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Vol. 24, No. 2-3, 2007
Issue release date: August 2007
Cerebrovasc Dis 2007;24:271–276

Cognitive Performance after Lacunar Stroke Correlates with Leukoaraiosis Severity

McMurtray A.M. · Liao A. · Haider J. · Licht E. · Mendez M.F.
aDepartments of Neurology and Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at the University of California at Los Angeles, and bV.A. Greater Los Angeles Healthcare System, Los Angeles, Calif., USA

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Background: This study investigates the effect of leukoaraiosis on patients presenting with cognitive impairment after lacunar stroke. Methods: Fourty-six patients with cognitive impairment and newly discovered lacunar stroke detected by brain magnetic resonance imaging underwent neuropsychological testing. Results: Patients with both lacunar infarct and leukoaraiosis performed less well on cognitive measures, compared to those with lacunar infarcts alone. Additionally, leukoaraiosis severity inversely correlated with cognitive performance. Conclusions: In patients with lacunar stroke, presence of leukoaraiosis is associated with worse performance in multiple cognitive domains. These findings suggest lacunar infarcts plus leukoaraiosis is a common etiology for vascular dementia.

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  1. Longstreth WT Jr, Bernick C, Manolio TA, Bryan N, Jungreis CA, Price TR: Lacunar infarcts defined by magnetic resonance imaging of 3660 elderly people: the Cardiovascular Health Study. Arch Neurol 1998;55:1217–1225
  2. Mendez MF, Cummings JL: Dementia. A Clinical Approach, ed 3. Philadelphia, Elsevier Science Publishing Company, 2003.
  3. Vermeer SE, Den Heijer T, Koudstaal PJ, Oudkerk M, Hofman A, Breteler MM; Rotterdam Scan Study: Incidence and risk factors of silent brain infarcts in the population-based Rotterdam Scan Study. Stroke 2003;34:392–396.
  4. Hachinski VC, Potter P, Merskey H: Leuko-araiosis. Arch Neurol 1987;44:21–23
  5. Roman GC, Erkinjuntti T, Wallin A, Pantoni L, Chui HC: Subcortical ischemic vascular dementia. Lancet Neurol 2002;1:426–436.
  6. De Groot JC, De Leeuw FE, Oudkerk M, van Gijn J, Hofman A, Jolles J, Breteler MM: Cerebral white matter lesions and cognitive function: the Rotterdam Scan Study. Ann Neurol 2000;47:145–151.
  7. Longstreth WT Jr, Manolio TA, Arnold A, Burke GL, Bryan N, Jungreis CA, Enright PL, O’Leary D, Fried L: Clinical correlates of white matter findings on cranial magnetic resonance imaging of 3301 elderly people: the Cardiovascular Health Study. Stroke 1996;27:1274–1282.
  8. De Groot JC, De Leeuw FE, Oudkerk M, Van Gijn J, Hofman A, Jolles J, Breteler MM: Periventricular cerebral white matter lesions predict rate of cognitive decline. Ann Neurol 2002;52:335–341.
  9. Wen HM, Mok VCT, Fan YH, Lam WWM, Tang WK, Wong A, Huang RX, Wong KS: Effect of white matter changes on cognitive impairment in patients with lacunar infarcts. Stroke 2004;35:1826–1830.
  10. Van Swieten JC, Staal S, Kappelle LJ, Derix MM, van Gijin J: Are white matter lesions directly associated with cognitive impairment in patients with lacunar infarcts? J Neurol 1996;243:196–200.
  11. Sabri O, Ringelstein EB, Hellwig D, Schneider R, Schreckenberger M, Kaiser HJ, Mull M, Buell U: Neuropsychological impairment correlates with hypoperfusion and hypometabolism but not with severity of white matter lesions on MRI in patients with cerebral microangiopathy. Stroke 1999;30:556–566.
  12. Folstein MF, Folstein SE, McHugh PR: Mini-Mental State: a practical method for grading cognitive states of patients for the clinician. J Psychiatr Res 1975;12:189–198.
  13. Morris JC, Heyman A, Mohs RC, Hughes JP, van Belle G, Fillenbaum G, Mellits ED, Clark C: The consortium to establish a registry for Alzheimer’s disease (CERAD). 1. Clinical and neuropsychological assessment of Alzheimer’s disease. Neurology 1989;9:1159–1165.
  14. De Leeuw F-E, de Groot JC, Achten E, Oudkerk M, Ramos LMP, Heijboer R, Hofman A, Jolles J, van Gijn J, Breteler MM: Prevalence of cerebral white matter lesions in elderly people: a population-based magnetic resonance imaging study – The Rotterdam Scan Study. J Neurol Neurosurg Psychiatry 2001;70:9–14.
  15. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, ed 4. Washington, American Psychiatric Association, 1994.
  16. Chui HC, Victoroff JI, Margolin D, Jagust W, Shankle R, Katzman R: Criteria for the diagnosis of ischemic vascular dementia proposed by the State of California Alzheimer’s Disease Diagnostic and Treatment Centers. Neurology 1992;42:473–480.
  17. Roman GC, Tatemichi TK, Erkinjuntti T, Cummings JL, Masdeu JC, Garcia JH, Amaducci L, Orgogozo JM, Brun A, Hofman A, et al: Vascular dementia: diagnostic criteria for research studies – report of the NINDS-AIREN International Workshop. Neurology 1993;43:250–260.
  18. Hachinski VC, Lassen NA, Marshall J: Multi-infarct dementia: a cause of mental deterioration in the elderly. Lancet 1974;2:207–210.
  19. World Health Organization: International Statistical Classification of Diseases and Related Health Problems, rev. Geneva, World Health Organization, 1992, pp 311–388.
  20. Knopman D, Parisi JE, Boeve BF, Cha RH, Apaydin H, Salviati A, Edland SD, Rocca WA: Vascular dementia in a population-based autopsy study. Arch Neurol 2003;60:569–575.
  21. Knopman D: Vascular dementia. Continuum 2004;10:113–134.
  22. Looi JC, Sachdev PS: Differentiation of vascular dementia from AD on neuropsychological tests. Neurology 1999;53:670–678.
  23. Lobo A, Launer LJ, Fratiglioni L, Andersen K, Di Carlo A, Breteler MM, Copeland JR, Dartiques JF, Jagger C, Martinez-Lage J, Soininen H, Hofman A; Neurologic Diseases in the Elderly Research Group: Prevalence of dementia and major subtypes in Europe: a collaborative study of population-based cohorts. Neurology 2000;54:S4–S9.
  24. Canadian Study of Health and Aging Working Group: Canadian Study of Health and Aging: study methods and prevalence of dementia. Can Med Assoc J 1994;150:899–913.
  25. Fratiglioni L, Launer LJ, Andersen K, Breteler MM, Copeland JR, Dartiques JF, Lobo A, Martinez-Lage J, Soininen H, Hofman A; Neurological Diseases in the Elderly Research Group: Incidence of dementia and major subtypes in Europe: a collaborative study of population-based cohorts. Neurology 2000;54:S10–S15.
  26. Jellinger KA, Attems J: Prevalence and impact of cerebrovascular pathology in Alzheimer’s disease and Parkinsonism. Acta Neurol Scand 2006;115:38–46.

    External Resources

  27. Knopman D, Rocca WA, Cha RH, Edland SD, Kokmen E: Incidence of vascular dementia in Rochester, Minnesota, 1985–1989. Arch Neurol 2002;59:1605–1610.

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