Identification of a specific functional network altered in poststroke cognitive impairment

Neurology ◽  
2018 ◽  
Vol 90 (21) ◽  
pp. e1879-e1888 ◽  
Author(s):  
Clément Bournonville ◽  
Hilde Hénon ◽  
Thibaut Dondaine ◽  
Christine Delmaire ◽  
Stephanie Bombois ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Clustering Coefficient ◽  
Functional Network ◽  
Cognitive Domain ◽  
Cortical Atrophy ◽  
Node Degree ◽  
Resting State Functional Connectivity ◽  
Stroke Patients ◽  
Whole Brain ◽  
Cognitive Domains

ObjectiveTo study the association between poststroke cognitive impairment and defining a specific resting functional marker.MethodsThe resting-state functional connectivity 6 months after an ischemic stroke in 56 patients was investigated. Twenty-nine of the patients who had an impairment of one or several cognitive domains were compared to 27 without any cognitive deficit. We studied the whole-brain connectivity using 2 complementary approaches: graph theory to study the functional network organization and network-based statistics to explore connectivity between brain regions. We assessed the potential cortical atrophy using voxel-based morphometry analysis.ResultsThe overall topological organization of the functional network was not altered in cognitively impaired stroke patients, who had the same mean node degree, average clustering coefficient, and global efficiency as cognitively healthy stroke patients. Network-based statistics analysis showed that poststroke cognitive impairment was associated with dysfunction of a whole-brain network composed of 167 regions and 178 connections, and functional disconnections between superior, middle, and inferior frontal gyri and the superior and inferior temporal gyri. These regions had connections that were specifically and positively correlated with cognitive domain scores. No intergroup differences in overall gray matter thickness and ischemic infarct topography were observed. To assess the effect of prestroke white matter hyperintensities on connectivity, we included the initial Fazekas scale in the regression model for a second network-based analysis. The resulting network was associated with the same key alterations but had fewer connections.ConclusionsThe observed functional network alterations suggest that the appearance of a cognitive impairment following stroke may be associated with a particular functional alteration, shared specifically between cognitive domains.

Associations between lesions and domain-specific cognitive decline in poststroke dementia

Neurology ◽  
2018 ◽  
Vol 91 (1) ◽  
pp. e45-e54 ◽  
Author(s):  
Chathuri Yatawara ◽  
Kok Pin Ng ◽  
Russell Chander ◽  
Nagaendran Kandiah
Keyword(s):  
Executive Functions ◽  
Acute Stroke ◽  
Cognitive Status ◽  
Cognitive Domain ◽  
Cortical Atrophy ◽  
Stroke Patients ◽  
Cognitive Domains ◽  
Domain Specific ◽  
Poststroke Dementia ◽  
Incident Cases

ObjectiveTo investigate whether the effect of prestroke and stroke-related lesions on incident poststroke dementia (PSD) is mediated by a unique pattern of domain-specific cognitive impairment, and the relative strength of these anatomical–cognitive associations in predicting incident PSD.MethodsIn this incident case-control study (n = 150), we defined incident cases as acute stroke patients who developed PSD and controls as acute stroke patients who remained free from dementia at a 6 month follow-up, matched on age, prestroke cognitive status, and number of stroke-related lesions. MRI was performed at initial clinical presentation; neuropsychological assessments and clinical diagnosis of PSD was performed 6 months poststroke. Moderated mediation analysis evaluated the interactions among PSD, anatomical lesions, cognitive domains, and individual demographic and medical characteristics.ResultsCompared to stroke-related lesions, prestroke lesions were associated with the widest range of cognitive domain impairments and had stronger clinical utility in predicting incident PSD. Specifically, global cortical atrophy (GCA) and deep white matter hyperintensities (WMH) were indirectly associated with PSD by disrupting executive functions, memory, and language. Acute infarcts were indirectly associated with PSD by disrupting executive functions and language. The strongest mediator was executive dysfunction, increasing risk of PSD in patients with deep WMH, GCA, and large infarcts by more than 9 times, with sex and educational attainment moderating the magnitude of association. Periventricular WMH were directly associated with incident PSD but not mediated by deficits in cognitive domains.ConclusionWe provide an anatomical–cognitive framework that can be applied to stratify patients at highest risk of PSD and to guide personalized interventions.

scholarly journals A Multimodal Imaging Approach Demonstrates Reduced Midbrain Functional Network Connectivity Is Associated With Freezing of Gait in Parkinson's Disease

