Explore the correlation between cerebral vessel characteristics with cognitive impairment among elder individuals: a community study from China

Abstract Background Brain Magnetic Resonance Imaging (MRI) examination of cerebral small vessel disease (CSVD) may help screen vascular cognitive impairment. A recently estimated CSVD score system was suggested to capture the overall CSVD burden. The study aimed to detect the association between systemic evaluation score of cerebral vascular imaging parameters with cognitive functions. Methods This was a cross-sectional study in community settings. From October 2017 to September 2018, elder (≧60) residents were recruited through on-site visit in 6 communities from Shanghai, China. The participants underwent brain MRI, carotid ultrasound, laboratory tests of blood and urine samples. Cognitive function was evaluated using Mini-Mental State Examination (MMSE). MRI score of CSVD was calculated according to the 2012 standard for the evaluation of statistical changes in imaging. Results Total 171 subjects completed survey and examinations. There were 55 participants diagnosed with cognitive impairment, with a total percentage of 32.2%. Participants with and without cognitive impairment showed significant differences in age, BMI and education level. Cognitive impaired participant had more disease history/comorbidity of hypertension and chronic renal insufficiency, higher level of creatinine, as well as lower level of full blood count (FBC) and alanine aminotransferase (ALT). A significant difference was detected in CSVD score between participants with and without cognitive impairment. Results of linear regression analysis showed significant negative correlations between MMSE score and both left and right carotid artery peak systolic velocity (PSV), however the CSVD score was only borderline (P = 0.0566) positively correlated with MMSE. Multivariate linear correlation analysis including all collected risk factor data showed that left carotid artery PSV score was among the independent negative correlated factors of MMSE. Multivariate binary logistic analysis showed that age, education and history of hypertension were the only statistically associated factors of cognitive impairment. Conclusions The current study identified high prevalence of cognitive impairment in a Chinese community. In addition, correlations between cerebral vascular disease imaging status and cognitive functions were confirmed although the sample size limited the possibility of screening cognitive impairment with imaging technique.

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Cognitive Impairment and Brain Imaging Characteristics of Patients with Congenital Cataracts, Facial Dysmorphism, Neuropathy Syndrome

Behavioural Neurology ◽

10.1155/2015/639539 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 4

Author(s):

Teodora Chamova ◽

Dora Zlatareva ◽

Margarita Raycheva ◽

Stoyan Bichev ◽

Luba Kalaydjieva ◽

...

Keyword(s):

Cognitive Impairment ◽

Verbal Memory ◽

Brain Mri ◽

Brain Magnetic Resonance Imaging ◽

Control Group ◽

Facial Dysmorphism ◽

Multisystem Disorder ◽

Congenital Cataracts ◽

Cognitive Domains ◽

Imaging Characteristics

Congenital cataracts, facial dysmorphism, neuropathy (CCFDN) syndrome is a complex autosomal recessive multisystem disorder. The aim of the current study is to evaluate the degree of cognitive impairment in a cohort of 22 CCFDN patients and its correlation with patients’ age, motor disability, ataxia, and neuroimaging changes. Twenty-two patients with genetically confirmed diagnosis of CCFDN underwent a detailed neurological examination. Verbal and nonverbal intelligence, memory, executive functions, and verbal fluency wеre assessed in all the patients aged 4 to 47 years. Brain magnetic resonance imaging was performed in 20 affected patients. Eighteen affected were classified as having mild intellectual deficit, whereas 4 had borderline intelligence. In all psychometric tests, evaluating different cognitive domains, CCFDN patients had statistically significant lower scores when compared to the healthy control group. All cognitive domains seemed equally affected. The main abnormalities on brain MRI found in 19/20 patients included diffuse cerebral atrophy, enlargement of the lateral ventricles, and focal lesions in the subcortical white matter, different in number and size, consistent with demyelination more pronounced in the older CCFDN patients. The correlation analysis of the structural brain changes and the cognitive impairment found a statistically significant correlation only between the impairment of short-term verbal memory and the MRI changes.

