title: Cerebral changes and cognitive impairment after an ischemic heart disease: a multimodal MRI study.
abstract: Three to 6 months after an acute coronary syndrome (ACS), cognitive impairment is observed in more than 30 % of the patients, mainly in executive functioning. The aim of this study was to investigate, using multimodal MRI, cerebral anatomo-functional substratum of executive dysfunction. Thirty-three patients were recruited 4 ± 1 months after a first ACS. Executive functions were evaluated with the Trail-Making-Test-B (TMTB) at baseline (ie 4 ± 1 months after ACS) and 6 months later (ie 10 ± 1 months after ACS). Using both time-points, we identified 3 groups of patients according to normative data based on age, gender and education level: 15 'cognitively normal' patients without impairment at each follow-up, 10 'transient impaired' patients with an impairment only at baseline and 8 'impairing' patients with an impairment only at follow-up. We explored, in the whole-brain, the structural integrity using Voxel-Based Morphometry and Tract-Based Spatial Statistics and the resting-state functional connectivity using Network-Based Statistics. No structural difference was observed between impaired and cognitively normal patients. At the functional level, compared to the 'cognitively normal' group, the 'transient impaired' patients presented an increased functional connectivity in a network centered on middle-orbito-frontal regions, whereas the 'impairing' patients presented only a non-significant decrease of functional connectivity. Executive dysfunction in ACS patients is associated to functional but no structural characteristics, particularly to an increased functional connectivity in cognitive networks in transient impaired patients. Further studies with larger sample size are needed to confirm these results and to determine if these patients could be at higher risk for developing permanent cognitive disorders.
authors.affiliation: Univ. Bordeaux, INCIA, UMR 5287, F-33400, Talence, France. charlotte.bernard1@yahoo.fr.|CNRS, INCIA, UMR 5287, F-33400, Talence, France. charlotte.bernard1@yahoo.fr.|INCIA UMR 5287 CNRS, Univ. Bordeaux, Equipe de Neuroimagerie et Cognition Humaine, 146 rue Léo Saignat, zone Nord-Case 22, 33076, Bordeaux, cedex, France. charlotte.bernard1@yahoo.fr.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Bernard
authors.affiliation: Univ. Bordeaux, INCIA, UMR 5287, F-33400, Talence, France.|CNRS, INCIA, UMR 5287, F-33400, Talence, France.|EPHE, Bordeaux, France.
authors.forename: Gwénaëlle
authors.initials: G
authors.lastname: Catheline
authors.affiliation: Univ. Bordeaux, INCIA, UMR 5287, F-33400, Talence, France.|CNRS, INCIA, UMR 5287, F-33400, Talence, France.
authors.forename: Bixente
authors.initials: B
authors.lastname: Dilharreguy
authors.affiliation: Univ Bordeaux, Centre Hospitalier Universitaire de Bordeaux, Centre d'Exploration, de Prévention et de Traitement de l'Athérosclérose (CEPTA), Pessac, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Couffinhal
authors.affiliation: Univ Bordeaux, Centre Hospitalier Universitaire de Bordeaux, Unité Neurovasculaire, Pôle de Neurosciences Cliniques, Hôpital Pellegrin, 33076, Bordeaux, France.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Ledure
authors.affiliation: Univ. Bordeaux, INCIA, UMR 5287, F-33400, Talence, France.|CNRS, INCIA, UMR 5287, F-33400, Talence, France.
authors.forename: Saioa
authors.initials: S
authors.lastname: Lassalle-Lagadec
authors.affiliation: Univ. Bordeaux, INCIA, UMR 5287, F-33400, Talence, France.|CNRS, INCIA, UMR 5287, F-33400, Talence, France.
authors.forename: Dorothée
authors.initials: D
authors.lastname: Callaert
authors.affiliation: Univ. Bordeaux, INCIA, UMR 5287, F-33400, Talence, France.|CNRS, INCIA, UMR 5287, F-33400, Talence, France.|EPHE, Bordeaux, France.
authors.forename: Michèle
authors.initials: M
authors.lastname: Allard
authors.affiliation: Univ. Bordeaux, INCIA, UMR 5287, F-33400, Talence, France.|CNRS, INCIA, UMR 5287, F-33400, Talence, France.|Univ Bordeaux, Centre Hospitalier Universitaire de Bordeaux, Unité Neurovasculaire, Pôle de Neurosciences Cliniques, Hôpital Pellegrin, 33076, Bordeaux, France.
authors.forename: Igor
authors.initials: I
authors.lastname: Sibon
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000523:psychology*; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003072:Cognition Disorders / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000503:physiopathology; D056324:Diffusion Tensor Imaging; D056344:Executive Function / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D066128:Gray Matter / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009434:Neural Pathways / Q000000981:diagnostic imaging / Q000503:physiopathology; D009483:Neuropsychological Tests; D012146:Rest
keywords: Acute coronary syndrome; Cognitive impairment; Executive functioning; Functional MRI; Resting-state; Structural MRI