Cognitive Impairment and Seizures in Patients with Lacunar Strokes

2012 ◽  
Vol 8 (1) ◽  
pp. 27 ◽  
Author(s):  
Jacques De Reuck ◽  
Keyword(s):  
Cognitive Impairment ◽  
White Matter ◽  
Executive Functions ◽  
Cognitive Decline ◽  
Late Onset ◽  
Neuronal Circuits ◽  
Cerebrovascular Lesions ◽  
White Matter Changes ◽  
Cerebral Microangiopathy ◽  
Nun Study

Lacunar strokes are mainly related to cerebral microangiopathy and to the presence of leukoaraiosis. Cognitive impairment is frequently linked to the presence of lacunes and white matter changes. The cognitive impairment consists mainly of disturbances of executive functions sometimes leading to dementia. It is mainly due to interruption of the frontal-subcortical neuronal circuits. Seizures are also observed in patients with lacunes and white matter changes. Although lacunes cannot be considered as the cause of the seizures, there is a relationship between the occurrence of cognitive impairment and seizures. Repeated seizures promote further cognitive decline. However, the development of dementia in patients with late-onset epilepsy is most probably not directly due to the lacunes but rather due to Alzheimer's disease or to cortical cerebrovascular lesions. The development of lacunes should only be the aggravating factor for the cognitive decline as demonstrated in the Nun study.

Depressive Symptoms Predict Cognitive Decline in an Elderly Non Disabled Population with White Matter Changes. Results of the LADIS Study

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
A. Verdelho ◽  
S. Madureira ◽  
C. Moleiro ◽  
J.M. Ferro
Keyword(s):  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
White Matter ◽  
Cognitive Decline ◽  
Elderly Population ◽  
Depression Scale ◽  
Elderly Subjects ◽  
White Matter Changes ◽  
The Impact ◽  
Independent Elderly

Aims:Depressive symptoms (DS) in the elderly have been implicated in cognitive decline, and are more frequent in patients with white matter changes (WMC). Our aim was to ascertain if DS influence cognition in an elderly population with WMC.Methods:The LADIS (Leukoaraiosis and Disability) is a prospective European study that evaluates the impact of WMC on the transition of independent elderly subjects into disability. Subjects were enrolled due to minor complaints without impact in daily-living activities, and presence of WMC. Subjects were evaluated at baseline and yearly during 3 years with a comprehensive clinical and functional protocol. DS were recorded with the Geriatric Depression Scale (GDS). Major depression was classified according to the DSM-IV criteria. Dementia and cognitive decline not dementia were diagnosed according to usual clinical criteria. MRI was performed at entry and at the end of the study. WMC severity was rated according to the Fazeka's scale.Results:639 subjects were included (74.1 ± 5 years old, 55% women, 9.6±3.8 years of schooling). 89% (568), 78.4% (501), and 75% (480) of the patients from the initial sample were followed-up in clinical visit at year 1, 2 and 3. At the end of the study 90 patients were demented and 147 patients had cognitive impairment not dementia. Using survival Cox regression we found that depressive symptoms were independent predictors of cognitive impairment independently of age, education, gender, WMC severity and temporal atrophy.Conclusion:Depressive symptoms are independent predictor of cognitive decline in an independent elderly population with WMC.

scholarly journals Identifying the Neural Correlates of Executive Functions in Early Cerebral Microangiopathy: A Combined VBM and DTI Study

2012 ◽  
Vol 32 (10) ◽  
pp. 1869-1878 ◽  
Author(s):  
Eva M Quinque ◽  
Katrin Arélin ◽  
Juergen Dukart ◽  
Elisabeth Roggenhofer ◽  
Daniel-P Streitbuerger ◽  
...  
Keyword(s):  
White Matter ◽  
Executive Functions ◽  
Rating Scales ◽  
Diffusion Tensor ◽  
Neural Correlates ◽  
Cognitive Domain ◽  
White Matter Changes ◽  
Visual Rating ◽  
Cerebral Microangiopathy ◽  
Network Disruption

