title: Cholinergic circuitry functioning in patients with vascular cognitive impairment--no dementia.
abstract: BACKGROUND
  An impairment of central cholinergic activity, as evaluated non-invasively by the short-latency afferent inhibition (SAI) of motor responses evoked by transcranial magnetic stimulation (TMS), was observed in patients with Alzheimer's disease (AD) and amnestic Mild Cognitive Impairment. Conversely, the involvement of central cholinergic neurotransmission in vascular dementia (VaD) is still under debate and data on Vascular Cognitive Impairment--No Dementia (VCI-ND) at risk for future VaD are lacking.
  
  
  OBJECTIVE
  To test for the first time SAI in patients with VCI-ND.
  
  
  METHODS
  Single-pulse TMS measures of cortical excitability and SAI were evaluated in 25 VCI-ND patients with subcortical ischemic lesions and 20 age-matched healthy controls. Functional status, neuropsychological tests evaluating frontal lobe abilities, and white matter lesions (WMLs) load were assessed.
  
  
  RESULTS
  A significant difference was found between patients and controls for the mean SAI, although this result did not resist after the Bonferroni correction. In the whole group of patients and controls, SAI showed a correlation with worse scores at the Montreal Cognitive Assessment (r = 0.376, p < 0.01). SAI also positively correlated with the total vascular burden (r = 0.345, p < 0.05) but not with the WML severity.
  
  
  CONCLUSIONS
  Central cholinergic pathway does not seem to be involved in VCI-ND, and the current results differ from those reported in primary cholinergic forms of dementia, such as AD. SAI might represent a valuable additional tool in the differential diagnosis of the dementing processes and in identifying potential responders to cholinergic agents.
authors.affiliation: Department of Medical and Surgical Sciences and Advanced Technologies, Section of Neurosciences, University of Catania, Catania, Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Bella
authors.affiliation: Department of Neurology I.C., "Oasi" Institute for Research on Mental Retardation and Brain Aging (I.R.C.C.S.), Troina (EN), Italy.
authors.forename: Mariagiovanna
authors.initials: M
authors.lastname: Cantone
authors.affiliation: Department of Neurology I.C., "Oasi" Institute for Research on Mental Retardation and Brain Aging (I.R.C.C.S.), Troina (EN), Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lanza
authors.affiliation: Department of Neurology I.C., "Oasi" Institute for Research on Mental Retardation and Brain Aging (I.R.C.C.S.), Troina (EN), Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Ferri
authors.affiliation: Department of Medical and Surgical Sciences and Advanced Technologies, Section of Neurosciences, University of Catania, Catania, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Vinciguerra
authors.affiliation: Department of Medical and Surgical Sciences and Advanced Technologies, Section of Neurosciences, University of Catania, Catania, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Puglisi
authors.affiliation: Spinal Unit, Emergency Hospital "Cannizzaro", Catania, Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Pennisi
authors.affiliation: Department of Medical and Surgical Sciences and Advanced Technologies, Section of Neurosciences, University of Catania, Catania, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Ricceri
authors.affiliation: Institute of Neurology, Campus Bio Medico University, Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Di Lazzaro
authors.affiliation: Department of Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy. Electronic address: pennigi@unict.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pennisi
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis / Q000503:physiopathology; D016022:Case-Control Studies; D018678:Cholinergic Agents / Q000627:therapeutic use; D059329:Cholinergic Neurons / Q000502:physiology*; D003071:Cognition; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology*; D015140:Dementia, Vascular / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000502:physiology; D009434:Neural Pathways; D009483:Neuropsychological Tests; D009435:Synaptic Transmission; D050781:Transcranial Magnetic Stimulation; D066127:White Matter / Q000473:pathology
chemical_list: D018678:Cholinergic Agents
keywords: Acetylcholine; Cortical excitability; Executive dysfunction; Transcranial magnetic stimulation; Vascular dementia; White matter lesions