Cortical atrophy, reduced integrity of white matter and cognitive impairment in subcortical vascular dementia of Binswanger type.
OBJECTIVE
An association between white matter hyperintensities (WMH) and cognitive dysfunction has long been recognized. However, subjects with identically appearing WMH on magnetic resonance imaging present with a wide variance in cognitive function ranging from normal cognition to dementia. The aim of this study was to compare cortical atrophy and integrity of white matter of patients with subcortical vascular dementia of Binswanger type (SVaD-BT) with those of the normal cognition group with WMH (ncWMH).


METHODS
Eleven patients with SVaD-BT and 11 age-, sex-, education- and grade of WMH-matched ncWMH underwent magnetic resonance imaging, including 3-D volumetric images for cortical atrophy and diffusion tensor imaging for integrity of white matter.


RESULTS
Compared to ncWMH, SVaD-BT patients showed cortical atrophies in frontal (i.e. frontal pole, precentral gyrus and frontal medial cortex) and occipital areas (i.e. lingual gyrus) followed by atrophies in temporal (i.e. fusiform cortex and middle temporal gyrus) areas. Along with cortical atrophies, reduced integrity with low fractional anisotropy and high mean diffusivity values in genu and splenium of the corpus callosum were detected in SVaD-BT patients.


CONCLUSIONS
Our findings suggest that cognitive decline from ncWMH to SVaD-BT may be associated with cortical atrophy and reduced integrity of white matter.
Department of Biomedical Engineering and FIRST, Inje University, Gimhae, Korea.
Won-Beom
WB
Jung
Department of Biomedical Engineering and FIRST, Inje University, Gimhae, Korea.
Chi-Woong
CW
Mun
Department of Psychiatry, Medical School, Haeundae Paik Hospital, Inje University, Busan, Korea.
Young-Hoon
YH
Kim
Department of Psychiatry, Pusan National University Hospital, Busan, Korea.|Medical Research Institute, Pusan National University Hospital, Busan, Korea.
Je Min
JM
Park
Department of Psychiatry, Pusan National University Hospital, Busan, Korea.|Medical Research Institute, Pusan National University Hospital, Busan, Korea.
Byung Dae
BD
Lee
Department of Psychiatry, Pusan National University Hospital, Busan, Korea.|Medical Research Institute, Pusan National University Hospital, Busan, Korea.
Young Min
YM
Lee
Department of Psychiatry, Pusan National University Hospital, Busan, Korea.|Medical Research Institute, Pusan National University Hospital, Busan, Korea.
Eunsoo
E
Moon
Department of Psychiatry, Pusan National University Hospital, Busan, Korea.|Medical Research Institute, Pusan National University Hospital, Busan, Korea.
Hee Jeong
HJ
Jeong
Department of Psychiatry, Pusan National University Yangsan Hospital, Yangsan, Korea.
Young In
YI
Chung
D000368:Aged; D001284:Atrophy / Q000473:pathology; D002540:Cerebral Cortex / Q000473:pathology*; D003072:Cognition Disorders / Q000209:etiology / Q000473:pathology*; D015140:Dementia, Vascular / Q000150:complications / Q000473:pathology*; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D066127:White Matter / Q000473:pathology*
cortical atrophy; diffusion tensor imaging; integrity of white matter; magnetic resonance imaging; subcortical vascular dementia of Binswanger type