title: Selective neuronal damage and Wisconsin Card Sorting Test performance in atherosclerotic occlusive disease of the major cerebral artery.
abstract: BACKGROUND
  In atherosclerotic internal carotid artery (ICA) or middle cerebral artery (MCA) disease, selective neuronal damage can be detected as a decrease in central benzodiazepine receptors (BZRs) in the normal-appearing cerebral cortex. This study aimed to determine whether a decrease in the BZRs in the non-infarcted cerebral cortex is associated with poor performance on the Wisconsin Card Sorting Test (WCST), which assesses executive functions.
  
  
  METHODS
  The authors measured the BZRs using positron emission tomography and (11)C-flumazenil in 60 non-disabled patients with unilateral atherosclerotic ICA or MCA disease and no cortical infarction. Using three-dimensional stereotactic surface projections, the abnormally decreased BZR index (extent (%) of pixels with Z score >2 compared with controls × average Z score in those pixels) in the cerebral cortex of the anterior cerebral artery (ACA) or MCA territory was calculated and found to be correlated with the patient's score on the WCST.
  
  
  RESULTS
  On the basis of the WCST results, 39 patients were considered abnormal (low categories achieved) for their age. The BZR index of the ACA territory in the hemisphere affected by arterial disease was significantly higher in abnormal patients than in normal patients. The BZR index of the MCA territory differed significantly between the two groups when patients with left arterial disease (n=28) were analysed separately.
  
  
  CONCLUSIONS
  In atherosclerotic ICA or MCA disease, selective neuronal damage that is manifested as a decrease in BZRs in the non-infarcted cerebral cortex may contribute to the development of executive dysfunction.
authors.affiliation: Human Brain Research Center, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, Japan. yamauchi@kuhp.kyoto-u.ac.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamauchi
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Nishii
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Higashi
authors.forename: Shinya
authors.initials: S
authors.lastname: Kagawa
authors.forename: Hidenao
authors.initials: H
authors.lastname: Fukuyama
mesh_terms: D000368:Aged; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000473:pathology* / Q000523:psychology*; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000523:psychology*; D001923:Brain Chemistry / Q000502:physiology; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000523:psychology; D002539:Cerebral Arterial Diseases / Q000000981:diagnostic imaging / Q000473:pathology* / Q000523:psychology*; D002560:Cerebrovascular Circulation / Q000502:physiology; D003627:Data Interpretation, Statistical; D056344:Executive Function / Q000502:physiology*; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000523:psychology; D002546:Ischemic Attack, Transient / Q000000981:diagnostic imaging / Q000473:pathology / Q000523:psychology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009474:Neurons / Q000473:pathology*; D009483:Neuropsychological Tests; D010101:Oxygen Consumption / Q000502:physiology; D049268:Positron-Emission Tomography; D011963:Receptors, GABA-A / Q000378:metabolism; D020521:Stroke / Q000000981:diagnostic imaging / Q000473:pathology / Q000523:psychology
chemical_list: D011963:Receptors, GABA-A
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