Cognitive Versus Hemorrhagic Onset in Cerebral Amyloid Angiopathy: Neuroimaging Features.

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY Current Alzheimer research Pub Date : 2023-01-01 DOI:10.2174/1567205020666230713151211

Perini Giulia, Cotta Ramusino Matteo, Farina Lisa Maria, Dal Fabbro Beatrice, Canavero Isabella, Picascia Marta, Muzic Shaun, Ballante Elena, Cavallini Anna, Pichiecchio Anna, Costa Alfredo

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Abstract

Background: Intracerebral hemorrhage and cognitive decline are typical clinical presentations of cerebral amyloid angiopathy (CAA).

Objective: To determine whether magnetic resonance imaging (MRI) features differ between CAA with hemorrhagic versus cognitive onset.

Methods: In this retrospective study, sixty-one patients with CAA were classified by onset presentation of the disease: hemorrhage (n = 31) or cognitive decline (n = 30). The two groups were compared for MRI markers of small vessel disease, namely cerebral microbleeds (CMBs), cortical superficial siderosis, white matter hyperintensities (WMHs), enlarged perivascular spaces, cortical microinfarcts, and visual rating scales for cortical atrophy. In the patients with cognitive onset, further exploratory analyses investigated MRI markers according to cerebrospinal fluid (CSF) and neuropsychological profiles.

Results: Patients with cognitive onset showed a higher prevalence of CMBs (p < 0.001), particularly in temporal (p = 0.015) and insular (p = 0.002) lobes, and a higher prevalence of WMHs (p = 0.012). Within the cognitive onset group, 12 out of 16 (75%) patients had an Alzheimer's disease (AD) CSF profile but did not differ in MRI markers from those without AD pathology. Patients with cognitive onset displayed a multidomain profile in 16 out of 23 (70%) cases; patients with this profile showed increased WMHs and CMBs in parietal lobes compared with the amnestic group (p = 0.002) and dysexecutive group (p = 0.032), respectively.

Conclusion: Higher burdens of WMHs and CMBs, especially in temporal and insular lobes, are associated with the cognitive onset of CAA. MRI markers could help to shed light on the clinical heterogeneity of the CAA spectrum and its underlying mechanisms.

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脑淀粉样血管病的认知与出血性发病:神经影像学特征。

背景:脑出血和认知能力下降是脑淀粉样血管病(CAA)的典型临床表现。目的:确定出血性CAA与认知性CAA的磁共振成像(MRI)特征是否不同。方法:在这项回顾性研究中，61例CAA患者根据发病表现进行分类:出血(n = 31)或认知能力下降(n = 30)。比较两组小血管疾病的MRI标志物，即脑微出血(CMBs)、皮质浅表性铁沉着、白质高信号(WMHs)、血管周围间隙扩大、皮质微梗死和皮质萎缩的视觉评分量表。在认知发病的患者中，进一步的探索性分析根据脑脊液(CSF)和神经心理学特征调查MRI标志物。结果:认知发病患者CMBs患病率较高(p < 0.001)，尤其是颞叶(p = 0.015)和岛叶(p = 0.002)， wmh患病率较高(p = 0.012)。在认知发病组中，16名患者中有12名(75%)患有阿尔茨海默病(AD) CSF谱，但MRI标记与无AD病理的患者没有差异。23例(70%)认知发病患者中有16例表现为多域特征;与遗忘组(p = 0.002)和执行障碍组(p = 0.032)相比，此组患者的顶叶wmh和CMBs分别增加。结论:较高的wmh和CMBs负担，特别是颞叶和岛叶，与CAA的认知发病有关。MRI标记物有助于揭示CAA谱的临床异质性及其潜在机制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Alzheimer research 医学-神经科学

CiteScore

4.00

自引率

4.80%

发文量

审稿时长

4-8 weeks

期刊介绍： Current Alzheimer Research publishes peer-reviewed frontier review, research, drug clinical trial studies and letter articles on all areas of Alzheimer’s disease. This multidisciplinary journal will help in understanding the neurobiology, genetics, pathogenesis, and treatment strategies of Alzheimer’s disease. The journal publishes objective reviews written by experts and leaders actively engaged in research using cellular, molecular, and animal models. The journal also covers original articles on recent research in fast emerging areas of molecular diagnostics, brain imaging, drug development and discovery, and clinical aspects of Alzheimer’s disease. Manuscripts are encouraged that relate to the synergistic mechanism of Alzheimer''s disease with other dementia and neurodegenerative disorders. Book reviews, meeting reports and letters-to-the-editor are also published. The journal is essential reading for researchers, educators and physicians with interest in age-related dementia and Alzheimer’s disease. Current Alzheimer Research provides a comprehensive ''bird''s-eye view'' of the current state of Alzheimer''s research for neuroscientists, clinicians, health science planners, granting, caregivers and families of this devastating disease.