SORA

Advancing, promoting and sharing knowledge of health through excellence in teaching, clinical practice and research into the prevention and treatment of illness

Strategic lacunes and their relationship to cognitive impairment in cerebral small vessel disease.

Benjamin, P; Lawrence, AJ; Lambert, C; Patel, B; Chung, AW; MacKinnon, AD; Morris, RG; Barrick, TR; Markus, HS (2014) Strategic lacunes and their relationship to cognitive impairment in cerebral small vessel disease. Neuroimage Clinical, 4. 828 - 837. ISSN 2213-1582 https://doi.org/10.1016/j.nicl.2014.05.009
SGUL Authors: Barrick, Thomas Richard Lawrence, Andrew John Lambert, Christian Paul Benjamin, Philip

[img]
Preview
["document_typename_application/pdf; charset=binary" not defined] Published Version
Available under License St George's repository terms & conditions.

Download (1MB) | Preview

Abstract

Objectives: Lacunes are an important disease feature of cerebral small vessel disease (SVD) but their relationship to cognitive impairment is not fully understood. To investigate this we determined (1) the relationship between lacune count and total lacune volume with cognition, (2) the spatial distribution of lacunes and the cognitive impact of lacune location, and (3) the whole brain anatomical covariance associated with these strategically located regions of lacune damage. Methods: One hundred and twenty one patients with symptomatic lacunar stroke and radiological leukoaraiosis were recruited and multimodal MRI and neuropsychological data acquired. Lacunes were mapped semi-automatically and their volume calculated. Lacune location was automatically determined by projection onto atlases, including an atlas which segments the thalamus based on its connectivity to the cortex. Lacune locations were correlated with neuropsychological results. Voxel based morphometry was used to create anatomical covariance maps for these ‘strategic’ regions. Results: Lacune number and lacune volume were positively associated with worse executive function (number p < 0.001; volume p < 0.001) and processing speed (number p < 0.001; volume p < 0.001). Thalamic lacunes, particularly those in regions with connectivity to the prefrontal cortex, were associated with impaired processing speed (Bonferroni corrected p = 0.016). Regions of associated anatomical covariance included the medial prefrontal, orbitofrontal, anterior insular cortex and the striatum. Conclusion: Lacunes are important predictors of cognitive impairment in SVD. We highlight the importance of spatial distribution, particularly of anteromedial thalamic lacunes which are associated with impaired information processing speed and may mediate cognitive impairment via disruption of connectivity to the prefrontal cortex.

Item Type: Article
Additional Information: 2014 Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license( http: // creativecommons.org / licenses / by-nc-nd / 3.0 / ).
Keywords: Cognitive Impairment, Lacunes, Small vessel disease, Cognitive Impairment, Lacunes, Small vessel disease
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) > Neuroscience (INCCNS)
Journal or Publication Title: Neuroimage Clinical
ISSN: 2213-1582
Related URLs:
Dates:
DateEvent
21 May 2014Published
PubMed ID: 24936433
Web of Science ID: 24936433
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/107177
Publisher's version: https://doi.org/10.1016/j.nicl.2014.05.009

Actions (login required)

Edit Item Edit Item