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Relationship between indicators of carotid artery rigidity and cognitive functions in arterial hypertension patients

Modern medical technologies ◽

10.34287/mmt.1(40).2019.6 ◽

2019 ◽

Vol 40 (1) ◽

pp. 38-44

Author(s):

N. Ya. Dotsenko ◽

S. S. Boev ◽

I. A. Shekhunova ◽

A. V. Molodan ◽

L. V. Gerasimenko ◽

...

Keyword(s):

Cognitive Impairment ◽

Carotid Artery ◽

Arterial Hypertension ◽

Cognitive Dysfunction ◽

Cognitive Functions ◽

Prognostic Significance ◽

Poor Quality ◽

Stiffness Index ◽

Control Group ◽

Complex Indicators

Purpose of the study. assessment of relationship between the thickness of the intima-media complex, indicators of carotid artery rigidity state and cognitive dysfunction as a marker of brain damage and the study of their prognostic significance in the development of cognitive impairment in arterial hypertension patients.Material and methods. The subject of the examination was a group of 69 patients with stage II arterial hypertension, grade 2–3, not receiving any antihypertensive therapy or being treated irregularly, aged 51,38 ± 0,94 years. The control group consisted of 12 practically healthy, normotensive individuals aged 54,25 ± 2,74 years, without cognitive impairment. The Montreal Scale (MoCA test) was used to assess cognitive functions. The state of the carotid artery was studied with the help of sonography with recording the thickness of the intima-media complex; Peterson and Young modules, linear tensile properties, radial tension of the vessel wall, parameter β, local pulse wave velocity were calculated.Results. There was a significant increase in the thickness of the intima-media complex in patients without cognitive impairment (0,83 ± 0,02; p < 0,05) and with cognitive impairment (0,89 ± 0,03; p < 0,05) relative to healthy individuals (0,68 ± 0,03) in the absence of significant differences between groups of patients (p > 0,05). Of the remaining indicators of vascular rigidity, only β parameter differed from the control group in patients without cognitive impairment, while in patients with cognitive impairment all studied parameters differed from the control group (p < 0,05). A correlation was established between cognitive impairment and the thickness of the carotid intima-media complex (only with increased values of the carotid intima-media complex thickness – r = 0,62; p < 0,05), with the stiffness index (r = –0,392; p < 0,05), local SPV SA (r = –0,326, p < 0,05).Analysis of the area under the ROC curve 0,60 ± 0,07 (95% CI: 0,47–0,74; p = 0,124) for the indicator of the intima-media complex to determine the likelihood of the development of cognitive impairment in patients with hypertension indicates the unsatisfactory quality of the model.Conclusions. Value of carotid intima-media complex thickness and other indicators of vascular rigidity to determine the likelihood of developing cognitive impairment in patients with poor-quality hypertension (AUC below 0,60) cannot serve as a marker for predicting cognitive dysfunction in patients with hypertensive disease. Keywords:cognitive impairment, arterial hypertension, rigidity of the carotid artery.

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Brain MRI in SARS-CoV-2 pneumonia patients with newly developed neurological manifestations suggestive of brain involvement

Scientific Reports ◽

10.1038/s41598-021-00064-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Batil Alonazi ◽

Ahmed M. Farghaly ◽

Mohamed A. Mostafa ◽

Jehad A. Al-Watban ◽

Salah A. Zindani ◽

...

Keyword(s):

