Association of Magnetic Resonance Imaging Markers of Cerebrovascular Disease Burden and Cognition.
OBJECTIVE
The present study sought to examine the association between the burden of cerebrovascular disease (CeVD) as assessed by multimodal magnetic resonance imaging and neurocognitive function.


METHODS
Cognitively impaired patients and controls were tested on an extensive neuropsychological battery and underwent multimodal brain magnetic resonance imaging. CeVD markers determined from magnetic resonance imaging included the presence of multiple lacunes, multiple cerebral microbleeds, and moderate or severe white matter hyperintensities as markers for small-vessel disease and cortical stroke and intracranial stenosis as markers for large-vessel disease. A weighted CeVD burden score was constructed, and its association with global and domain-specific cognitive performance was investigated.


RESULTS
A total of 305 cases and 94 controls were included in the analysis. A graded association of CeVD burden with neurocognitive function was found. Moreover, a clear threshold of CeVD burden was associated with severe impairment. White matter hyperintensities was associated with global neurocognitive deficits, whereas microbleeds were associated with domain-specific impairments.


CONCLUSIONS
The weighted CeVD burden score comprising markers of both small- and large-vessel diseases were associated with deficits in both global and domain-specific neurocognitive function. Additional studies are needed to validate the use of this CeVD burden score for the prediction of dementia.
From the Departments of Pharmacology (X.X., S.H., E.J.Y.C., C.L.-H.C.) and Psychology (S.L.C.) and Academic Medicine Research Institute, Duke-NUS Graduate Medical School (M.K.I.), National University of Singapore, Singapore, Singapore; Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore (X.X., S.H., E.J.Y.C., M.K.I., N.V., C.L.-H.C.); and Raffles Neuroscience Centre, Raffles Hospital, Singapore, Singapore (N.V.).
Xin
X
Xu
From the Departments of Pharmacology (X.X., S.H., E.J.Y.C., C.L.-H.C.) and Psychology (S.L.C.) and Academic Medicine Research Institute, Duke-NUS Graduate Medical School (M.K.I.), National University of Singapore, Singapore, Singapore; Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore (X.X., S.H., E.J.Y.C., M.K.I., N.V., C.L.-H.C.); and Raffles Neuroscience Centre, Raffles Hospital, Singapore, Singapore (N.V.).
Saima
S
Hilal
From the Departments of Pharmacology (X.X., S.H., E.J.Y.C., C.L.-H.C.) and Psychology (S.L.C.) and Academic Medicine Research Institute, Duke-NUS Graduate Medical School (M.K.I.), National University of Singapore, Singapore, Singapore; Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore (X.X., S.H., E.J.Y.C., M.K.I., N.V., C.L.-H.C.); and Raffles Neuroscience Centre, Raffles Hospital, Singapore, Singapore (N.V.).
Simon L
SL
Collinson
From the Departments of Pharmacology (X.X., S.H., E.J.Y.C., C.L.-H.C.) and Psychology (S.L.C.) and Academic Medicine Research Institute, Duke-NUS Graduate Medical School (M.K.I.), National University of Singapore, Singapore, Singapore; Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore (X.X., S.H., E.J.Y.C., M.K.I., N.V., C.L.-H.C.); and Raffles Neuroscience Centre, Raffles Hospital, Singapore, Singapore (N.V.).
Eddie Jun Yi
EJ
Chong
From the Departments of Pharmacology (X.X., S.H., E.J.Y.C., C.L.-H.C.) and Psychology (S.L.C.) and Academic Medicine Research Institute, Duke-NUS Graduate Medical School (M.K.I.), National University of Singapore, Singapore, Singapore; Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore (X.X., S.H., E.J.Y.C., M.K.I., N.V., C.L.-H.C.); and Raffles Neuroscience Centre, Raffles Hospital, Singapore, Singapore (N.V.).
Mohammad Kamran
MK
Ikram
From the Departments of Pharmacology (X.X., S.H., E.J.Y.C., C.L.-H.C.) and Psychology (S.L.C.) and Academic Medicine Research Institute, Duke-NUS Graduate Medical School (M.K.I.), National University of Singapore, Singapore, Singapore; Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore (X.X., S.H., E.J.Y.C., M.K.I., N.V., C.L.-H.C.); and Raffles Neuroscience Centre, Raffles Hospital, Singapore, Singapore (N.V.).
Narayanaswamy
N
Venketasubramanian
From the Departments of Pharmacology (X.X., S.H., E.J.Y.C., C.L.-H.C.) and Psychology (S.L.C.) and Academic Medicine Research Institute, Duke-NUS Graduate Medical School (M.K.I.), National University of Singapore, Singapore, Singapore; Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore (X.X., S.H., E.J.Y.C., M.K.I., N.V., C.L.-H.C.); and Raffles Neuroscience Centre, Raffles Hospital, Singapore, Singapore (N.V.). phccclh@nus.edu.sg.
Christopher Li-Hsian
CL
Chen
D000368:Aged; D016022:Case-Control Studies; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000473:pathology*; D003072:Cognition Disorders / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging / Q000379:methods*; D009483:Neuropsychological Tests
cerebrovascular disorders; cognition; magnetic resonance imaging; stroke