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Lacune infarct or silent infarction

Yan Liang, Yang-Kun Chen, Vincent Chung-Tong Mok, De-Feng Wang, Gabor S Ungvari, Winnie Chiu-Wing Chu, Hee-Ju Kang, Wai-Kwong Tang
Objective: All types of cerebral small vessel disease (SVD) markers including lacune, white matter hyperintensities (WMH), cerebral microbleeds, and perivascular spaces were found to be associated with poststroke depressive symptoms (PDS). This study explored whether the combination of the four markers constituting an overall SVD burden was associated with PDS. Methods: A cohort of 563 patients with acute ischemic stroke were followed over a 15-month period after the index stroke. A score of ≥7 on the 15-item Geriatric Depression Scale was defined as clinically significant PDS...
2018: Frontiers in Aging Neuroscience
Philip Benjamin, Sarah Trippier, Andrew J Lawrence, Christian Lambert, Eva Zeestraten, Owen A Williams, Bhavini Patel, Robin G Morris, Thomas R Barrick, Andrew D MacKinnon, Hugh S Markus
BACKGROUND AND PURPOSE: Cerebral small-vessel disease is a major cause of cognitive impairment. Perivascular spaces (PvS) occur in small-vessel disease, but their relationship to cognitive impairment remains uncertain. One reason may be difficulty in distinguishing between lacunes and PvS. We determined the relationship between baseline PvS score and PvS volume with change in cognition over a 5-year follow-up. We compared this to the relationship between baseline lacune count and total lacune volume with cognition...
February 2, 2018: Stroke; a Journal of Cerebral Circulation
Melissa C Caughey, Ye Qiao, B Gwen Windham, Rebecca F Gottesman, Thomas H Mosley, Bruce A Wasserman
Background: Both hypertensive and atherosclerotic processes contribute to common carotid artery intima-media thickness (CCA-IMT). Elevated CCA-IMT may be indicative of subclinical cerebrovascular disease; however, its role in the absence of concomitant carotid artery plaque is uncertain, and few studies have examined associations in black populations. Materials and Methods: At cohort visit 3 (1993-1995) a subset of stroke-free participants (641 blacks and 702 whites, mean age 63) from the Atherosclerosis Risk in Communities (ARIC) study was imaged by brain MRI and carotid ultrasound...
February 7, 2018: American Journal of Hypertension
Yanan Zhu, Saima Hilal, Yuek L Chai, M K Ikram, Narayanaswamy Venketasubramanian, Christopher P Chen, Mitchell K P Lai
Background: While hepatocyte growth factor (HGF) is known to exert cell growth, migration and morphogenic effects in various organs, recent studies suggest that HGF may also play a role in synaptic maintenance and cerebrovascular integrity. Although increased levels of HGF have been reported in brain and cerebrospinal fluid (CSF) samples of patients with Alzheimer's disease (AD), it is unclear whether peripheral HGF may be associated with cerebrovascular disease (CeVD) and dementia. In this study, we examined the association of baseline serum HGF with neuroimaging markers of CeVD in a cohort of pre-dementia (cognitive impaired no dementia, CIND) and AD patients...
2018: Frontiers in Aging Neuroscience
Mika Shibuya, Claudia da Costa Leite, Leandro Tavares Lucato
In recent years, small vessel disease (SVD) has been recognized for its major impact on cognitive impairment in elderly people, where it is often difficult to separate its effects from those of neurodegenerative diseases individually. SVD is a systemic disease, probably related to diffuse endothelial dysfunction, which affects the perforating arterioles, capillaries and venules in the brain. Although often asymptomatic, it is responsible for almost half of all dementia cases and a significant proportion of stroke cases...
October 2017: Dementia & Neuropsychologia
J Matthijs Biesbroek, Alexander Leemans, Hanna den Bakker, Marco Duering, Benno Gesierich, Huiberdina L Koek, Esther van den Berg, Albert Postma, Geert Jan Biessels
BACKGROUND: White matter injury is an important factor for cognitive impairment in memory clinic patients. We determined the added value of diffusion tensor imaging (DTI) of strategic white matter tracts in explaining variance in cognition in memory clinic patients with vascular brain injury. METHODS: We included 159 patients. Conventional MRI markers (white matter hyperintensity volume, lacunes, nonlacunar infarcts, brain atrophy, and microbleeds), and fractional anisotropy and mean diffusivity (MD) of the whole brain white matter and of 18 white matter tracts were related to cognition using linear regression and Bayesian network analysis...
January 19, 2018: Dementia and Geriatric Cognitive Disorders
Ji-Rong He, Yu Zhang, Wen-Jing Lu, Huai-Bin Liang, Xuan-Qiang Tu, Fei-Yue Ma, Guo-Yuan Yang, Li-Li Zeng
Objective: To explore the correlationship among white matter hyperintensities (WMHs), miR-92a-3p and early-onset post-stroke depression (PSD). Methods: We recruited consecutively 238 patients with acute cerebral infarction and MRI examination in the Department of neurology, Ruijin hospital, Shanghai Jiaotong University School of Medicine. The diagnosis of early-onset PSD was made in accordance with DSM-IV criteria for depression in 2 weeks after stroke. Clinical information and assessments of stroke severity were recorded on admission...
