Dement Neurocogn Disord.  2013 Sep;12(3):61-71. 10.12779/dnd.2013.12.3.61.

Diffusion Tensor Imaging Changes Correlate with Clinical Progression in Vascular Mild Cognitive Impairment and Vascular Dementia of Subcortical Type

• Ryoo NY
• Yoon BN
• Yoon CW
• Ahn JH
• Choi JY
• Lim MK
• Kwon H
• Park JS
• Lee JM
• Choi SH

• KMID: 1488582
• DOI: http://doi.org/10.12779/dnd.2013.12.3.61

Abstract

BACKGROUND
Cerebral small vessel disease (SVD) induces vascular cognitive impairment (VCI) such as subcortical vascular dementia (SVaD) and subcortical vascular mild cognitive impairment (svMCI). We compared MRI parameters between SVaD and svMCI and determined which MRI parameters best correlated with cognitive function and disability on cross-sectional and longitudinal analyses within them.
METHODS
Twenty-four patients with SVaD and twelve with svMCI were recruited. They underwent multimodal MRIs including fluid-attenuated inversion recovery lesion load, lacunar infarct number, and fractional anisotropy (FA) and mean diffusivity (MD) from diffusion tensor imaging (DTI), neuropsychological testing, Sum of Boxes of Clinical Dementia Rating Scale (CDR-SB), Barthel Index, and the Korean version of a Geriatric Depression Scale (GDS-K). Seventeen patients were retested after 20 months for a brain MRI and clinical evaluation.
RESULTS
There were significant differences in average MD and peak height of MD histograms within normal-appearing brain tissue (NABT) between SVaD and svMCI patients. In the cross-sectional analysis, average MD within NABT significantly correlated with the composite neuropsychology score (r=-0.80, p<0.001), the composite executive function score (r=-0.67, p< 0.001), and the CDR-SB (r=0.54, p=0.001), and the Barthel Index correlated with peak heights of the MD histograms (r=0.37, p=0.03) in NABT. Changes of CDR-SB was associated with changes of average MD within WMH (r=0.57, p=0.02), and changes of GDS-K was associated with changes of WMH volume (r=0.51, p=0.04) on a longitudinal scale.
CONCLUSIONS
DTI parameters in NABT correlated with cognitive impairment and disability in VCI associated with SVD. Clinical progression of SVD was associated with some increment of WML volume and ultrastructural changes in WMH.

Keyword

Subcortical vascular dementia; Small vessel disease; Diffusion tensor imaging

MeSH Terms

Anisotropy
Brain
Cerebral Small Vessel Diseases
Cross-Sectional Studies
Dementia
Dementia, Vascular
Depression
Diffusion
Diffusion Tensor Imaging
Executive Function
Glycosaminoglycans
Humans
Mild Cognitive Impairment
Neuropsychological Tests
Neuropsychology
Stroke, Lacunar
Glycosaminoglycans

Figure

• 

  Fig. 1 Mean diffusivity histograms in normal-appearing brain tissue (n=17) at baseline and at follow-up.

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