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Mesiotemporal atrophy and hippocampal diffusivity distinguish amnestic from non‐amnestic vascular cognitive impairment
Author(s) -
Hosseini A. A.,
Meng D.,
Simpson R. J.,
Auer D. P.
Publication year - 2017
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13299
Subject(s) - medicine , hippocampal formation , cognitive impairment , neuroscience , atrophy , cardiology , audiology , cognition , psychiatry , psychology
Background and purpose The role of clinical factors, cerebral infarcts and hippocampal damage in vascular cognitive impairment ( VCI ) subtypes remains unclear. Methods Non‐demented patients with carotid stenosis and recent transient ischemic attack/stroke had cognitive assessment and brain magnetic resonance imaging ( MRI ). Amnestic VCI was defined as memory impairment; non‐amnestic VCI was any other subdomain impairment. Associations of MRI metrics [log‐transformed total ischemic lesion load (log TILL ), mesiotemporal atrophy ( MTA ) score, hippocampal mean diffusivity (hip MD )] with cognitive performance were assessed. Results A hundred and eight patients, 47 with amnestic VCI and 21 with non‐amnestic VCI , were assessed. A higher MTA (odds ratio 12.89, P = 0.001) and left hip MD (odds ratio 4.43, P = 0.003) contributed to amnestic VCI versus normal. Age‐adjusted fluency correlated with log TILL ( P = 0.002). Age‐adjusted memory was associated with left hip MD ( P = 0.001), MTA ( P < 0.001) but not log TILL ( P = 0.14). Left hip MD , MTA and smoking showed classification potential between amnestic VCI versus normal (area 0.859, P < 0.001). Conclusions Neuroimaging assists stratification in amnestic VCI characterized by hippocampal changes and in non‐amnestic VCI by higher ischemic burden. MTA and hippocampal diffusivity show diagnostic biomarker potential.