Linear brain measurement: a new screening method for cognitive impairment in elderly patients with cerebral small vessel disease

Jing Wang; Jinhua Lu; Mingqing He; Ziyang Song; Lingyan Dong; Haiying Tang; Yueju Wang; Zheping Zhou

doi:10.3389/fneur.2024.1297076

Linear brain measurement: a new screening method for cognitive impairment in elderly patients with cerebral small vessel disease

Front Neurol. 2024 Jan 22:15:1297076. doi: 10.3389/fneur.2024.1297076. eCollection 2024.

Authors

Jing Wang^#¹, Jinhua Lu^#¹, Mingqing He¹, Ziyang Song², Lingyan Dong¹, Haiying Tang¹, Yueju Wang¹, Zheping Zhou³

Affiliations

¹ Department of Geratology, The First Affiliated Hospital of Soochow University, Suzhou, China.
² Department of Radiology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China.
³ Department of Geratology, Affiliated Changshu Hospital of Nantong University, Changshu, China.

^# Contributed equally.

Abstract

Background: The old adults have high incidence of cognitive impairment, especially in patients with cerebral small vessel disease (CSVD). Cognitive impairment is not easy to be detected in such populations. We aimed to develop clinical prediction models for different degrees of cognitive impairments in elderly CSVD patients based on conventional imaging and clinical data to determine the better indicators for assessing cognitive function in the CSVD elderly.

Methods: 210 CSVD patients were screened out by the evaluation of Magnetic Resonance Imaging (MRI). Then, participants were divided into the following three groups according to the cognitive assessment results: control, mild cognitive impairment (MCI), and dementia groups. Clinical data were collected from all patients, including demographic data, biochemical indicators, carotid ultrasound, transcranial Doppler (TCD) indicators, and linear measurement parameters based on MRI.

Results: Our results showed that the brain atrophy and vascular lesions developed progressive worsening with increased degree of cognitive impairment. Crouse score and Interuncal distance/Bitemporal distance (IUD/BTD) were independent risk factors for MCI in CSVD patients, and independent risk factors for dementia in CSVD were Crouse Score, the pulsatility index of the middle cerebral artery (MCAPI), IUD/BTD, and Sylvian fissure ratio (SFR). Overall, the parameters with high performance were the IUD/BTD (OR 2.28; 95% CI 1.26-4.10) and SFR (OR 3.28; 95% CI 1.54-6.91), and the AUC (area under the curve) in distinguishing between CSVD older adults with MCI and with dementia was 0.675 and 0.724, respectively. Linear brain measurement parameters had larger observed effect than other indexes to identify cognitive impairments in CSVD patients.

Conclusion: This study shows that IUD/BTD and SFR are good predictors of cognitive impairments in CSVD elderly. Linear brain measurement showed a good predictive power for identifying MCI and dementia in elderly subjects with CSVD. Linear brain measurement could be a more suitable and novel method for screening cognitive impairment in aged CSVD patients in primary healthcare facilities, and worth further promotion among the rural population.

Keywords: cerebral small vessel disease; cognitive impairment; elderly patients; imaging; linear measurement.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was partially supported by the Jiangsu Province Cadre Health Project (Grant No. BJ19008). The leader project of clinical technology application research of Jiangsu elderly health research project (Project LR2021011). Study on the intervention effect of intestinal flora debugging on elderly patients with sarcopenia (Project 2020YFC2005604-5). Clinical technology application research project unit of Jiangsu Province Geriatric Health Research Project (Project LR2021024). Suzhou Medical Key Discipline Construction Project (Project SZXK202101).