Mild cognitive impairment after lacunar infarction: voxel-based morphometry and neuropsychological assessment.
BACKGROUND
The aim of the present study was to investigate whether there were differences in neuroradiological features, including white-matter lesions and gray-matter volumes, between patients with lacunar infarction with and without mild cognitive impairment of the vascular type (MCI-V).


METHODS
A total of 40 patients with lacunar infarction were studied within 1 month after stroke.


RESULTS
MCI-V was found in 22 patients, who in comparison with patients without cognitive impairment were significantly older and had fewer years of formal education. MRI subcortical hyperintensities especially in the basal ganglia (putamen and thalamus) were significantly more frequent in the MCI-V group. In the voxel-based morphometric study, patients with MCI-V showed more atrophy bilaterally in the middle temporal gyrus, right and left frontal and posterior bilateral occipitoparietal regions including the posterior cingulate as well as in the cerebellum. A region of interest analysis restricted to the parahippocampi and hippocampi showed further reduced bilateral parahippocampal gyrus and right hippocampus volume reductions in this group of patients. Finally, the amount of white-matter lesions among MCI-V showed negative correlations with gray-matter volume in frontal and temporal areas as well as with the thalamus and mesencephalon.


CONCLUSIONS
The present findings provide support for an anatomical substrate of the MCI entity in patients with lacunar infarction. Both gray- and white-matter changes seem to contribute to the cognitive impairment of such patients.
Grau-Olivares
Marta
M
Cerebrovascular Division, Department of Neurology, Hospital Universitari del Sagrat Cor, Barcelona, Spain.
Bartrés-Faz
David
D
Arboix
Adrià
A
Soliva
Joan-Carles
JC
Rovira
Mariana
M
Targa
Cecilia
C
Junqué
Carme
C
D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy; D001479:Basal Ganglia / Q000473:pathology; D020520:Brain Infarction / Q000150:complications* / Q000473:pathology / Q000523:psychology; D001931:Brain Mapping / Q000379:methods*; D002531:Cerebellum / Q000473:pathology; D002540:Cerebral Cortex / Q000473:pathology; D003072:Cognition Disorders / Q000209:etiology* / Q000473:pathology / Q000523:psychology; D015140:Dementia, Vascular / Q000150:complications / Q000209:etiology* / Q000473:pathology / Q000523:psychology; D005260:Female; D006624:Hippocampus / Q000473:pathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008636:Mesencephalon / Q000473:pathology; D009483:Neuropsychological Tests; D012720:Severity of Illness Index; D013788:Thalamus / Q000473:pathology