2021 ◽  
Vol 12 ◽  
Author(s):  
Amgad Droby ◽  
Elisa Pelosin ◽  
Martina Putzolu ◽  
Giulia Bommarito ◽  
Roberta Marchese ◽  
...  
Keyword(s):  
Structural Damage ◽  
Imaging Techniques ◽  
Freezing Of Gait ◽  
Cognitive Networks ◽  
Functional Network ◽  
Cortical Atrophy ◽  
Seed Region ◽  
Whole Brain ◽  
Severity Scores ◽  
Imaging Approach

Background: The pathophysiological mechanisms underlying freezing of gait (FOG) are poorly defined. MRI studies in FOG showed a distinct pattern of cortical atrophy and decreased functional connectivity (FC) within motor and cognitive networks. Furthermore, reduced rs-FC within midbrain, frontal, and temporal areas has been also described. This study investigated the patterns of whole-brain FC alterations within midbrain inter-connected regions in PD-FOG patients, and whether these patterns are linked to midbrain structural damage using a multi-modal imaging approach, combing structural and functional imaging techniques.Methods: Thirty three PD patients (16 PD-FOG, 17 PD noFOG), and 21 sex- and age-matched healthy controls (HCs) were prospectively enrolled. All subjects underwent MRI scan at 1.5T, whereas only PD patients underwent clinical and cognitive assessment. Grey matter (GM) integrity was measured using voxel-based morphometry (VBM). VBM findings served as basis to localize midbrain damage, and were further used as a seed region for investigating whole-brain FC alterations using rs-fMRI.Results: In rs-fMRI, patients with PD and FOG demonstrated significant decrease of midbrain-cortical FC levels in the R PCG, right postcentral, and supramarginal gyri compared to controls and the middle cingulate compared to noFOG group. Based on the regression analysis, MOCA, UPDRS-III total score, and FOG severity scores were associated with FC levels in several frontal, parietal and temporal regions.Discussion: The present results suggest that midbrain structural damage as well as decreased FC within the brainstem functional network might contribute to FOG occurrence in PD patients.

P3714Cerebral blood flow and cognitive functioning in the heart-brain axis

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A E Leeuwis ◽  
A M Hooghiemstra ◽  
E E Bron ◽  
H P Brunner-La Rocca ◽  
L J Kappelle ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cognitive Impairment ◽  
Cognitive Functioning ◽  
Sex Education ◽  
Vascular Cognitive Impairment ◽  
Cognitive Domain ◽  
Cardiovascular Research ◽  
Whole Brain ◽  
Symptomatic Carotid ◽  
Brain Study

Abstract Background Recent studies suggest that cardiovascular disease and dementia are closely related, which led to the concept of a “heart-brain axis”. Dysfunction in any component of the heart-brain axis could be a risk factor for the development of brain damage and consequently to the development of cognitive impairment. In the Heart-Brain study, we focus on vascular cognitive impairment (VCI), symptomatic carotid occlusive disease (COD) and heart failure (HF) as three extreme phenotypes of haemodynamic dysfunction in different components of the heart-brain axis (i.e. heart – carotids – brain). We compared values of cerebral blood flow (CBF), measured with arterial spin labeling (ASL) between patients with HF, COD and VCI and investigated the association between CBF and cognitive functioning. Methods We included 442 participants (129 VCI; 75 COD; 124 HF; and 114 controls) from the Heart-Brain Study (67±9 yrs; 38% F; MMSE 28±2). We used 3T pseudo-continuous ASL to estimate whole-brain and regional partial volume-corrected CBF. Using a standardized neuropsychological assessment, we measured global cognitive functioning and four cognitive domains. Compound z-scores were constructed for each cognitive domain. We investigated associations using linear regression analyses, adjusted for age, sex, education, center and diagnosis. Subsequently, we stratified for diagnosis. Results Whole-brain and regional CBF values were lowest in patients with COD, followed by VCI and HF, compared to controls. Global cognitive functioning was lowest in patients with VCI, followed by COD and HF, compared to controls. Overall, we found hardly any association between whole-brain or regional CBF values and cognitive functioning (standardized beta [stb] = 0.00–0.10, p>0.05). Subsequent stratification for diagnosis showed no association between whole-brain or regional CBF and cognitive functioning in any participant group. Conclusions Our results suggest that reduced CBF is not the major explanatory factor underlying impaired cognitive functioning in patients with disorders along the heart-brain axis. The predisposition of cognitive impairment in these patients is likely to be driven by other (haemodynamic) mechanisms than CBF. Acknowledgement/Funding We acknowledge the support of the Netherlands CardioVascular Research Initiative: the Dutch Heart Foundation (CVON 2012-06 Heart Brain Connection), Du

scholarly journals Correlation of MRI Visual Scales with Neuropsychological Profile in Mild Cognitive Impairment of Parkinson’s Disease