2017: Frontiers in Aging Neuroscience
Pablo J Blanco, Lucas O Müller, J David Spence
RATIONALE: The role of hypertension in cerebral small vessel disease is poorly understood. At the base of the brain (the 'vascular centrencephalon'), short straight arteries transmit blood pressure directly to small resistance vessels; the cerebral convexity is supplied by long arteries with many branches, resulting in a drop in blood pressure. Hypertensive small vessel disease (lipohyalinosis) causes the classically described lacunar infarctions at the base of the brain; however, periventricular white matter intensities (WMIs) seen on MRI and WMI in subcortical areas over the convexity, which are often also called 'lacunes', probably have different aetiologies...
September 2017: Stroke and Vascular Neurology
Iain D Croall, Valerie Lohner, Barry Moynihan, Usman Khan, Ahamad Hassan, John T O'Brien, Robin G Morris, Daniel J Tozer, Victoria C Cambridge, Kirsty Harkness, David J Werring, Andrew M Blamire, Gary A Ford, Thomas R Barrick, Hugh S Markus
Diffusion tensor imaging (DTI) metrics such as fractional anisotropy (FA) and mean diffusivity (MD) have been proposed as clinical trial markers of cerebral small vessel disease (SVD) due to their associations with outcomes such as cognition. However, studies investigating this have been predominantly single-centre. As clinical trials are likely to be multisite, further studies are required to determine whether associations with cognition of similar strengths can be detected in a multicentre setting. One hundred and nine patients (mean age =68 years) with symptomatic lacunar infarction and confluent white matter hyperintensities (WMH) on MRI was recruited across six sites as part of the PRESERVE DTI substudy...
June 1, 2017: Clinical Science (1979-)
J Matthijs Biesbroek, Nick A Weaver, Geert Jan Biessels
Cerebral small vessel disease (SVD) is an important cause of cognitive impairment. Important MRI manifestations of SVD include white matter hyperintensities (WMH) and lacunes. This narrative review addresses the role of anatomical lesion location in the impact of SVD on cognition, integrating findings from early autopsy studies with emerging findings from recent studies with advanced image analysis techniques. Early autopsy and imaging studies of small case series indicate that single lacunar infarcts in, for example the thalamus, caudate nucleus or internal capsule can cause marked cognitive impairment...
April 25, 2017: Clinical Science (1979-)
Yanan Zhu, Yuek Ling Chai, Saima Hilal, M Kamran Ikram, Narayanaswamy Venketasubramanian, Boon-Seng Wong, Christopher P Chen, Mitchell K P Lai
INTRODUCTION: Neuroinflammation and cerebrovascular disease (CeVD) have been implicated in cognitive impairment and Alzheimer's disease (AD). The present study aimed to examine serum inflammatory markers in preclinical stages of dementia and in AD, as well as to investigate their associations with concomitant CeVD. METHODS: We performed a cross-sectional case-control study including 96 AD, 140 cognitively impaired no dementia (CIND), and 79 noncognitively impaired participants...
2017: Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring
Maria Del C Valdés Hernández, Xinyi Qiu, Xin Wang, Stewart Wiseman, Eleni Sakka, Lucy C Maconick, Fergus Doubal, Cathie L M Sudlow, Joanna M Wardlaw
BACKGROUND: In structural Magnetic Resonance Imaging (MRI) of patients with a recent small subcortical infarct (RSSI) and small vessel disease (SVD) imaging markers coexist. However, their spatial distribution and prevalence with respect to the hemisphere of the RSSI remain unknown. MATERIALS AND METHODS: From brain MRI in 187 patients with an acute lacunar ischemic stroke clinical syndrome and a relevant diffusion weighted imaging (DWI)-positive lesion, we semiautomatically extracted the RSSI, microbleeds, lacunes, old cortical infarcts, and white matter hyperintensities (WMH) using optimized thresholding in the relevant sequences, and rated the load of perivascular spaces...
January 2017: Brain and Behavior
Yifeng Ling, François De Guio, Marco Duering, Eric Jouvent, Dominique Hervé, Ophélia Godin, Martin Dichgans, Hugues Chabriat
BACKGROUND AND PURPOSE: Previous studies in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy showed that accumulation of lacunes strongly relate to clinical severity. However, the potential predictors of incident lacunes and their clinical consequences over a short time frame have not been investigated. This study aimed to determine the predictors and clinical impact of such lesions in a large cohort of patients. METHODS: Two hundred and six NOTCH3 mutation carriers (mean age, 49...
