Cognitive consequences of thalamic, basal ganglia, and deep white matter lacunes in brain aging and dementia

Détails

ID Serval
serval:BIB_73E09D3B0793
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Cognitive consequences of thalamic, basal ganglia, and deep white matter lacunes in brain aging and dementia
Périodique
Stroke
Auteur(s)
Gold Gabriel, Kövari Enikö, Herrmann François R., Canuto Alessandra, Hof Patrick R., Michel Jean-Pierre, Bouras Constantin, Giannakopoulos Panteleimon
ISSN
0039-2499
Statut éditorial
Publié
Date de publication
2005
Peer-reviewed
Oui
Volume
36
Numéro
6
Pages
1184-1188
Notes
SAPHIRID:61500
Résumé
BACKGROUND AND PURPOSE: Most previous studies addressed the cognitive impact of lacunar infarcts using radiologic correlations that are known to correlate poorly with neuropathological data. Moreover, absence of systematic bilateral assessment of vascular lesions and masking effects of Alzheimer disease pathology and macrovascular lesions may explain discrepancies among previous reports. To define the relative contribution of silent lacunes to cognitive decline, we performed a detailed analysis of lacunar and microvascular pathology in both cortical and subcortical areas of 72 elderly individuals without significant neurofibrillary tangle pathology or macrovascular lesions. METHODS: Cognitive status was assessed prospectively using the Clinical Dementia Rating (CDR) scale; neuropathological evaluation included Abeta-protein deposition staging and bilateral assessment of microvascular ischemic pathology and lacunes; statistical analysis included multivariate models controlling for age, amyloid deposits, and microvascular pathology. RESULTS: Thalamic and basal ganglia lacunes were negatively associated with CDR scores; cortical microinfarcts, periventricular and diffuse white matter demyelination also significantly affected cognition. In a multivariate model, cortical microinfarcts and thalamic and basal ganglia lacunes explained 22% of CDR variability; amyloid deposits and microvascular pathology explained 12%, and the assessment of thalamic and basal ganglia lacunes added an extra 17%. Deep white matter lacunes were not related to cognitive status in univariate and multivariate models. CONCLUSIONS: In agreement with the recently proposed concept of subcortical ischemic vascular dementia, our autopsy series provides important evidence that gray matter lacunes are independent predictors of cognitive decline in elderly individuals without concomitant dementing processes such as Alzheimer disease
Y2 - 2006/01/18/
Pubmed
Web of science
Open Access
Oui
Création de la notice
10/03/2008 12:04
Dernière modification de la notice
08/05/2019 20:26
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