Abstract
Lacunar cerebral infarction (LI) is one of risk factors of vascular dementia and correlates with progression of cognitive impairment including the executive functions. However, little is known on spatial navigation impairment and its underlying microstructural alteration of white matter in patients with LI and with or without mild cognitive impairment (MCI). Our aim was to investigate whether the spatial navigation impairment correlated with the white matter integrity in LI patients with MCI (LI-MCI). Thirty patients with LI were included in the study and were divided into LI-MCI (n=17) and non MCI (LI-Non MCI) groups (n=13) according neuropsychological tests.The microstructural integrity of white matter was assessed by calculating a fractional anisotropy (FA) and mean diffusivity (MD) from diffusion tensor imaging (DTI) scans. The spatial navigation accuracy, separately evaluated as egocentric and allocentric, was assessed by a computerized human analogue of the Morris Water Maze tests Amunet. LI-MCI performed worse than the CN and LI-NonMCI groups on egocentric and delayed spatial navigation subtests. LI-MCI patients have spatial navigation deficits. The microstructural abnormalities in diffuse brain regions, including hippocampus, uncinate fasciculus and other brain regions may contribute to the spatial navigation impairment in LI-MCI patients at follow-up.
Highlights
Lacunar infarcts (LI) are small subcortical infarcts resulting from occlusion of one of the penetrating arteries, which comprise approximately 25% of all ischemic strokes [1]
This study explored the effects of brain microstructural alterations on spatial navigation and cognitive impairment in patients with LI and without additional mild cognitive impairment (MCI)
The results indicated that an egocetric spatial navigation was impaired in patients with both LI and MCI compared to patients with LI but without MCI and cognitively normal controls
Summary
Lacunar infarcts (LI) are small subcortical infarcts resulting from occlusion of one of the penetrating arteries, which comprise approximately 25% of all ischemic strokes [1]. The symptomatic LI have a favorable shortterm prognosis, but the mid- and long-term prognosis is poor because of recurrence of vascular cognitive impairment, stroke and increased risk of death [1]. The multinational Leukoaraiosis and Disability study showed that an increase in silent lacunes parallels significantly with cognitive decline, especially in executive functions [2]. Symptomatic LI predispose to vascular dementia [3]. Some studied have identified silent lacunar infarction as a risk factor for cognitive impairment [2, 4]. The identification of appropriate neuropsychological and neuroimaging markers to detect early cognitive decline in patients with lacunar infarction and track the disease progression is crucial
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