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Luiz Felipe Vasconcellos ◽  
João Santos Pereira ◽  
Marcelo Adachi ◽  
Denise Greca ◽  
Manuela Cruz ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Verbal Learning ◽  
Stroop Test ◽  
Memory Test ◽  
Cognitive Domain ◽  
Cortical Atrophy ◽  
Neuropsychological Profile

Few studies have evaluated magnetic resonance imaging (MRI) visual scales in Parkinson’s disease-Mild Cognitive Impairment (PD-MCI). We selected 79 PD patients and 92 controls (CO) to perform neurologic and neuropsychological evaluation. Brain MRI was performed to evaluate the following scales: Global Cortical Atrophy (GCA), Fazekas, and medial temporal atrophy (MTA). The analysis revealed that both PD groups (amnestic and nonamnestic) showed worse performance on several tests when compared to CO. Memory, executive function, and attention impairment were more severe in amnestic PD-MCI group. Overall analysis of frequency of MRI visual scales by MCI subtype did not reveal any statistically significant result. Statistically significant inverse correlation was observed between GCA scale and Mini-Mental Status Examination (MMSE), Montreal Cognitive Assessment (MoCA), semantic verbal fluency, Stroop test, figure memory test, trail making test (TMT) B, and Rey Auditory Verbal Learning Test (RAVLT). The MTA scale correlated with Stroop test and Fazekas scale with figure memory test, digit span, and Stroop test according to the subgroup evaluated. Visual scales by MRI in MCI should be evaluated by cognitive domain and might be more useful in more severely impaired MCI or dementia patients.

scholarly journals Corpus callosal atrophy and associations with cognitive impairment in Parkinson disease

Neurology ◽  
2017 ◽  
Vol 88 (13) ◽  
pp. 1265-1272 ◽  
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.

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

2021 ◽  
pp. 1-9
Author(s):  
Morag E. Taylor ◽  
Annika Toots ◽  
Stephen R. Lord ◽  
Narelle Payne ◽  
Jacqueline C.T. Close
Keyword(s):  
Cognitive Impairment ◽  
Older People ◽  
Verbal Fluency ◽  
Community Dwelling ◽  
Cognitive Domain ◽  
Balance Performance ◽  
Visuospatial Ability ◽  
Cognitive Domains ◽  
Community Dwelling Older People ◽  
Global Cognition

Background: In older people with cognitive impairment (CI), executive function (EF) has been associated with motor performance including balance and gait. The literature examining and supporting a relationship between balance performance and other cognitive domains is limited. Objective: To investigate the relationship between global cognition and cognitive domain function and balance performance in older people with CI. Methods: The iFOCIS randomized controlled trial recruited 309 community-dwelling older people with CI. Baseline assessments completed before randomization were used for analyses including the Addenbrooke’s Cognitive Examination-III (ACE-III; global cognition) and its individual cognitive domains (attention; memory; verbal fluency; language; visuospatial ability) and the Frontal Assessment Battery (FAB), a measure of EF. A composite balance score was derived from postural sway and leaning balance tests. Results: In linear regression analyses adjusted for covariates, global cognition and each cognitive domain were significantly associated with balance performance. EF (verbal fluency; β= –0.254, p <  0.001, adjusted R2 = 0.387) and visuospatial ability (β= –0.258, p <  0.001, adjusted R2 = 0.391) had the strongest associations with balance performance. In a comprehensively adjusted multivariable model including all of the ACE-III cognitive domains, visuospatial ability and EF (verbal fluency) were independently and significantly associated with balance performance. Conclusion: Poorer global cognition and cognitive domain function were associated with poorer balance performance in this sample of people with CI. Visuospatial ability and EF were independently associated with balance, highlighting potential shared neural networks and the role higher-level cognitive processes and spatial perception/processing play in postural control.

scholarly journals The Distinct Disrupted Plasticity in Structural and Functional Network in Mild Stroke With Basal Ganglia Region Infarcts

2021 ◽  
Author(s):  
Hua Zhu ◽  
Lijun Zuo ◽  
Wanlin Zhu ◽  
Jing Jing ◽  
Zhe Zhang ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Basal Ganglia ◽  
Functional Connectivity ◽  
Network Analysis ◽  
Structural Connectivity ◽  
Functional Network ◽  
Imaging Biomarkers ◽  
Functional Networks ◽  
Stroke Patients ◽  
Post Stroke

