Brain atrophy and cerebral small vessel disease: a prospective follow-up study.

Abstract:

BACKGROUND AND PURPOSE:cerebral small vessel disease (SVD) is the most common cause of vascular dementia. Interest in the use of surrogate markers is increasing. The aims of this study were to determine if brain volume was different between patients with SVD and control subjects, whether it correlated with cognition in SVD, and whether changes in brain volume could be detected during prospective follow-up. METHODS:thirty-five patients (mean age, 68.8 years) who had a lacunar stroke and radiological evidence of confluent leukoaraiosis and 70 age- and gender-matched control subjects were recruited. Whole-brain T1-weighted imaging and neuropsychological testing were performed after 1 year on all patients and after 2 years for the control subjects. Fully automated software was used to determine brain volume and percentage brain volume change. An executive function score was derived. RESULTS:there was a significant difference in brain volume between the patients with SVD and control subjects (mean ± SD [mL] 1529 ± 84 versus 1573 ± 69, P=0.019). In the patients with SVD, there was a significant association between brain volume and executive function (r=0.501, P<0.05). The mean ± SD yearly brain atrophy rate for patients with SVD and control subjects was significantly different (-0.914% ± 0.8% versus -0.498% ± 0.4%, respectively, P=0.017). No change in executive function score was detected over this period. CONCLUSIONS:brain volume is reduced in SVD and a decline is detectable prospectively. The correlation with executive function at a cross-sectional level and the change in brain volume with time are both promising for the use of brain atrophy as a surrogate marker of SVD progression.

journal_name

Stroke

journal_title

Stroke

authors

Nitkunan A,Lanfranconi S,Charlton RA,Barrick TR,Markus HS

doi

10.1161/STROKEAHA.110.594267

subject

Has Abstract

pub_date

2011-01-01 00:00:00

pages

133-8

issue

1

eissn

0039-2499

issn

1524-4628

pii

STROKEAHA.110.594267

journal_volume

42

pub_type

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