Cerebral microangiopathy (CMA) has been associated with executive dysfunction and fronto-parietal neural network disruption. Advances in magnetic resonance imaging allow more detailed analyses of gray (e.g., voxel-based morphometry—VBM) and white matter (e.g., diffusion tensor imaging—DTI) than traditional visual rating scales. The current study investigated patients with early CMA and healthy control subjects with all three approaches. Neuropsychological assessment focused on executive functions, the cognitive domain most discussed in CMA. The DTI and age-related white matter changes rating scales revealed convergent results showing widespread white matter changes in early CMA. Correlations were found in frontal and parietal areas exclusively with speeded, but not with speed-corrected executive measures. The VBM analyses showed reduced gray matter in frontal areas. All three approaches confirmed the hypothesized fronto-parietal network disruption in early CMA. Innovative methods (DTI) converged with results from conventional methods (visual rating) while allowing greater spatial and tissue accuracy. They are thus valid additions to the analysis of neural correlates of cognitive dysfunction. We found a clear distinction between speeded and nonspeeded executive measures in relationship to imaging parameters. Cognitive slowing is related to disease severity in early CMA and therefore important for early diagnostics.

scholarly journals The Effects of Longitudinal White Matter Hyperintensity Change on Cognitive Decline and Cortical Thinning over Three Years

2020 ◽  
Vol 9 (8) ◽  
pp. 2663
Author(s):  
Seung Joo Kim ◽  
Dong Kyun Lee ◽  
Young Kyoung Jang ◽  
Hyemin Jang ◽  
Si Eun Kim ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
White Matter ◽  
Cognitive Decline ◽  
Dynamic Change ◽  
Surrogate Marker ◽  
Brain Magnetic Resonance Imaging ◽  
Longitudinal Change ◽  
White Matter Hyperintensity ◽  
Cortical Thinning ◽  
Automated Method

White matter hyperintensity (WMH) has been recognised as a surrogate marker of small vessel disease and is associated with cognitive impairment. We investigated the dynamic change in WMH in patients with severe WMH at baseline, and the effects of longitudinal change of WMH volume on cognitive decline and cortical thinning. Eighty-seven patients with subcortical vascular mild cognitive impairment were prospectively recruited from a single referral centre. All of the patients were followed up with annual neuropsychological tests and 3T brain magnetic resonance imaging. The WMH volume was quantified using an automated method and the cortical thickness was measured using surface-based methods. Participants were classified into WMH progression and WMH regression groups based on the delta WMH volume between the baseline and the last follow-up. To investigate the effects of longitudinal change in WMH volume on cognitive decline and cortical thinning, a linear mixed effects model was used. Seventy patients showed WMH progression and 17 showed WMH regression over a three-year period. The WMH progression group showed more rapid cortical thinning in widespread regions compared with the WMH regression group. However, the rate of cognitive decline in language, visuospatial function, memory and executive function, and general cognitive function was not different between the two groups. The results of this study indicated that WMH volume changes are dynamic and WMH progression is associated with more rapid cortical thinning.

scholarly journals Protocols for cognitive enhancement. A user manual for Brain Health Services—part 5 of 6

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Andrea Brioschi Guevara ◽  
Melanie Bieler ◽  
Daniele Altomare ◽  
Marcelo Berthier ◽  
Chantal Csajka ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Executive Functions ◽  
Cognitive Decline ◽  
Physical Training ◽  
Cognitive Enhancement ◽  
Memory Performance ◽  
Subjective Cognitive Decline ◽  
Strategic Learning

AbstractCognitive complaints in the absence of objective cognitive impairment, observed in patients with subjective cognitive decline (SCD), are common in old age. The first step to postpone cognitive decline is to use techniques known to improve cognition, i.e., cognitive enhancement techniques.We aimed to provide clinical recommendations to improve cognitive performance in cognitively unimpaired individuals, by using cognitive, mental, or physical training (CMPT), non-invasive brain stimulations (NIBS), drugs, or nutrients. We made a systematic review of CMPT studies based on the GRADE method rating the strength of evidence.CMPT have clinically relevant effects on cognitive and non-cognitive outcomes. The quality of evidence supporting the improvement of outcomes following a CMPT was high for metamemory; moderate for executive functions, attention, global cognition, and generalization in daily life; and low for objective memory, subjective memory, motivation, mood, and quality of life, as well as a transfer to other cognitive functions. Regarding specific interventions, CMPT based on repeated practice (e.g., video games or mindfulness, but not physical training) improved attention and executive functions significantly, while CMPT based on strategic learning significantly improved objective memory.We found encouraging evidence supporting the potential effect of NIBS in improving memory performance, and reducing the perception of self-perceived memory decline in SCD. Yet, the high heterogeneity of stimulation protocols in the different studies prevent the issuing of clear-cut recommendations for implementation in a clinical setting. No conclusive argument was found to recommend any of the main pharmacological cognitive enhancement drugs (“smart drugs”, acetylcholinesterase inhibitors, memantine, antidepressant) or herbal extracts (Panax ginseng, Gingko biloba, and Bacopa monnieri) in people without cognitive impairment.Altogether, this systematic review provides evidence for CMPT to improve cognition, encouraging results for NIBS although more studies are needed, while it does not support the use of drugs or nutrients.

