Abstract
Objectives: Cerebral small vessel disease (CSVD) is the most common vascular cause of dementia, and mild cognitive impairment (MCI) is an intermediate state between dementia and normal cognitive aging. The present study investigated the main imaging features of CSVD on different MCI subtypes in memory clinics.Methods: A total of 236 patients with MCI and 85 healthy controls were included. One hundred nine amnestic MCI-multiple domains (amMCI), 38 amnestic MCI-single domain (asMCI), 36 non-amnestic MCI-multiple domains (namMCI), and 53 non-amnestic MCI-single domain (nasMCI) patients were diagnosed. All participants were evaluated with the cognitive assessments and imaging features including white matter hyperintensity (WMH), enlarged perivascular spaces (EPVS), cerebral microbleeds (CMBs), and cerebral atrophy according to a standard procedure.Results: The patients with amMCI, namMCI, and nasMCI had more high-grade basal ganglia EPVS compared with healthy controls, while the percentages of high-grade basal ganglia EPVS in the patients with amMCI were also more than those in patients with asMCI, namMCI, and nasMCI. There were more high-grade centrum semiovale EPVS in patients with amMCI in comparison with all other groups. The patients with amMCI and namMCI had more percentages of severe deep and periventricular WMH and deep CMBs compared with healthy controls. All MCI groups had higher scores of the medial temporal lobe atrophy than healthy controls, whereas the scores of the amMCI group were also higher than those of the namMCI and nasMCI groups.Conclusions: There were varied neuroimaging features of CSVD including cerebral atrophy in different MCI groups, which meant that vascular mechanism contributed to the prodromal stage of dementia.
Highlights
Dementia has become an important health problem among the aging population in China with 249.49 million people aged 60 years or older
The concept of MCIMild cognitive impairment (MCI) was expanded to four subtypes, namely, amnestic MCI-single domain, amnestic MCImultiple domains, non-amnestic MCI-single domain, and non-amnestic MCI-multiple domains, which differ in etiology and outcome
The healthy controls were younger than patients with amnestic MCImultiple domains (amMCI), amnestic MCI-single domain (asMCI), and non-amnestic MCI-multiple domains (namMCI), whereas amMCI patients were slightly older than non-amnestic MCI-single domain (nasMCI) patients
Summary
Dementia has become an important health problem among the aging population in China with 249.49 million people aged 60 years or older. Overall age-adjusted and sexadjusted prevalence was estimated to be 6.0% for dementia, 3.9% for Alzheimer’s disease (AD), and 1.6% for vascular dementia in people aged 60 years or older in China [1]. Amnestic MCI (aMCI) is thought to have a high likelihood of progressing to AD, especially amMCI. Brain atrophy was thought to have a close relationship with neurodegenerative diseases, but many studies reported an association between atrophy and CSVD [4]. Neurodegenerative diseases such as AD commonly coexist with cerebrovascular disease in older people, especially CSVD. CSVD could cause cognitive impairments and is a common cause of dementia, but the relationship has been questioned between CSVD and the various MCI types
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