scholarly journals Diagnostic Values of Serum Levels of Homocysteine and Uric Acid for Predicting Vascular Mild Cognitive Impairment in Patients with Cerebral Small Vessel Disease

2017 ◽  
Vol 23 ◽  
pp. 2217-2225 ◽  
Author(s):  
Ting Wang ◽  
Zhong-Wu Sun ◽  
Liang-Qing Shao ◽  
Xiao-Bin Xu ◽  
Yang Liu ◽  
...  
2009 ◽  
Vol 15 (6) ◽  
pp. 898-905 ◽  
Author(s):  
AIHONG ZHOU ◽  
JIANPING JIA

AbstractControversy surrounds the differences of the cognitive profile between mild cognitive impairment resulting from cerebral small vessel disease (MCI-SVD) and mild cognitive impairment associated with prodromal Alzheimer’s disease (MCI-AD). The aim of this study was to explore and compare the cognitive features of MCI-SVD and MCI-AD. MCI-SVD patients (n = 56), MCI-AD patients (n = 30), and normal control subjects (n = 80) were comprehensively evaluated with neuropsychological tests covering five cognitive domains. The performance was compared between groups. Tests that discriminated between MCI-SVD and MCI-AD were identified. Multiple cognitive domains were impaired in MCI-SVD group, while memory and executive function were mainly impaired in MCI-AD group. Compared with MCI-SVD, MCI-AD patients performed relatively worse on memory tasks, but better on processing speed measures. The AVLT Long Delay Free Recall, Digit Symbol Test, and Stroop Test Part A (performance time) in combination categorized 91.1% of MCI-SVD patients and 86.7% of MCI-AD patients correctly. Current study suggested a nonspecific neuropsychological profile for MCI-SVD and a more specific cognitive pattern in MCI-AD. MCI-AD patients demonstrated greater memory impairment with relatively preserved mental processing speed compared with MCI-SVD patients. Tests tapping these two domains might be potentially useful for differentiating MCI-SVD and MCI-AD patients. (JINS, 2009, 15, 898–905.)


2021 ◽  
Vol 13 ◽  
Author(s):  
Xuanting Li ◽  
Junliang Yuan ◽  
Wei Qin ◽  
Lei Yang ◽  
Shuna Yang ◽  
...  

Background and ObjectiveThe combination of neuroimaging and cognition characteristics may provide complementary information for early identification of mild cognitive impairment (MCI). This study aimed to establish the clinical relevance between cerebral small vessel disease (CSVD) burden and MCI and further explored the cognitive characteristics linked to CSVD applying a propensity score matching (PSM) approach.MethodsThe study was designed as a case–control study. All the subjects underwent the standard clinical assessments, neuropsychological testing battery (including global cognition, memory, executive function, and speed and motor control domains), and brain magnetic resonance imaging (MRI). A 1:2 nearest-neighbor matching approach without replacement was employed with a caliper of 0.15 in the PSM approach.ResultsA total of 84 MCI patients and 186 cognitively normal controls were included in this study. After PSM, 74 MCI patients and 129 controls were successfully matched, and the covariate imbalance was well eliminated. Compared with controls, the MCI group had more severe CSVD burden. In the binary logistic regression analysis, CSVD was associated with MCI after adjusting for all confounders. The results of multivariate linear regression analyses showed that higher total MRI CSVD burden was related to the deficit of cognitive performance in global cognition and three important cognitive domains after adjusting for all confounders.ConclusionCerebral small vessel disease was an independent risk factor of MCI. Moreover, higher total MRI CSVD burden was associated with the overall cognitive impairment among middle-aged and elderly Chinese adults.


2021 ◽  
Vol 18 ◽  
Author(s):  
TianTian Jiang ◽  
Yong Zhou ◽  
Dongmei Zhang ◽  
Zhiyong Cao ◽  
Laifang Bian ◽  
...  

