participants.CONCLUSIONSIn this diverse community-based cohort, white matter hyperintensity burden partially explained disparities in MCI and dementia prevalence in Black but not Hispanic participants compared to Whites. Longer follow-up and incidence data are needed to further clarify these relationships.

scholarly journals Changes in Cerebral Volume and White Matter Integrity in Adults on Hemodialysis and Relationship to Cognitive Function

Nephron ◽  
2020 ◽  
Vol 145 (1) ◽  
pp. 35-43
Author(s):  
Wesley T. Richerson ◽  
Laura G. Umfleet ◽  
Brian D. Schmit ◽  
Dawn F. Wolfgram
Keyword(s):  
Cognitive Impairment ◽  
White Matter ◽  
Cognitive Performance ◽  
Gray Matter ◽  
Structural Changes ◽  
Structural Integrity ◽  
Diffusion Tensor ◽  
White Matter Integrity ◽  
Healthy Controls ◽  
Matter Volume

<b><i>Introduction:</i></b> Patients on hemodialysis (HD) have a significant burden of cognitive impairment. Characterizing the cerebral structural changes in HD patients compared to healthy controls and evaluating the relationship of cerebral structural integrity with cognitive performance in HD patients can help clarify the pathophysiology of the cognitive impairment in HD patients. <b><i>Methods:</i></b> In this cross-sectional study, in-center HD patients ≥50 years of age underwent brain structural and diffusion MRIs and cognitive assessment using the NIH Toolbox cognition battery. The cerebral imaging measures of the HD participants were compared to imaging from age-matched controls. Gray matter volume, white matter volume, and white matter integrity determined by diffusion tensor imaging parameters (including fractional anisotropy [FA]) were measured in both cohorts to determine differences in the cerebral structure between HD participants and healthy controls. The association between cognitive performance on the NIH Toolbox cognition battery and cerebral structural integrity was evaluated using multiple linear regression models. <b><i>Results:</i></b> We compared imaging measures form 23 HD participants and 15 age-matched controls. The HD participants had decreased gray matter volumes (526.8 vs. 589.5 cm<sup>3</sup>, <i>p</i> &#x3c; 0.01) and worsened white matter integrity overall (FA values of 0.2864 vs. 0.3441, <i>p</i> &#x3c; 0.01) within major white matter tracts compared to healthy controls. Decreases in white matter integrity in the left superior longitudinal fasciculus was associated with lower executive function scores (<i>r</i><sup><i>2</i></sup> = 0.24, <i>p</i> = 0.02) and inferior longitudinal fasciculus with lower memory scores (<i>r</i> = 0.25 and <i>p</i> = 0.03 for left and <i>r</i><sup>2</sup> = 0.21 and <i>p</i> = 0.03 for right). <b><i>Conclusions:</i></b> HD patients have a pattern of decreased white matter integrity and gray matter atrophy compared to controls. Decreases in white matter integrity were associated with decreased cognitive performance in the HD population.

Abstract WP451: Cognitive Impairment in Cardiac Disease - Neuroimaging Associations

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Jane Cannon ◽  
Mark Findlay ◽  
Krishna Dani ◽  
Jesse Dawson ◽  
David A Dickie ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
White Matter ◽  
Cardiac Disease ◽  
Small Vessel Disease ◽  
Brain Mri ◽  
Perivascular Spaces ◽  
Intracranial Volume ◽  
Brain Volumes ◽  
Multivariable Models ◽  
Cardiac Status

Introduction: Atrial fibrillation (AF) and heart failure (HF) are associated with cognitive impairment. We used neuroimaging to describe if this association is explained by cardioembolism or other mechanisms. Methods: We included adults with HF (ejection fraction<45%) and AF but no stroke history. Healthy volunteer controls were matched, 1:2 ratio. Participants were assessed with Repeatable Battery for the Assessment of Neurospychological Status (RBANS), Hospital Anxiety and Depression Score (HADS) and 3-T brain MRI. Scans were graded for:infarct, enlarged perivascular spaces, microbleeds, global and regional (hippocampal) atrophy with consensus scoring by four raters using validated, ordinal assessment scales. Brain volumes were semi-automatically acquired using cluster analysis of T1-weighted and FLAIR voxel intensities and diffeomorphic atlas-based segmentation. CSF, hippocampal and white matter volumes were corrected for intracranial volume. We described univariable differences between groups and then created multivariable models where cardiac status was the dependent variable, RBANS and MRI data were the predictors. Results: Of 50 participants, AF-HF (n=34) had poorer RBANS (MD:16.9, SE:3.44; p<0.001). Differences were independent of education and HADS. Infarcts and ordinal markers of atrophy were significantly different between groups, SVD markers were increased in AF-HF but did not reach significance. Quantitative measures of white matter differed between groups but measures of atrophy did not.(Table) On multivariable models, no imaging feature was independently associated with cardiac status. Discussion: The association between cognitive impairment and cardiac disease may not be solely driven by occult cardioembolism; small vessel disease and other, neuroimaging independent, factors also interact. Differences between ordinal scales and quantitative scores suggest that future studies should use robust volumetric analyses.

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