February 2017: Stroke; a Journal of Cerebral Circulation
Hiroko H Dodge, Jian Zhu, Randy Woltjer, Peter T Nelson, David A Bennett, Nigel J Cairns, David W Fardo, Jeffrey A Kaye, Deniz-Erten Lyons, Nora Mattek, Julie A Schneider, Lisa C Silbert, Chengjie Xiong, Lei Yu, Frederick A Schmitt, Richard J Kryscio, Erin L Abner
INTRODUCTION: The presence of cerebrovascular pathology may increase the risk of clinical diagnosis of Alzheimer's disease (AD). METHODS: We examined excess risk of incident clinical diagnosis of AD (probable and possible AD) posed by the presence of lacunes and large infarcts beyond AD pathology using data from the Statistical Modeling of Aging and Risk of Transition study, a consortium of longitudinal cohort studies with more than 2000 autopsies. We created six mutually exclusive pathology patterns combining three levels of AD pathology (low, moderate, or high AD pathology) and two levels of vascular pathology (without lacunes and large infarcts or with lacunes and/or large infarcts)...
June 2017: Alzheimer's & Dementia: the Journal of the Alzheimer's Association
Simrin Sennik, Tom A Schweizer, Corinne E Fischer, David G Munoz
BACKGROUND: Neuropsychiatric symptoms are common manifestations of Alzheimer's disease (AD). A number of studies have targeted psychosis, i.e., hallucinations and delusions in AD, but few have assessed agitation/aggression in AD. OBJECTIVE: To investigate the risk factors and pathological substrates associated with presence [A(+)] and absence [A(-)] of agitation/aggression (A) in autopsy-confirmed AD. METHODS: Data was collected from the UDS data as of 2015 on the NACC database...
2017: Journal of Alzheimer's Disease: JAD
Laurens Jl De Cocker, Arjen Lindenholz, Jaco Jm Zwanenburg, Anja G van der Kolk, Maarten Zwartbol, Peter R Luijten, Jeroen Hendrikse
Stroke and related cerebrovascular diseases are a major cause of mortality and disability. Even at standard-field-strengths (1.5T), MRI is by far the most sensitive imaging technique to detect acute brain infarctions and to characterize incidental cerebrovascular lesions, such as white matter hyperintensities, lacunes and microbleeds. Arterial time-of-flight (TOF) MR angiography (MRA) can depict luminal narrowing or occlusion of the major brain feeding arteries, and this without the need for contrast administration...
November 18, 2016: NeuroImage
Eric Jouvent, Edouard Duchesnay, Foued Hadj-Selem, François De Guio, Jean-François Mangin, Dominique Hervé, Marco Duering, Stefan Ropele, Reinhold Schmidt, Martin Dichgans, Hugues Chabriat
OBJECTIVE: To obtain simple models predicting disease evolution at 3 years for a given patient with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). METHODS: Based on data obtained in a prospective study of 236 patients, we built and validated models predicting, at the individual level, 3-year changes in Mini-Mental State Examination (MMSE), Mattis Dementia Rating Scale (MDRS), Trail Making Test version B (TMTB), and modified Rankin Scale (mRS)...
October 25, 2016: Neurology
Yuek Ling Chai, Saima Hilal, Jenny P C Chong, Yan Xia Ng, Oi Wah Liew, Xin Xu, Mohammad Kamran Ikram, Narayanaswamy Venketasubramanian, A Mark Richards, Mitchell K P Lai, Christopher P Chen
Vascular pathology plays an important role in the development of cognitive decline and dementia. In this context, growth differentiation factor-15 (GDF-15) has been suggested to be a biomarker due to its regulatory roles in inflammatory and trophic responses during tissue injury. However, limited data exist on the associations of GDF-15 with either cerebrovascular disease (CeVD) burden or the spectrum of cognitive impairment. Therefore, we aimed to study peripheral levels of GDF-15 incognitive impairment no dementia (CIND) or Alzheimer disease (AD) subjects assessed for CeVD using a case-control cohort design, with cases recruited from memory clinics and controls from memory clinics and the community...
August 2016: Medicine (Baltimore)
Xiangliang Chen, Lihui Duan, Yunfei Han, Ling Tian, Qiliang Dai, Shang Wang, Ying Lin, Yunyun Xiong, Xinfeng Liu
BACKGROUND: Around two thirds stroke patients may suffer from vascular cognitive impairment (VCI). Our previous study has validated the NINDS-CSN harmonization standard for VCI diagnosis in Chinese. In this study, we aimed to investigate the predictors for VCI in Chinese post-stroke patients. METHODS: We compared epidemiological, clinical, and neuroimaging data (number, size and location of acute infarcts and lacunes, severities of white matter hyperintensities and brain atrophy) between stroke patients with and without VCI...
July 26, 2016: BMC Neurology
Shanshan Duan, Shan Zhang, Liang Li, Chuancheng Ren, Juan Xie
BACKGROUND AND PURPOSE: Small deep brain infarcts are often caused by two different vascular pathologies: branch atheromatous disease (BAD) and lipohyalinotic degeneration (LD). In this study, we compare the clinical characteristics of BAD and LD and investigate the role of C-reactive protein (CRP), homocysteine (Hcy), and carotid artery intima-media thickness (IMT) in the prognosis of patients with BAD and LD. METHODS: Of 262 adult patients with small deep infarcts, 104 were considered BAD and 158 were considered LD...
April 2017: International Journal of Neuroscience
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