Imaging Modality ◽

Brain Mri ◽

Brain Lesion ◽

Brain Magnetic Resonance Imaging ◽

Neurological Manifestations ◽

Rt Pcr ◽

Significant Difference ◽

Brain Involvement ◽

Magnetic Resonance Imaging Mri ◽

The Impact

AbstractThe increased frequency of neurological manifestations, including central nervous system (CNS) manifestations, in patients with coronavirus disease 2019 (COVID-19) pandemic is consistent with the virus's neurotropic nature. In most patients, brain magnetic resonance imaging (MRI) is a sensitive imaging modality in the diagnosis of viral encephalitides in the brain. The purpose of this study was to determine the frequency of brain lesion patterns on brain MRI in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia patients who developed focal and non-focal neurological manifestations. In addition, it will compare the impact of the Glasgow Coma Scale (GCS) as an index of deteriorating cerebral function on positive brain MRIs in both neurological manifestations. This retrospective study included an examination of SARS-CoV-2 pneumonia patients with real-time reverse transcription polymerase chain reaction (RT-PCR) confirmation, admitted with clinicoradiologic evidence of COVID-19 pneumonia, and who were candidates for brain MRI due to neurological manifestations suggesting brain involvement. Brain imaging acquired on a 3.0 T MRI system (Skyra; Siemens, Erlangen, Germany) with a 20-channel receive head coil. Brain MRI revealed lesions in 38 (82.6%) of the total 46 patients for analysis and was negative in the remaining eight (17.4%) of all finally enclosed patients with RT-PCR confirmed SARS-CoV-2 pneumonia. Twenty-nine (63%) patients had focal neurological manifestations, while the remaining 17 (37%) patients had non-focal neurological manifestations. The patients had a highly significant difference (p = 0.0006) in GCS, but no significant difference (p = 0.4) in the number of comorbidities they had. Brain MRI is a feasible and important imaging modality in patients with SARS-CoV-2 pneumonia who develop neurological manifestations suggestive of brain involvement, particularly in patients with non-focal manifestations and a decline in GCS.

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Post Stroke Rehabilitation Using Computer-based Cognitive Intervention (CBCI): A Systematic Review

Current Psychiatry Research and Reviews ◽

10.2174/2666082216999200622135105 ◽

2020 ◽

Vol 16 (2) ◽

pp. 93-102

Author(s):

Sudhi Kulshrestha ◽

Manju Agrawal ◽

Ajai K. Singh ◽

Dinkar Kulshreshtha

Keyword(s):

Cognitive Impairment ◽

Cognitive Functions ◽

Cognitive Intervention ◽

Cochrane Library ◽

Stroke Patients ◽

Future Studies ◽

Computer Based Training ◽

Post Stroke ◽

Significant Difference ◽

Computer Based

Background: Cognitive impairment as a consequence of stroke is a major cause affecting the patient’s functional independence, activity participation, daily living skills, and occupation. Almost 75% of post-stroke patients are diagnosed with significant cognitive impairment, which includes problems with attention, orientation, memory, language, and perception. Along with effective pharmaceutical cures, cognitive intervention as a part of rehabilitation approaches that may prevent, delay, or treat cognitive impairment is becoming increasingly important. Many studies have reported improvement in cognitive functions of post-stroke patients after using computer-based cognitive intervention (CBCI). CBCI can be an effective add-on to available rehabilitation programs. Objective: This article provides reviews related to relevant literature and, represents a structure to specify the efficacy of CBCI for the rehabilitation of post-stroke patients for future research. Methods: We searched many search engines namely MEDLINE, Web of Science, clinical key and The Cochrane Library, for studies investigating the effect of cognitive intervention based on a computer program for post-stroke patients. The results of selected studies were summarized. Total 19 publications from January 2007 to January 2019 are included in this review. The search terms entered were a combination of these search areas that defined (1) the population as adults who had suffered a stroke and cognitive dysfunction, (2) intervention search term included cognitive abilities, cognitive training, and computer-based training; computer-based cognitive intervention for rehabilitation. Results: The results after computer-based training showed improvement in various cognitive functions such as; memory, attention and executive functions of post-stroke patients. However, a significant difference between the study groups has not been observed in all the studies. Most studies analyzed in this research project indicated that such interventions might contribute to the improvement of cognitive function, especially attention concentration and memory. Of the 19 kinds of research that discussed CBCI outcomes 18 found significant improvements for one or more cognitive functions. When the effect size for CBCI was reported, effects were large in comparison to other traditional cognitive interventions of post-stroke patients. Conclusion: Studies related to cognitive functions strongly support CBCI except few have reported a significant difference. The review of all the studies suggests that CBCI may help to change the functional aspect of post-stroke patients by improving their cognitive functions. In this field, it is a challenge to conduct well designed and sufficiently powered studies due to low budgets availability, the limited number of available patients, heterogeneity of the population, and ethical considerations. Future studies should examine all the challenges, limitations, and valuable insights into the study and emphasize the need for a carefully designed computer-based cognitive intervention program for the future. Future studies should target to compare CBCI with active and passive control conditions and include a larger sample size.