O2-02-06: Depressive symptoms predict cognitive impairment in nondisabled elderly with white matter changes: The LADIS study

2009 ◽  
Vol 5 (4S_Part_4) ◽  
pp. P105-P106
Author(s):  
Ana Verdelho ◽  
Sofia Madureira ◽  
Carla Moleiro ◽  
Jose M. Ferro ◽  
John O'Brien ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
White Matter ◽  
White Matter Changes

Alexander disease causing hereditary late-onset ataxia with only minimal white matter changes: A report of two sibs

2008 ◽  
Vol 23 (11) ◽  
pp. 1613-1615 ◽  
Author(s):  
Catherine C.S. Delnooz ◽  
Jurgen H. Schelhaas ◽  
Bart P.C. van de Warrenburg ◽  
Robert-Jan de Graaf ◽  
Gajja S. Salomons
Keyword(s):  
White Matter ◽  
Late Onset ◽  
Alexander Disease ◽  
White Matter Changes

scholarly journals Prediction of Cognitive Decline in Temporal Lobe Epilepsy and Mild Cognitive Impairment by EEG, MRI, and Neuropsychology

2020 ◽  
Vol 2020 ◽  
pp. 1-16
Author(s):  
Yvonne Höller ◽  
Kevin H. G. Butz ◽  
Aljoscha C. Thomschewski ◽  
Elisabeth V. Schmid ◽  
Christoph D. Hofer ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Temporal Lobe Epilepsy ◽  
Executive Functions ◽  
Cognitive Decline ◽  
Temporal Lobe ◽  
Divided Attention ◽  
Verbal Memory ◽  
Feature Subset Selection ◽  
Wavelet Features

Cognitive decline is a severe concern of patients with mild cognitive impairment. Also, in patients with temporal lobe epilepsy, memory problems are a frequently encountered problem with potential progression. On the background of a unifying hypothesis for cognitive decline, we merged knowledge from dementia and epilepsy research in order to identify biomarkers with a high predictive value for cognitive decline across and beyond these groups that can be fed into intelligent systems. We prospectively assessed patients with temporal lobe epilepsy (N = 9), mild cognitive impairment (N = 19), and subjective cognitive complaints (N = 4) and healthy controls (N = 18). All had structural cerebral MRI, EEG at rest and during declarative verbal memory performance, and a neuropsychological assessment which was repeated after 18 months. Cognitive decline was defined as significant change on neuropsychological subscales. We extracted volumetric and shape features from MRI and brain network measures from EEG and fed these features alongside a baseline testing in neuropsychology into a machine learning framework with feature subset selection and 5-fold cross validation. Out of 50 patients, 27 had a decline over time in executive functions, 23 in visual-verbal memory, 23 in divided attention, and 7 patients had an increase in depression scores. The best sensitivity/specificity for decline was 72%/82% for executive functions based on a feature combination from MRI volumetry and EEG partial coherence during recall of memories; 95%/74% for visual-verbal memory by combination of MRI-wavelet features and neuropsychology; 84%/76% for divided attention by combination of MRI-wavelet features and neuropsychology; and 81%/90% for increase of depression by combination of EEG partial directed coherence factor at rest and neuropsychology. Combining information from EEG, MRI, and neuropsychology in order to predict neuropsychological changes in a heterogeneous population could create a more general model of cognitive performance decline.

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