Cortical microinfarcts and demyelination significantly affect cognition in brain aging

Détails

ID Serval
serval:BIB_598569717599
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Cortical microinfarcts and demyelination significantly affect cognition in brain aging
Périodique
Stroke
Auteur(s)
Kövari Enikö, Gold Gabriel, Herrmann François R., Canuto Alessandra, Hof Patrick R., Michel Jean-Pierre, Bouras Constantin, Giannakopoulos Panteleimon
ISSN
0039-2499
Statut éditorial
Publié
Date de publication
2004
Peer-reviewed
Oui
Volume
35
Numéro
2
Pages
410-414
Langue
anglais
Notes
SAPHIRID:64345
Résumé
BACKGROUND AND PURPOSE: Microvascular lesions are common in brain aging, but their clinical impact is debated. Methodological problems such as the masking effect of concomitant pathologies may explain discrepancies among previous studies. To evaluate the cognitive consequences of such lesions, we prospectively investigated elderly individuals with various degrees of cognitive impairment but without significant neurofibrillary tangle pathology or macrovascular lesions. METHODS: This was a clinicopathological study of 45 elderly individuals. Cognitive status was assessed prospectively with the Clinical Dementia Rating (CDR) scale; neuropathological evaluation included Abeta-protein deposition staging and bilateral semiquantitative assessment of cortical microinfarcts, focal cortical and white matter glioses, and diffuse white matter and periventricular demyelination. RESULTS: In a univariate logistic regression model, cortical microinfarcts explained 36.1% of the variability in CDR; periventricular demyelination, 10.6%; and diffuse white matter demyelination, 4.6%. After controlling for age and Abeta-protein deposition, cortical microinfarcts were the best predictor of cognitive status (19.9% of CDR variability), whereas periventricular and diffuse white matter demyelination accounted for 9.7% and 5.4% of CDR variability, respectively. Altogether, these 3 types of microvascular lesions explained 27.9% of the clinical variability. Focal cortical and white matter glioses were not related to clinical outcome. CONCLUSIONS: Our data imply that cortical microinfarcts and both periventricular and deep white matter demyelination contribute significantly to the progression of cognitive deficits in brain aging. In contrast, the neuropathological evaluation of focal cortical and white matter gliosis has no clinical validity.
Pubmed
Web of science
Open Access
Oui
Création de la notice
10/03/2008 12:04
Dernière modification de la notice
20/08/2019 15:13
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