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Interaction between dislipidaemia, atherosclerosis of carotid artery and cognitive impairment in discirculatory encephalopathy

Bulletin of Siberian Medicine ◽

10.20538/1682-0363-2009-3(2)-12-15 ◽

2009 ◽

Vol 8 (3(2)) ◽

pp. 12-15

Author(s):

A. F. Vasilenko ◽

N. S. Artyomova ◽

Yu. S. Shamurov

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Carotid Artery ◽

Cognitive Functions ◽

Atherosclerotic Plaques ◽

Low Density ◽

Vascular Parkinsonism ◽

Memory And Attention

107 patients with discirculatory encephalopathy were examined. The main syndromes of the disease were a mild cognitive impairment, vascular parkinsonism, pseudobulbar, ataxia. Сorrelations between level cholesterol, lipoproteids low density in the blood with extent of atherosclerosis in the carotid artery and cognitive functions were analysed. The presence of atherosclerotic plaques, not thicking of intima-media complex, correlates with changes of memory and attention.

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Apgar Scores at 10 Minutes and Outcomes in Term and Late Preterm Neonates with Hypoxic-Ischemic Encephalopathy in the Cooling Era

American Journal of Perinatology ◽

10.1055/s-0038-1670637 ◽

2018 ◽

Vol 36 (05) ◽

pp. 545-554 ◽

Cited By ~ 2

Author(s):

Marina Ayrapetyan ◽

Kiran Talekar ◽

Kathleen Schwabenbauer ◽

David Carola ◽

Kolawole Solarin ◽

...

Keyword(s):

Therapeutic Hypothermia ◽

Brain Mri ◽

Brain Magnetic Resonance Imaging ◽

Hypoxic Ischemic Encephalopathy ◽

Preterm Neonates ◽

Short Term ◽

Apgar Scores ◽

Significant Difference ◽

The Brain ◽

Ischemic Encephalopathy

Objective To determine the short-term outcomes (abnormal brain magnetic resonance imaging [MRI]/death) in infants born with a 10-minute Apgar score of 0 who received therapeutic hypothermia and compare them with infants with higher scores. Study Design This is a retrospective review of 293 neonates (gestational age ≥ 35 weeks) born between November 2006 and October 2015 admitted with hypoxic-ischemic encephalopathy who received therapeutic hypothermia. Results of brain MRIs were assessed by the basal ganglia/watershed scoring system. Short-term outcomes were compared between infants with Apgar scores of 0, 1 to 4, and ≥5 at 10 minutes. Results Eight of 17 infants (47%) with an Apgar of 0 at 10 minutes survived, having 4 (24%) without abnormalities on the brain MRI and 7 (41%) without severe abnormalities. There was no significant difference in the combined outcomes of “death/abnormal MRI” and “death/severe abnormalities on the MRI” between infants with Apgar scores of 0 and 1 to 4. Follow-up data were available for six of eight surviving infants, and none had moderate or severe neurodevelopmental impairment. Conclusion In the cooling era, 47% of infants with no audible heart rate at 10 minutes and who were admitted to the neonatal intensive care unit survived; 24% without abnormalities on the brain MRI and 41% without severe abnormalities.

