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Cortical microinfarcts and demyelination affect cognition in cases at high risk for dementia.
Neurology. 2007 Mar 20; 68(12):927-31.Neur

Abstract

OBJECTIVE

To investigate the possible synergistic effect of microvascular lesions with mild Alzheimer disease (AD) pathology in mixed cases.

METHODS

We assessed the cognitive impact of cortical microinfarcts, deep white matter and periventricular demyelination, as well as diffuse and focal gliosis in a large series of 43 prospectively evaluated autopsy cases scored Braak neurofibrillary tangle stage III, but without macroscopic vascular pathology or substantial non-AD, nonvascular microscopic lesions. We included bilateral assessment of all types of microvascular lesions and used multivariate models that control for the possible confounding effect of age and amyloid beta-protein (Abeta) deposits.

RESULTS

Only cortical microinfarcts and periventricular demyelination were significantly associated with the Clinical Dementia Rating Scale (CDR) score. In a univariate model, the cortical microinfarct score explained 9% of the variability in CDR scores and periventricular demyelination score 7.3%. Abeta deposition explained only 3.5% of the CDR variability. In a logistic regression model, both variables were strongly associated with the presence of dementia (R = 0.45; p < 0.05). When the CDR sum of the boxes was used, Abeta staging explained 8.9% of cognitive variability, the addition of cortical microinfarct predicted an extra 15.5%, and that of periventricular demyelination an extra 9%.

CONCLUSIONS

Cortical microinfarcts and, to a lesser degree, periventricular demyelination contribute to the cognitive decline in individuals at high risk for dementia. Both should be taken into account when defining the neuropathologic criteria for mixed dementia.

Authors+Show Affiliations

Department of Psychiatry, University of Geneva School of Medicine, Chêne-Bourg, Switzerland. eniko.kovari@hcuge.chNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17372128

Citation

Kövari, E, et al. "Cortical Microinfarcts and Demyelination Affect Cognition in Cases at High Risk for Dementia." Neurology, vol. 68, no. 12, 2007, pp. 927-31.
Kövari E, Gold G, Herrmann FR, et al. Cortical microinfarcts and demyelination affect cognition in cases at high risk for dementia. Neurology. 2007;68(12):927-31.
Kövari, E., Gold, G., Herrmann, F. R., Canuto, A., Hof, P. R., Bouras, C., & Giannakopoulos, P. (2007). Cortical microinfarcts and demyelination affect cognition in cases at high risk for dementia. Neurology, 68(12), 927-31.
Kövari E, et al. Cortical Microinfarcts and Demyelination Affect Cognition in Cases at High Risk for Dementia. Neurology. 2007 Mar 20;68(12):927-31. PubMed PMID: 17372128.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cortical microinfarcts and demyelination affect cognition in cases at high risk for dementia. AU - Kövari,E, AU - Gold,G, AU - Herrmann,F R, AU - Canuto,A, AU - Hof,P R, AU - Bouras,C, AU - Giannakopoulos,P, PY - 2007/3/21/pubmed PY - 2007/4/17/medline PY - 2007/3/21/entrez SP - 927 EP - 31 JF - Neurology JO - Neurology VL - 68 IS - 12 N2 - OBJECTIVE: To investigate the possible synergistic effect of microvascular lesions with mild Alzheimer disease (AD) pathology in mixed cases. METHODS: We assessed the cognitive impact of cortical microinfarcts, deep white matter and periventricular demyelination, as well as diffuse and focal gliosis in a large series of 43 prospectively evaluated autopsy cases scored Braak neurofibrillary tangle stage III, but without macroscopic vascular pathology or substantial non-AD, nonvascular microscopic lesions. We included bilateral assessment of all types of microvascular lesions and used multivariate models that control for the possible confounding effect of age and amyloid beta-protein (Abeta) deposits. RESULTS: Only cortical microinfarcts and periventricular demyelination were significantly associated with the Clinical Dementia Rating Scale (CDR) score. In a univariate model, the cortical microinfarct score explained 9% of the variability in CDR scores and periventricular demyelination score 7.3%. Abeta deposition explained only 3.5% of the CDR variability. In a logistic regression model, both variables were strongly associated with the presence of dementia (R = 0.45; p < 0.05). When the CDR sum of the boxes was used, Abeta staging explained 8.9% of cognitive variability, the addition of cortical microinfarct predicted an extra 15.5%, and that of periventricular demyelination an extra 9%. CONCLUSIONS: Cortical microinfarcts and, to a lesser degree, periventricular demyelination contribute to the cognitive decline in individuals at high risk for dementia. Both should be taken into account when defining the neuropathologic criteria for mixed dementia. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/17372128/Cortical_microinfarcts_and_demyelination_affect_cognition_in_cases_at_high_risk_for_dementia_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&amp;pmid=17372128 DB - PRIME DP - Unbound Medicine ER -