scholarly journals Cerebral Ischemia is Associated With Corneal Nerve Loss and Brain Atrophy in Mild Cognitive Impairment and Dementia

2020 ◽  
Author(s):  
Georgios Ponirakis ◽  
Ahmed Elsotouhy ◽  
Hanadi Al Hamad ◽  
Surjith Vattoth ◽  
Ioannis N. Petropoulos ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cerebral Ischemia ◽  
Brain Atrophy ◽  
Hippocampal Volume ◽  
Cognitive Screening ◽  
Fiber Density ◽  
Corneal Confocal Microscopy ◽  
Corneal Nerve ◽  
Ventricle Volume

Abstract BackgroundThe prevalence of cerebral ischemia increases with age and is a risk factor for cognitive impairment and dementia. This study assessed the association of brain ischemic lesions with the severity of neurodegeneration utilizing brain volumetric MRI and corneal confocal microscopy (CCM) in patients with mild cognitive impairment (MCI) and dementia.MethodsSubjects with MCI and dementia without diabetes underwent cognitive screening, CCM, assessment of ischemic lesions and quantitative brain MRI.ResultsOf 63 subjects with MCI (n=44) and dementia (n=19), 11 had no ischemia, 32 had subcortical ischemia and 20 had both cortical and subcortical ischemia. Subjects with MCI and dementia had comparable percentage of cerebral ischemia (P=0.25). Global cognitive function was significantly impaired in subjects with both cortical and subcortical ischemia (P<0.05) but not in those with subcortical ischemia (P=0.10) compared to those without ischemia. Corneal nerve fiber density (CNFD)(P<0.01), branch density (CNBD) (P<0.05) and fiber length (CNFL) (P<0.01) were significantly lower in subjects with both cortical and subcortical ischemia compared to those without ischemia and CNFD (P<0.05), CNBD (P<0.05) and CNFL (P<0.05) were significantly lower in subjects with both cortical and subcortical ischemia compared to those with subcortical ischemia. In subjects with both cortical and subcortical ischemia whole brain (P<0.01) and hippocampal volume (P<0.001) were significantly lower and ventricle volume was higher (P<0.05) compared to those without ischemia and hippocampal volume (P<0.01) was lower and ventricle volume was higher (P<0.01) in subjects with both cortical and subcortical ischemia compared to those with subcortical ischemia.ConclusionsThe presence of cortical and subcortical ischemia is associated with cognitive impairment, corneal nerve loss and brain atrophy in patients with MCI and dementia.

scholarly journals Association of Cerebral Ischemia With Corneal Nerve Loss and Brain Atrophy in MCI and Dementia

2021 ◽  
Vol 15 ◽  
Author(s):  
Georgios Ponirakis ◽  
Ahmed Elsotouhy ◽  
Hanadi Al Hamad ◽  
Surjith Vattoth ◽  
Ioannis N. Petropoulos ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cerebral Ischemia ◽  
Nerve Fiber ◽  
Brain Atrophy ◽  
Ventricular Volume ◽  
Hippocampal Volume ◽  
Fiber Density ◽  
Corneal Confocal Microscopy ◽  
Corneal Nerve ◽  
Cortical Ischemia

IntroductionThis study assessed the association of cerebral ischemia with neurodegeneration in mild cognitive impairment (MCI) and dementia.MethodsSubjects with MCI, dementia and controls underwent assessment of cognitive function, severity of brain ischemia, MRI brain volumetry and corneal confocal microscopy.ResultsOf 63 subjects with MCI (n = 44) and dementia (n = 19), 11 had no ischemia, 32 had subcortical ischemia and 20 had both subcortical and cortical ischemia. Brain volume and corneal nerve measures were comparable between subjects with subcortical ischemia and no ischemia. However, subjects with subcortical and cortical ischemia had a lower hippocampal volume (P &lt; 0.01), corneal nerve fiber length (P &lt; 0.05) and larger ventricular volume (P &lt; 0.05) compared to those with subcortical ischemia and lower corneal nerve fiber density (P &lt; 0.05) compared to those without ischemia.DiscussionCerebral ischemia was associated with cognitive impairment, brain atrophy and corneal nerve loss in MCI and dementia.

scholarly journals Corneal nerve and brain imaging in mild cognitive impairment and dementia: A cross-sectional study