Abstract ObjectiveTo characterize brain structural and functional networks in post-stroke patients with or without cognitive impairment. MethodsGraph theory analysis was applied to diffusion-weighted imaging (DWI) data and resting-state functional MRI (fMRI) data from 23 post-stroke patients with cognitive impairment (PSCI), 17 post-stroke patients without cognitive impairment (NPSCI), and 29 healthy controls (HC). Structural and functional connectivity between 90 cortical and subcortical brain regions was estimated and thresholded to construct a set of undirected graphs. Network-based statistics (NBS) was used to characterize altered connectivity patterns among the three groups. ResultsCompared to HC, the PSCI group demonstrated substantial reductions in all three types of connections - rich club, feeder, and local - in structural and functional networks. Specifically, in structural network analysis, reduced connections were observed within basal ganglia and basal ganglia-frontal networks, whereas in the functional network analysis, reduced connections were observed in fronto-parietal network (FPN) and cingulo-opercular networks (CON). Meanwhile, compared to HC, the NPSCI group demonstrated reductions in both feeder and local connections only within occipital area and occipital-temporal structural networks. ConclusionsThe findings of reduced structural connectivity in regions stemming from a basal ganglia core and reduced functional connectivity in FPN and CON may indicate a bottom-up cognitive impairment induced by stroke. Graph analysis and connectomics may aid clinical diagnosis and serve as potential imaging biomarkers for post-stroke patients with cognitive impairment.

scholarly journals Cognitive impairment in COPD: a systematic review

2015 ◽  
Vol 41 (2) ◽  
pp. 182-190 ◽  
Author(s):  
Irene Torres-Sánchez ◽  
Elisabeth Rodríguez-Alzueta ◽  
Irene Cabrera-Martos ◽  
Isabel López-Torres ◽  
Maria Paz Moreno-Ramírez ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Verbal Memory ◽  
Visual Memory ◽  
Cognitive Domain ◽  
Disease Stage ◽  
Cognitive Domains ◽  
Future Studies ◽  
Memory And Attention ◽  
Copd Patients

The objectives of this study were to characterize and clarify the relationships between the various cognitive domains affected in COPD patients and the disease itself, as well as to determine the prevalence of impairment in the various cognitive domains in such patients. To that end, we performed a systematic review using the following databases: PubMed, Scopus, and ScienceDirect. We included articles that provided information on cognitive impairment in COPD patients. The review of the findings of the articles showed a significant relationship between COPD and cognitive impairment. The most widely studied cognitive domains are memory and attention. Verbal memory and learning constitute the second most commonly impaired cognitive domain in patients with COPD. The prevalence of impairment in visuospatial memory and intermediate visual memory is 26.9% and 19.2%, respectively. We found that cognitive impairment is associated with the profile of COPD severity and its comorbidities. The articles reviewed demonstrated that there is considerable impairment of the cognitive domains memory and attention in patients with COPD. Future studies should address impairments in different cognitive domains according to the disease stage in patients with COPD.

scholarly journals Effects of Glycemic Gap on Post-Stroke Cognitive Impairment in Acute Ischemic Stroke Patients

2021 ◽  
Vol 11 (5) ◽  
pp. 612
Author(s):  
Minwoo Lee ◽  
Jae-Sung Lim ◽  
Yerim Kim ◽  
Ju Hun Lee ◽  
Chul-Ho Kim ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cognitive Impairment ◽  
Acute Ischemic Stroke ◽  
Sex Education ◽  
Cognitive Domain ◽  
P Value ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Stroke Treatment ◽  
Post Stroke

Background: Post-stroke hyperglycemia is a frequent finding in acute ischemic stroke patients and is associated with poor functional and cognitive outcomes. However, it is unclear as to whether the glycemic gap between the admission glucose and HbA1c-derived estimated average glucose (eAG) is associated with post-stroke cognitive impairment (PSCI). Methods: We enrolled acute ischemic stroke patients whose cognitive functions were evaluated three months after a stroke using the Korean version of the vascular cognitive impairment harmonization standards neuropsychological protocol (K-VCIHS-NP). The development of PSCI was defined as having z-scores of less than −2 standard deviations in at least one cognitive domain. The participants were categorized into three groups according to the glycemic gap status: non-elevated (initial glucose − eAG ≤ 0 mg/dL), mildly elevated (0 mg/dL < initial glucose − eAG < 50 mg/dL), and severely elevated (50 mg/dL ≤ initial glucose − eAG). Results: A total of 301 patients were enrolled. The mean age was 63.1 years, and the median National Institute of Health Stroke Scale (NIHSS) score was two (IQR: 1–4). In total, 65 patients (21.6%) developed PSCI. In multiple logistic regression analyses, the severely elevated glycemic gap was a significant predictor for PSCI after adjusting for age, sex, education level, initial stroke severity, Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification, and left hemispheric lesion (aOR: 3.65, p-value = 0.001). Patients in the severely elevated glycemic gap group showed significantly worse performance in the frontal and memory domains. Conclusions: In conclusion, our study demonstrated that an elevated glycemic gap was significantly associated with PSCI three months after a stroke, with preferential involvement of frontal and memory domain dysfunctions.

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