Cortical thickness and hippocampal shape in pure vascular mild cognitive impairment and dementia of subcortical type

• Published in: European journal of neurology Vol. 21; no. 5; pp. 744 - 751
• Main Authors: Kim, H. J., Ye, B. S., Yoon, C. W., Noh, Y., Kim, G. H., Cho, H., Jeon, S., Lee, J. M., Kim, J.-H., Seong, J.-K., Kim, C.-H., Choe, Y. S., Lee, K. H., Kim, S. T., Kim, J. S., Park, S. E., Chin, J., Cho, J., Kim, C., Lee, J. H., Weiner, M. W., Na, D. L., Seo, S. W.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01-05-2014; John Wiley & Sons, Inc
• Subjects: Aged; Alzheimer's disease; Aniline Compounds; Cerebral Cortex - diagnostic imaging; Cerebral Cortex - pathology; Cognitive ability; Cognitive Dysfunction - pathology; cortical thickness; Dementia - pathology; Dementia, Vascular - diagnostic imaging; Dementia, Vascular - pathology; Female; hippocampal shape; Hippocampus - diagnostic imaging; Hippocampus - pathology; Humans; Imaging, Three-Dimensional; Magnetic Resonance Imaging; Male; Medical research; Middle Aged; Neuropsychological Tests; Pittsburgh compound B PET; Positron-Emission Tomography; subcortical vascular dementia; subcortical vascular mild cognitive impairment; Thiazoles; subcortical vascular dementia; Pittsburgh compound B PET; subcortical vascular mild cognitive impairment; hippocampal shape; cortical thickness
• ISSN: 1351-5101; 1468-1331
• DOI: 10.1111/ene.12376

Background and purpose
The progression pattern of brain structural changes in patients with isolated cerebrovascular disease (CVD) remains unclear. To investigate the role of isolated CVD in cognitive impairment patients, patterns of cortical thinning and hippocampal atrophy in pure subcortical vascular mild cognitive impairment (svMCI) and pure subcortical vascular dementia (SVaD) patients were characterized.
Methods
Forty‐five patients with svMCI and 46 patients with SVaD who were negative on Pittsburgh compound B (PiB) positron emission tomography imaging and 75 individuals with normal cognition (NC) were recruited.
Results
Compared with NC, patients with PiB(−) svMCI exhibited frontal, language and retrieval type memory dysfunctions, which in patients with PiB(−) SVaD were further impaired and accompanied by visuospatial and recognition memory dysfunctions. Compared with NC, patients with PiB(−) svMCI exhibited cortical thinning in the frontal, perisylvian, basal temporal and posterior cingulate regions. This atrophy was more prominent and extended further toward the lateral parietal and medial temporal regions in patients with PiB(−) SVaD. Compared with NC subjects, patients with PiB(−) svMCI exhibited hippocampal shape deformities in the lateral body, whilst patients with PiB(−) SVaD exhibited additional deformities within the lateral head and inferior body.
Conclusions
Our findings suggest that patients with CVD in the absence of Alzheimer's disease pathology can be demented, showing cognitive impairment in multiple domains, which is consistent with the topography of cortical thinning and hippocampal shape deformity.