2020 ◽  
Author(s):  
Eiman Al-Janahi ◽  
Georgios Ponirakis ◽  
Hanadi Al Hamad ◽  
Surjith Vattoth ◽  
Ahmed Elsotouhy ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Diagnostic Accuracy ◽  
Roc Curve ◽  
Statistical Tests ◽  
Imaging Biomarker ◽  
Kappa Statistics ◽  
Non Invasive ◽  
Corneal Confocal Microscopy ◽  
Corneal Nerve

Abstract Background: Visual rating of medial temporal lobe atrophy (MTA) is an accepted biomarker of Alzheimer’s disease. Corneal confocal microscopy (CCM) is a non-invasive ophthalmic imaging biomarker of neurodegeneration. We sought to determine the diagnostic accuracy of CCM to distinguish mild cognitive impairment (MCI) and dementia from no cognitive impairment (NCI) in relation to MTA rating.Methods: Subjects aged 60-85 with NCI, MCI and dementia were recruited from the geriatric and memory clinic in Rumailah Hospital, Doha, Qatar between 18/09/16 and 31/07/19. The diagnosis of MCI and dementia were based on the International Classification of Diseases (ICD-10) criteria. Subjects underwent cognitive screening using the Montreal Cognitive Assessment (MoCA), CCM and MTA rating on MRI. Statistical tests used were ANOVA with Bonferroni’s post hoc test, kappa statistics and receiver operating characteristic (ROC) curve analysis. A two-tailed P value of ≤0.05 was considered significant.Results: 182 subjects with NCI (n=36), MCI (n=80) and dementia (n=66), including AD (n=19, 28.8%), VaD (n=13, 19.7%) and combined AD (n=34, 51.5%) were studied. CCM showed a progressive reduction in corneal nerve fiber density (CNFD, fibers/mm2) (32.0±7.5 vs 24.5±9.6 vs 20.8±9.3, p<0.0001), branch density (CNBD, branches/mm2) (90.9±46.5 vs 59.3±35.7 vs 53.9±38.7, p<0.0001), and fiber length (CNFL, mm/mm2) (22.9±6.1 vs 17.2±6.5 vs 15.8±7.4, p<0.0001), in subjects with MCI and dementia compared to NCI. The MTA rating in the dementia group was significantly higher compared with the NCI and MCI group in the right (1.9±1.0 vs 0.5±0.6 and 0.6±0.8, p<0.0001) and left (2.1±1.1 vs 0.6±0.7 and 0.8±0.8, p<0.0001) hemispheres. The area under the ROC curve (95% CI) for the diagnostic accuracy of CNFD, CNBD, CNFL vs MTA-right and -left for MCI was 78% (67-90%), 82% (72-92%), 86% (77-95%) vs 53% (36-69%) and 40% (25-55%), respectively, and for dementia it was 85% (76-94%), 84% (75-93%), 85% (76-94%) vs 86% (76-96%) and 82% (72-92%), respectively.Conclusions: The diagnostic accuracy of CCM, a non-invasive ophthalmic biomarker of neurodegeneration was high and comparable with MTA rating for dementia and superior to MTA rating for MCI.

scholarly journals Corneal Nerve and Brain Imaging in Mild Cognitive Impairment and Dementia

2020 ◽  
Vol 77 (4) ◽  
pp. 1533-1543
Author(s):  
Eiman Al-Janahi ◽  
Georgios Ponirakis ◽  
Hanadi Al Hamad ◽  
Surjith Vattoth ◽  
Ahmed Elsotouhy ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Diagnostic Accuracy ◽  
Temporal Lobe ◽  
Medial Temporal Lobe ◽  
Medial Temporal Lobe Atrophy ◽  
Non Invasive ◽  
Corneal Confocal Microscopy ◽  
Corneal Nerve ◽  
Lobe Atrophy

