Identifying preclinical vascular dementia in symptomatic small vessel disease using MRI

Publication date: 2018Source: NeuroImage: Clinical, Volume 19Author(s): Christian Lambert, Eva Zeestraten, Owen Williams, Philip Benjamin, Andrew J. Lawrence, Robin G. Morris, Andrew D. Mackinnon, Thomas R. Barrick, Hugh S. MarkusAbstractSporadic cerebral small vessel disease is an important cause of vascular dementia, a syndrome of cognitive impairment together with vascular brain damage. At post-mortem pure vascular dementia is rare, with evidence of co-existing Alzheimer's disease pathology in 95% of cases. This work used MRI to characterize structural abnormalities during the preclinical phase of vascular dementia in symptomatic small vessel disease.121 subjects were recruited into the St George's Cognition and Neuroimaging in Stroke study and followed up longitudinally for five years. Over this period 22 individuals converted to dementia. Using voxel-based morphometry, we found structural abnormalities present at baseline in those with preclinical dementia, with reduced grey matter density in the left striatum and hippocampus, and more white matter hyperintensities in the frontal white-matter. The lacunar data revealed that some of these abnormalities may be due to lesions within the striatum and centrum semiovale.Using support vector machines, future dementia could be best predicted using hippocampal and striatal Jacobian determinant data, achieving a balanced classification accuracy of 73%. Using cluster ward linkage we identified four anatomical subtypes. Successful p...

Source: NeuroImage: Clinical - July 11, 2018 Category: Radiology Source Type: research