Magnetic resonance imaging and neuropsychological findings for predicting of cognitive deterioration in memory clinic patients

Kana Matsuda; Masaki Shinohara; Yuichiro Ii; Ken-Ichi Tabei; Yukito Ueda; Naoko Nakamura; Yoshinori Hirata; Hidehiro Ishikawa; Hirofumi Matsuyama; Keita Matsuura; Masayuki Satoh; Masayuki Maeda; Ryo Momosaki; Hidekazu Tomimoto; Akihiro Shindo

doi:10.3389/fnagi.2023.1155122

Magnetic resonance imaging and neuropsychological findings for predicting of cognitive deterioration in memory clinic patients

Front Aging Neurosci. 2023 Aug 3:15:1155122. doi: 10.3389/fnagi.2023.1155122. eCollection 2023.

Authors

Affiliations

¹ Department of Dementia Prevention and Therapeutics, Mie University Graduate School of Medicine, Tsu, Japan.
² Department of Neurology, Mie University Graduate School of Medicine, Tsu, Japan.
³ Department of Neuroradiology, Mie University Graduate School of Medicine, Tsu, Japan.
⁴ Department of Rehabilitation Medicine, Mie University Graduate School of Medicine, Tsu, Japan.

Abstract

Objective: The severity of cerebral small vessel disease (SVD) on magnetic resonance imaging (MRI) has been assessed using hypertensive arteriopathy SVD and cerebral amyloid angiopathy (CAA)-SVD scores. In addition, we reported the modified CAA-SVD score including cortical microinfarcts and posterior dominant white matter hyperintensity. Each SVD score has been associated with cognitive function, but the longitudinal changes remain unclear. Therefore, this study prospectively examined the prognostic value of each SVD score, imaging findings of cerebral SVD, and neuropsychological assessment.

Methods: This study included 29 patients diagnosed with mild cognitive impairment or mild dementia at memory clinic in our hospital, who underwent clinical dementia rating (CDR) and brain MRI (3D-fluid attenuated inversion recovery, 3D-double inversion recovery, and susceptibility-weighted imaging) at baseline and 1 year later. Each SVD score and neuropsychological tests including the Mini-Mental State Examination, Japanese Raven's Colored Progressive Matrices, Trail Making Test -A/-B, and the Rivermead Behavioral Memory Test were evaluated at baseline and 1 year later.

Results: Twenty patients had unchanged CDR (group A), while nine patients had worsened CDR (group B) after 1 year. At baseline, there was no significant difference in each SVD score; after 1 year, group B had significantly increased CAA-SVD and modified CAA-SVD scores. Group B also showed a significantly higher number of lobar microbleeds than group A at baseline. Furthermore, group B had significantly longer Japanese Raven's Colored Progressive Matrices and Trail Making test-A times at baseline. After 1 year, group B had significantly lower Mini-Mental State Examination, Japanese Raven's Colored Progressive Matrices, and Rivermead Behavioral Memory Test scores and significantly fewer word fluency (letters).

Conclusion: Patients with worsened CDR 1 year after had a higher number of lobar microbleeds and prolonged psychomotor speed at baseline. These findings may become predictors of cognitive deterioration in patients who visit memory clinics.

Keywords: cerebral amyloid angiopathy-small vessel disease score; hypertensive arteriopathy-small vessel disease score; memory clinic; mild cognitive impairment; mild dementia; modified cerebral amyloid angiopathy-small vessel disease score.