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Biochemical and morphometric methods for assessing cognitive impairment in patients with type 2 diabetes

CARDIOVASCULAR THERAPY AND PREVENTION ◽

10.15829/1728-8800-2020-2636 ◽

2020 ◽

Vol 19 (4) ◽

pp. 2636

Author(s):

Yu. G. Samoilova ◽

O. P. Leyman ◽

O. S. Tonkih ◽

M. V. Matveeva ◽

D. A. Kudlay ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cognitive Impairment ◽

Nucleus Accumbens ◽

Globus Pallidus ◽

Brain Magnetic Resonance Imaging ◽

Brain Structures ◽

Control Group ◽

Subcortical Structures ◽

Significant Difference

Aim. To study the features of biochemical and morphometric parameters in patients with type 2 diabetes (T2D) and cognitive impairment (CI).Material and methods. The experimental group included 72 patients with CI and T2D, the control group − 20 patients with T2D and without CI. We used the Montreal Cognitive Scale (MoCA) to assess the presence of CI. We also evaluated the levels of 1,5-anhydroglucitol (1,5-AG), continuous glucose monitoring (CGM), and data of brain magnetic resonance imaging (MRI).Results. We revealed that patients with T2D and CI have high HbA1c levels, but there was no significant difference of 1,5-AG levels between the groups. In patients with CI, we also established a decrease in gray and white matter surface area, as well as subcortical structures (the hippocampus, nucleus accumbens and putamen on both sides; the amygdala and globus pallidus on the right). The severity of CI correlated with polyneuropathy severity. In patients with proliferative retinopathy, there was a decrease in the volume of the caudate nucleus, globus pallidus, putamen and nucleus accumbens. Conclusion. The study revealed that patients with T2D with CI have worse levels of carbohydrate metabolism parameters, as well as a decrease in the cortical and subcortical brain structures.

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Effect of Carotid Artery Morphological Variations on Cognitive Function

Behavioural Neurology ◽

10.1155/2018/7290431 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Lin Chen ◽

Jialu Huang ◽

Suxia Wang ◽

Hong Ran ◽

Lan Wen ◽

...

Keyword(s):

Cognitive Impairment ◽

Cognitive Function ◽

Carotid Artery ◽

Verbal Fluency ◽

Morphological Variations ◽

Type Group ◽

Significant Difference ◽

Positive Rate ◽

Digital Subtract Angiography ◽

State Scale

Background. Carotid artery morphological variations (CAMV) are common variations on medical imaging; the effects of CAMV on cognition were still unknown. This study is aimed at investigating whether carotid artery morphological variations (CAMV) cause cognitive impairment. Methods. Hospitalized patients from March 2017 to October 2017 who underwent digital subtract angiography (DSA) were divided into non-CAMV group, T-type group, K-type group, and C-type group according to their carotid artery morphology. Cognitive function in each group was evaluated with the Mini-Mental State Scale (MMSE), the Montreal Cognitive Assessment (MoCA), the Verbal Fluency Test (VFT), and the Digital Span Test (DST). Results. A total of 96 patients were included in the study (32 in non-CAMV group, 34 in T-type group, 30 in K-type group, and none in C-group). The positive rate of MMSE in the non-CAMV group, the T-type group, and the K-type group was 15.6%, 14.7%, and 20.0%, respectively, with no statistical difference in the three groups (p=0.836). The positive rate of MoCA in the K-type group was significantly higher than that in the non-CAMV and the T-type groups (p<0.001), but there was no significant difference between the non-CAMV group and the T-type group (p=0.826). The VFT, DST forward score, and backward score in the K-type group were significantly lower than those in the non-CAMV and the T-type groups (p<0.001). Conclusions. K-type CAMV may cause cognitive impairment, and MoCA is superior to MMSE in identifying mild cognitive impairment caused by CAMV.