Objective: Insulin resistance (IR) is a key pathological process during the development of cerebral small vessel disease (CSVD) and vascular cognitive impairment (VCI). The triglyceride-glucose in-dex(TyG index) is considered as a novel marker of insulin resistance and can represent peripheral tissue insulin sensitivity. Interleukin-34(IL-34) is a cytokine of the short-chain helical hematopoietic cytokine family and recent studies have shown that it's serum levels may represent an important biomarker for atherosclerosis. Here, we aimed to investigate whether the TyG index and serum IL-34 levels were re-lated to VCI in patients with CSVD. Method: This study included a total of 280 CSVD patients. TyG index, clinical baseline data, and fast-ed venous blood for quantification serum levels of IL-34 were acquired within 24 hours of admission. Multiple logistic regression analysis was applied to analyze the association between potential risk fac-tors and VCI, and receiver operator characteristic(ROC) curve was used to evaluate the diagnostic value of IL-34, TyG index, and their combination for detecting VCI. Results: Among all included CSVD patients, 166 patients (59.3%) were diagnosed with VCI based on the cognitive function scale (MOCA). After adjusting for confounding factors, serum IL-34 levels and TyG index were independently associated with VCI (P<0.05). Using ROC curve analysis, the optimal thresholds for identification of VCI based on serum IL-34 levels and TyG index were 41.57pg/ml (area under the curve (AUC): 0.723; sensitivity 76.5%; specificity 64%) and 3.94(AUC:0.727; sensitivity 72.3%; specificity 62.3%), respectively. Conclusion: This study demonstrated that IL-34 and TyG index are closely associated with VCI in CSVD patients and may represent clinical therapeutic targets for CSVD.


2020 ◽  
Vol 92 (1) ◽  
pp. 45-52
Author(s):  
Audrey Low ◽  
Elijah Mak ◽  
Maura Malpetti ◽  
Luca Passamonti ◽  
Nicolas Nicastro ◽  
...  

IntroductionAssociations between cerebral small vessel disease (SVD) and inflammation have been largely examined using peripheral blood markers of inflammation, with few studies measuring inflammation within the brain. We investigated the cross-sectional relationship between SVD and in vivo neuroinflammation using [11C]PK11195 positron emission tomography (PET) imaging.MethodsForty-two participants were recruited (according to NIA-AA guidelines, 14 healthy controls, 14 mild Alzheimer’s disease, 14 amyloid-positive mild cognitive impairment). Neuroinflammation was assessed using [11C]PK11195 PET imaging, a marker of microglial activation. To quantify SVD, we assessed white matter hyperintensities (WMH), enlarged perivascular spaces, cerebral microbleeds and lacunes. Composite scores were calculated for global SVD burden, and SVD subtypes of hypertensive arteriopathy and cerebral amyloid angiopathy (CAA). General linear models examined associations between SVD and [11C]PK11195, adjusting for sex, age, education, cognition, scan interval, and corrected for multiple comparisons via false discovery rate (FDR). Dominance analysis directly compared the relative importance of hypertensive arteriopathy and CAA scores as predictors of [11C]PK11195.ResultsGlobal [11C]PK11195 binding was associated with SVD markers, particularly in regions typical of hypertensive arteriopathy: deep microbleeds (β=0.63, F(1,35)=35.24, p<0.001), deep WMH (β=0.59, t=4.91, p<0.001). In dominance analysis, hypertensive arteriopathy score outperformed CAA in predicting [11C]PK11195 binding globally and in 28 out of 37 regions of interest, especially the medial temporal lobe (β=0.66–0.76, t=3.90–5.58, FDR-corrected p (pFDR)=<0.001–0.002) and orbitofrontal cortex (β=0.51–0.57, t=3.53–4.30, pFDR=0.001–0.004).ConclusionMicroglial activation is associated with SVD, particularly with the hypertensive arteriopathy subtype of SVD. Although further research is needed to determine causality, our study suggests that targeting neuroinflammation might represent a novel therapeutic strategy for SVD.


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