| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the Division of Clinical Neuroscience, St. George’s Hospital Medical School, London, UK.
Address correspondence and reprint requests to Dr. H.S. Markus, Division of Clinical Neuroscience, St. George’s Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK; e-mail: h.markus{at}sghms.ac.uk
Background: Executive dysfunction is an early feature in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) and may progress to a subcortical dementia. The mechanism of cognitive impairment is incompletely understood, and correlations with T2 lesion volumes are not strong. Diffusion tensor imaging (DTI) may provide a better index of white matter tract damage. Previous DTI studies in CADASIL demonstrated abnormalities in normal-appearing white matter, thalamus, and putamen and correlations with the Mini-Mental State Examination (MMSE).
Objectives: To determine whether DTI abnormalities could be identified in nondemented patients with CADASIL and whether these correlated particularly strongly with executive function.
Methods: Eighteen CADASIL subjects underwent DTI and cognitive assessment, including tests of several aspects of executive function. DTI was also performed on 12 age-matched control subjects.
Results: Mean diffusivity was increased in white matter lesions, normal-appearing white matter, and normal-appearing gray matter (thalamus, putamen, and globus pallidus). A composite score of executive function correlated with diffusivity in both normal-appearing gray matter (r = -0.73, p = 0.002) and white matter (r = -0.68, p = 0.004). The strongest correlation for gray matter was for the thalamus (r = -0.66, p = 0.004); this remained after controlling for age, gender, and T2 lesion volumes. Correlations with MMSE were much weaker, and there was no correlation between T2 lesion volume and the executive function score (r = -0.29, p = 0.27).
Conclusions: Abnormalities of normal-appearing white and deep gray matter are present in nondemented CADASIL patients, and these DTI measurements correlate particularly strongly with executive function.
Received April 2, 2003. Accepted in final form September 17, 2003.
This article has been cited by other articles:
|
|
 |
|
  Y. Yakushiji, M. Nishiyama, S. Yakushiji, T. Hirotsu, A. Uchino, J. Nakajima, M. Eriguchi, Y. Nanri, M. Hara, E. Horikawa, et al. Brain Microbleeds and Global Cognitive Function in Adults Without Neurological Disorder Stroke, December 1, 2008; 39(12): 3323 - 3328. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Nitkunan, T. R. Barrick, R. A. Charlton, C. A. Clark, and H. S. Markus Multimodal MRI in Cerebral Small Vessel Disease: Its Relationship With Cognition and Sensitivity to Change Over Time Stroke, July 1, 2008; 39(7): 1999 - 2005. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. T. Stebbins, D. L. Nyenhuis, C. Wang, J. L. Cox, S. Freels, K. Bangen, L. deToledo-Morrell, K. Sripathirathan, M. Moseley, D. A. Turner, et al. Gray Matter Atrophy in Patients With Ischemic Stroke With Cognitive Impairment Stroke, March 1, 2008; 39(3): 785 - 793. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. K. Liem, J. van der Grond, J. Haan, R. van den Boom, M. D. Ferrari, Y. M. Knaap, M. H. Breuning, M. A. van Buchem, H. A.M. Middelkoop, and S. A.J. Lesnik Oberstein Lacunar Infarcts Are the Main Correlate With Cognitive Dysfunction in CADASIL Stroke, March 1, 2007; 38(3): 923 - 928. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Viswanathan, J.-P. Guichard, A. Gschwendtner, F. Buffon, R. Cumurcuic, C. Boutron, E. Vicaut, M. Holtmannspotter, C. Pachai, M.-G. Bousser, et al. Blood pressure and haemoglobin A1c are associated with microhaemorrhage in CADASIL: a two-centre cohort study Brain, September 1, 2006; 129(9): 2375 - 2383. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Peters, M. Holtmannspotter, C. Opherk, A. Gschwendtner, J. Herzog, P. Samann, and M. Dichgans Brain volume changes in CADASIL: A serial MRI study in pure subcortical ischemic vascular disease Neurology, May 23, 2006; 66(10): 1517 - 1522. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. A. Charlton, R. G. Morris, A. Nitkunan, and H. S. Markus The cognitive profiles of CADASIL and sporadic small vessel disease Neurology, May 23, 2006; 66(10): 1523 - 1526. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L Caeiro and J M Ferro Cognitive profile in CADASIL patients J. Neurol. Neurosurg. Psychiatry, February 1, 2006; 77(2): 144 - 145. [Full Text] [PDF]
|
|
|
|
 |
|
 M. G. M. Olde Rikkert, W. M. van der Flier, F. E. deLeeuw, M. Verbeek, R. W. M. M. Jansen, F. Verhey, and P. Scheltens Multiple Diagnostic Tests Are Needed to Assess Multiple Causes of Dementia Arch Neurol, January 1, 2006; 63(1): 144 - 146. [Full Text] [PDF]
|
|
|
|
|
|
M. Holtmannspotter, N. Peters, C. Opherk, D. Martin, J. Herzog, H. Bruckmann, P. Samann, A. Gschwendtner, and M. Dichgans Diffusion Magnetic Resonance Histograms as a Surrogate Marker and Predictor of Disease Progression in CADASIL: A Two-Year Follow-Up Study Stroke, December 1, 2005; 36(12): 2559 - 2565. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. O'Sullivan, T. R. Barrick, R. G. Morris, C. A. Clark, and H. S. Markus Damage within a network of white matter regions underlies executive dysfunction in CADASIL Neurology, November 22, 2005; 65(10): 1584 - 1590. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