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The Role of Brain Magnetic Resonance Imaging (MRI) as an Early Detector of Cognitive Impairment

Journal of Neurosciences in Rural Practice ◽

10.4103/jnrp.jnrp_542_17 ◽

2018 ◽

Vol 09 (03) ◽

pp. 350-353

Author(s):

Yuyun Yueniwati ◽

Charles Wangsadjaja ◽

Islana Gadis Yulidani ◽

Sri Budhi Rianawati ◽

Harun Al Rasyid

Keyword(s):

Cognitive Impairment ◽

Brain Mri ◽

Brain Magnetic Resonance Imaging ◽

Cross Sectional Study ◽

Spearman Correlation ◽

Strong Negative Correlation ◽

Cross Sectional ◽

Early Therapy ◽

Fazekas Scale ◽

Analytic Design

ABSTRACT Background: Along with the increase of the health and prosperity level will affect the life expectancy in Indonesia, there has also been an increase in degenerative disease cases. One of the problems arises is cognitive impairment. The mild version of this impairment is often associated with the increase risk that will eventually lead to dementia. Therefore, early detection of this impairment is necessary. Objective: This study is aimed at proving the correlation between Fazekas scale on brain MRI and MoCA-Ina score in defining the degree of cognitive impairment. Methods: This study employed observational analytic design and cross sectional study for its data collection method. The Fazekas scale on brain MRI of 32 patients was read by 3 radiologist, while the MoCA-Ina scoring was done by a competent neurologist. Both tests were done double blindly. Later on, the correlation between Fazekas scale and MoCA-Ina score would be assessed using Spearman Correlation. Results: Statistical calculation conducted using Spearman Correlation reveals that the coefficient is -0.519 with significant score (P) 0.002, which is smaller than α: 0.05. Therefore, it can be concluded that there is a strong negative correlation between Fazekas scale and MoCA-Ina score. Conclusion: Fazekas scale evaluation on brain MRI is necessary to be performed as it helps predicting the decline of one's cognitive function, so that an early therapy can be acted upon to prevent dementia in the future.

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Optimal ATN biomarkers and their role in predicting cognitive progress of mild cognitive impairment

10.21203/rs.3.rs-201708/v1 ◽

2021 ◽

Author(s):

Rao Song ◽

Xiaojia Wu ◽

Huan Liu ◽

Dajing Guo ◽

Lin Tang ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

High Risk ◽

Brain Mri ◽

Progression Rate ◽

Amyloid A ◽

Cognitive Stability ◽

Conversion Rates ◽

Significant Difference ◽

Risk Of Progression

Abstract Background It is of great significance to investigate the optimal cerebrospinal fluid (CSF) and magnetic resonance image biomarkers of ATN system and clarify their predictive value in cognitive progression of mild cognitive impairment individuals (MCI). Methods 147 healthy control (HC), 197 patients with MCI, and 128 patients with Alzheimer’ Disease (AD) were included from the ADNI database. All MCI patients were followed up from 6 to 60 months. The amyloid (A) was assessed by CSF Aβ42 or Aβ42/Aβ40. The tau pathology (T) was assessed by CSF p-tau. The neurodegeneration (N) was assessed by radiomics of the whole brain MRI or by CSF t-tau. Biomarkers with larger area under the receiver operating characteristic curve (AUC) in the discrimination of AD and HC were considered to be the optimal biomarkers. The conversion rates of different ATN profiles in MCI subjects during follow-up were analyzed using Kaplan-Meier estimates and compared using the Log-rank test. Results The CSF Aβ 42 and the radiomics signature (AUC 0.822 and 0.998, respectively) were identified as the optimal A and N biomarkers, respectively. For MCI patients of the Alzheimer continuum, there was no significant difference in the progression rate of A + T − N− and A − T−N − profiles (p > 0.05). The A + T + N−, A + T − N + profiles had a significant higher progression rate than that of the A + T − N− patients (all p < 0.05). For MCI of the suspected non-AD pathophysiology (SNAP), patients with the A − T−N + profile (p < 0.05) showed significant higher progression rate than A − T−N − profile. There was no significant difference in the progression rate of A − T + N − and A − T−N − profiles (p > 0.05). Discussion We proposed a new radiomics method to assess N accurately and ascertained the optimal A/T/N biomarkers for the discrimination of HC and AD. For MCI patients of the Alzheimer continuum, isolated A + was indicator of cognitive stability, while the abnormality of T and N, respectively or simultaneously, indicated the high risk of progression. For MCI patients of SNAP, isolated T + indicated the cognitive stability, while the appearance of N + indicated the high risk of progression.

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