One-year follow-up of neuropsychology, MRI, rCBF and glucose metabolism (rMRGlu) in cerebral microangiopathy.
BACKGROUND
MRI shows lacunar infarctions (LI), deep white matter lesions (DWML) and atrophy in cerebral microangiopathy, which is said to lead to vascular dementia. In a first trial series on 57 patients with confirmed pure cerebral microangiopathy (without concomitant macroangiopathy), neuropsychological impairment and (where present) brain atrophy correlated with decreased rCBF and rMRGlu. LI and DWML did not correlate with either neuropsychological impairment or decreased rCBF/rMRGlu. This study was done one year later to detect changes in any of the study parameters.


METHODS
26 patients were re-examined for rCBF, rMRGlu, LI, DWML, atrophy and neuropsychological performance (7 cognitive, 3 mnestic, 4 attentiveness tests). Using a special head holder for exact repositioning, rCBF (SPECT) and rMRGlu (PET) were measured and imaged slice by slice. White matter/cortex were quantified using MRI-defined ROIs.


RESULTS
After one year the patients did not show significant decreases in rCBF or rMRGlu either in cortex or in white matter (p > 0.05), nor did any patient show LI, DWML or atrophy changes on MRI. There were no significant neuropsychological decreases (p > 0.05).


CONCLUSIONS
Cerebral microangiopathy ought to show progressive neuropsychological, functional (rCBF, rMRGlu) and morphological deterioration over periods > 1 year. It is unlikely that direct cortical damage (e.g., incomplete infarction) is responsible for neuropsychological impairment since one-year follow-up of our patients revealed no progression of brain atrophy or any other cortical damage.
Sabri
O
O
Department of Nuclear Medicine, Aachen University of Technology, Germany.
Hellwig
D
D
Schreckenberger
M
M
Schneider
R
R
Kaiser
H J
HJ
Wagenknecht
G
G
Setani
K
K
Reinartz
P
P
Zimny
M
M
Mull
M
M
Ringelstein
E B
EB
Büll
U
U
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000523:psychology*; D003071:Cognition; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D005500:Follow-Up Studies; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D008875:Middle Aged; D009483:Neuropsychological Tests; D009928:Organ Specificity; D019690:Technetium Tc 99m Exametazime / Q000493:pharmacokinetics; D013997:Time Factors; D014055:Tomography, Emission-Computed; D015899:Tomography, Emission-Computed, Single-Photon
D019788:Fluorodeoxyglucose F18; D019690:Technetium Tc 99m Exametazime; D005947:Glucose