Cortical thinning in vascular mild cognitive impairment and vascular dementia of subcortical type.
OBJECTIVE
Amnestic mild cognitive impairment (MCI) is known to be a preclinical stage of Alzheimer's disease (AD). Similarly, MCI associated with small-vessel disease (svMCI), might be a forme froste of subcortical vascular dementia (SVaD). Patterns of cortical thinning in addition to the ischemia rating on MRI may further elucidate the clinical characteristics and pathogenesis of SVaD and svMCI. We tried to determine if svMCI differs from SVaD in the distribution of cortical atrophy, which may help understand the hierarchy between svMCI and SVaD and possibly also how svMCI evolves into SVaD.


METHODS
Twenty patients with SVaD, 34 patients with svMCI, 115 patients with AD, and 96 individuals with normal-cognition (NC) were imaged with magnetic resonance imaging (MRI) including 3-dimensional volumetric images for cortical thickness analysis across the entire brain.


RESULTS
Compared to NC, svMCI patients showed cortical thinning in inferior frontal and orbitofrontal gyri, anterior cingulate, insula, superior temporal gyrus, and lingual gyrus, while cortical thinning in SVaD patients involved all these areas plus dorsolateral prefrontal and temporal cortices.


CONCLUSIONS
Our findings suggest the presence of hierarchy between svMCI and SVaD, and that the cognitive decline from svMCI to SVaD is associated with lesions in dorsolateral prefrontal and temporal cortices.
Seo
Sang Won
SW
Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.
Ahn
Jaewon
J
Yoon
Uicheul
U
Im
Kiho
K
Lee
Jong-Min
JM
Tae Kim
Sung
S
Ahn
Hyun-Jung
HJ
Chin
Juhee
J
Jeong
Yong
Y
Na
Duk L
DL
D000367:Age Factors; D000368:Aged; D002540:Cerebral Cortex / Q000473:pathology*; D002561:Cerebrovascular Disorders / Q000473:pathology*; D003072:Cognition Disorders / Q000473:pathology*; D003430:Cross-Sectional Studies; D003627:Data Interpretation, Statistical; D015140:Dementia, Vascular / Q000473:pathology*; D004522:Educational Status; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009413:Nerve Fibers, Myelinated / Q000473:pathology; D009483:Neuropsychological Tests; D015588:Observer Variation; D009929:Organ Size; D012737:Sex Factors