Progressive gray matter atrophy in lacunar patients with vascular mild cognitive impairment

• Published in: Cerebrovascular diseases (Basel, Switzerland) Vol. 30; no. 2; p. 157
• Main Authors: Grau-Olivares, Marta, Arboix, Adrià, Junqué, Carme, Arenaza-Urquijo, Eider M, Rovira, Mariana, Bartrés-Faz, David
• Format: Journal Article
• Language: English
• Published: Switzerland 01-01-2010
• Subjects: Aged; Aged, 80 and over; Analysis of Variance; Atrophy; Cerebral Cortex - pathology; Cerebral Infarction - complications; Cerebral Infarction - pathology; Cerebral Infarction - psychology; Chi-Square Distribution; Cognition; Cognition Disorders - etiology; Cognition Disorders - pathology; Cognition Disorders - psychology; Disease Progression; Female; Follow-Up Studies; Frontal Lobe - physiopathology; Humans; Magnetic Resonance Imaging; Male; Memory; Middle Aged; Neuropsychological Tests; Severity of Illness Index; Spain; Time Factors; Spain
• ISSN: 1421-9786
• DOI: 10.1159/000316059

We investigated the progression of cognitive and cerebral changes in 30 patients with a first-ever lacunar infarct (LI): 15 with vascular mild cognitive impairment (MCI-V) and 15 without cognitive impairment. All cases were followed up 18 +/- 6 months after the stroke and underwent neurological, neuropsychological and MRI assessments at baseline and longitudinally.
Differences in the changes in cognitive function over time were observed between the 2 groups, with the MCI-V patients showing slight memory improvements and frontal-lobe-related test impairments from baseline to follow-up evaluations. At baseline, the 2 groups presented similar white matter hyperintensity (WMH) ratings and whole brain gray matter (GM) volumes, and at the follow-up evaluations, both groups had increased WMH lesions and decreased GM volumes; no statistical differences between groups were found. In contrast, a voxel-based morphometry analysis revealed that only MCI-V patients presented clear regional GM volume losses between the first and the second evaluations in cortical (frontal and temporal) and subcortical (pons, cerebellum and caudate) regions.
Frontal lobe dysfunction and regional cortical and subcortical GM atrophy best differentiate the clinical course of LI patients with and without cognitive impairment.