Background: Visual rating of medial temporal lobe atrophy (MTA) is an accepted structural neuroimaging marker of Alzheimer’s disease. Corneal confocal microscopy (CCM) is a non-invasive ophthalmic technique that detects neuronal loss in peripheral and central neurodegenerative disorders. Objective: To determine the diagnostic accuracy of CCM for mild cognitive impairment (MCI) and dementia compared to medial temporal lobe atrophy (MTA) rating on MRI. Methods: Subjects aged 60–85 with no cognitive impairment (NCI), MCI, and dementia based on the ICD-10 criteria were recruited. Subjects underwent cognitive screening, CCM, and MTA rating on MRI. Results: 182 subjects with NCI (n = 36), MCI (n = 80), and dementia (n = 66), including AD (n = 19, 28.8%), VaD (n = 13, 19.7%), and mixed AD (n = 34, 51.5%) were studied. CCM showed a progressive reduction in corneal nerve fiber density (CNFD, fibers/mm2) (32.0±7.5 versus 24.5±9.6 and 20.8±9.3, p < 0.0001), branch density (CNBD, branches/mm2) (90.9±46.5 versus 59.3±35.7 and 53.9±38.7, p < 0.0001), and fiber length (CNFL, mm/mm2) (22.9±6.1 versus 17.2±6.5 and 15.8±7.4, p < 0.0001) in subjects with MCI and dementia compared to NCI. The area under the ROC curve (95% CI) for the diagnostic accuracy of CNFD, CNBD, CNFL compared to MTA-right and MTA-left for MCI was 78% (67–90%), 82% (72–92%), 86% (77–95%) versus 53% (36–69%) and 40% (25–55%), respectively, and for dementia it was 85% (76–94%), 84% (75–93%), 85% (76–94%) versus 86% (76–96%) and 82% (72–92%), respectively. Conclusion: The diagnostic accuracy of CCM, a non-invasive ophthalmic biomarker of neurodegeneration, was high and comparable with MTA rating for dementia but was superior to MTA rating for MCI.

P3-031: THE CRITICAL PATH FOR ALZHEIMER'S DISEASE: HIPPOCAMPAL VOLUME AS AN ENRICHMENT BIOMARKER IN TRIALS OF PATIENTS WITH MILD COGNITIVE IMPAIRMENT

2006 ◽  
Vol 14 (7S_Part_20) ◽  
pp. P1076-P1076
Author(s):  
Daniela J. Conrado ◽  
Timothy Nicholas ◽  
Jackson Burton ◽  
Stephen P. Arnerić ◽  
Danny Chen ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Critical Path ◽  
Hippocampal Volume

Functional implications of hippocampal volume and diffusivity in mild cognitive impairment

NeuroImage ◽  
2005 ◽  
Vol 28 (4) ◽  
pp. 1033-1042 ◽  
Author(s):  
Matthias J. Müller ◽  
Dirk Greverus ◽  
Paulo Roberto Dellani ◽  
Carsten Weibrich ◽  
Paulo R. Wille ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Hippocampal Volume ◽  
Functional Implications

scholarly journals Structural Analysis of Brain Hub Region Volume and Cortical Thickness in Patients with Mild Cognitive Impairment and Dementia

Medicina ◽  
2020 ◽  
Vol 56 (10) ◽  
pp. 497
Author(s):  
Nauris Zdanovskis ◽  
Ardis Platkājis ◽  
Andrejs Kostiks ◽  
Guntis Karelis
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Entorhinal Cortex ◽  
Cortical Thickness ◽  
Test Scores ◽  
Cognitive Assessment ◽  
Significant Positive Correlation ◽  
Hippocampal Volume ◽  
Positive Correlation ◽  
Hippocampus Volume

Background and Objectives: A complex network of axonal pathways interlinks the human brain cortex. Brain networks are not distributed evenly, and brain regions making more connections with other parts are defined as brain hubs. Our objective was to analyze brain hub region volume and cortical thickness and determine the association with cognitive assessment scores in patients with mild cognitive impairment (MCI) and dementia. Materials and Methods: In this cross-sectional study, we included 11 patients (5 mild cognitive impairment; 6 dementia). All patients underwent neurological examination, and Montreal Cognitive Assessment (MoCA) test scores were recorded. Scans with a 3T MRI scanner were done, and cortical thickness and volumetric data were acquired using Freesurfer 7.1.0 software. Results: By analyzing differences between the MCI and dementia groups, MCI patients had higher hippocampal volumes (p < 0.05) and left entorhinal cortex thickness (p < 0.05). There was a significant positive correlation between MoCA test scores and left hippocampus volume (r = 0.767, p < 0.01), right hippocampus volume (r = 0.785, p < 0.01), right precuneus cortical thickness (r = 0.648, p < 0.05), left entorhinal cortex thickness (r = 0.767, p < 0.01), and right entorhinal cortex thickness (r = 0.612, p < 0.05). Conclusions: In our study, hippocampal volume and entorhinal cortex showed significant differences in the MCI and dementia patient groups. Additionally, we found a statistically significant positive correlation between MoCA scores, hippocampal volume, entorhinal cortex thickness, and right precuneus. Although other brain hub regions did not show statistically significant differences, there should be additional research to evaluate the brain hub region association with MCI and dementia.

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