A Six Year Follow-up Study on the Influence of Silent Ischemic Brain Lesions on Cognitive Function and Brain Atrophy in Elderly People
Methods; To investigate the influence of silent ischemic brain lesions (silent brain infarction (SBI) and periventricular hyperintensity (PVH)) on cognitive function and brain atrophy, we studied MRI and cognitive tests in 27 healthy elderly people (above 65 years old) for 6 years. We examined Okabe...
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| Published in | Nihon Rōnen Igakkai zasshi Vol. 37; no. 4; pp. 298 - 303 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
Japan
The Japan Geriatrics Society
2000
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0300-9173 |
| DOI | 10.3143/geriatrics.37.298 |
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| Abstract | Methods; To investigate the influence of silent ischemic brain lesions (silent brain infarction (SBI) and periventricular hyperintensity (PVH)) on cognitive function and brain atrophy, we studied MRI and cognitive tests in 27 healthy elderly people (above 65 years old) for 6 years. We examined Okabe's Scale for verbal intelligence, Koh's Block Design Test for performance intelligence and Zung's Self-rating Depression Scale (SDS). On MRI, lesions with high intensity on T2-weighted image and low intensity on T1-weighted image, and which were larger than 3mm were diagnosed as SBI. The PVH was classified into 5 grades (0-4), and we divided the subjects into the PVH 0-1 group and the PVH 2-4 group. We evaluated brain atrophy using the ventricular area index (VAI) (the ratio of ventricular area to intracranial area at the level of lateral ventricle) on MRI by NIH image 1.55 (Macintosh). Results; The SBI group and the PVH 2-4 group showed significant decline in Okabe's Score, and Koh's IQ, increase in SDS and VAI during six years. On the other hand, the non-SBI and the PVH0-1 group showed a decline only in Okabe's score, and an increase in VAI. The rate of change in VAI was significantly higher in the subjects with SBI than those without it. However, there was no significant difference in the VAI change rate between the PVH 2-4 group and the PVH 0-1 group. Conclusion; Silent ischemic brain lesions such as SBI and PVH may have significant influence on decline of cognitive functions and progression of brain atrophy even in healthy elderly people. |
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| AbstractList | To investigate the influence of silent ischemic brain lesions (silent brain infarction (SBI) and periventricular hyperintensity (PVH) on cognitive function and brain atrophy, we studied MRI and cognitive tests in 27 healthy elderly people (above 65 years old) for 6 years. We examined Okabe's Scale for verbal intelligence, Koh's Block Design Test for performance intelligence and Zung's Self-rating Depression Scale (SDS). On MRI, lesions with high intensity on T2-weighted image and low intensity on T1-weighted image, and which were larger than 3 mm were diagnosed as SBI. The PVH was classified into 5 grades (0-4), and we divided the subjects into the PVH 0-1 group and the PVH 2-4 group. We evaluated brain atrophy using the ventricular area index (VAI) (the ratio of ventricular area to intracranial area at the level of lateral ventricle) on MRI by NIH image 1.55 (Macintosh).METHODSTo investigate the influence of silent ischemic brain lesions (silent brain infarction (SBI) and periventricular hyperintensity (PVH) on cognitive function and brain atrophy, we studied MRI and cognitive tests in 27 healthy elderly people (above 65 years old) for 6 years. We examined Okabe's Scale for verbal intelligence, Koh's Block Design Test for performance intelligence and Zung's Self-rating Depression Scale (SDS). On MRI, lesions with high intensity on T2-weighted image and low intensity on T1-weighted image, and which were larger than 3 mm were diagnosed as SBI. The PVH was classified into 5 grades (0-4), and we divided the subjects into the PVH 0-1 group and the PVH 2-4 group. We evaluated brain atrophy using the ventricular area index (VAI) (the ratio of ventricular area to intracranial area at the level of lateral ventricle) on MRI by NIH image 1.55 (Macintosh).The SBI group and the PVH 2-4 group showed significant decline in Okabe's Score, and Koh's IQ, increase in SDS and VAI during six years. On the other hand, the non-SBI and the PVH 0-1 group showed a decline only in Okabe's score, and an increase in VAI. The rate of change in VAI was significantly higher in the subjects with SBI than those without it. However, there was no significant difference in the VAI change rate between the PVH 2-4 group and the PVH 0-1 group.RESULTSThe SBI group and the PVH 2-4 group showed significant decline in Okabe's Score, and Koh's IQ, increase in SDS and VAI during six years. On the other hand, the non-SBI and the PVH 0-1 group showed a decline only in Okabe's score, and an increase in VAI. The rate of change in VAI was significantly higher in the subjects with SBI than those without it. However, there was no significant difference in the VAI change rate between the PVH 2-4 group and the PVH 0-1 group.Silent ischemic brain lesions such as SBI and PVH may have significant influence on decline of cognitive functions and progression of brain atrophy even in healthy elderly people.CONCLUSIONSilent ischemic brain lesions such as SBI and PVH may have significant influence on decline of cognitive functions and progression of brain atrophy even in healthy elderly people. Methods; To investigate the influence of silent ischemic brain lesions (silent brain infarction (SBI) and periventricular hyperintensity (PVH)) on cognitive function and brain atrophy, we studied MRI and cognitive tests in 27 healthy elderly people (above 65 years old) for 6 years. We examined Okabe's Scale for verbal intelligence, Koh's Block Design Test for performance intelligence and Zung's Self-rating Depression Scale (SDS). On MRI, lesions with high intensity on T2-weighted image and low intensity on T1-weighted image, and which were larger than 3mm were diagnosed as SBI. The PVH was classified into 5 grades (0-4), and we divided the subjects into the PVH 0-1 group and the PVH 2-4 group. We evaluated brain atrophy using the ventricular area index (VAI) (the ratio of ventricular area to intracranial area at the level of lateral ventricle) on MRI by NIH image 1.55 (Macintosh). Results; The SBI group and the PVH 2-4 group showed significant decline in Okabe's Score, and Koh's IQ, increase in SDS and VAI during six years. On the other hand, the non-SBI and the PVH0-1 group showed a decline only in Okabe's score, and an increase in VAI. The rate of change in VAI was significantly higher in the subjects with SBI than those without it. However, there was no significant difference in the VAI change rate between the PVH 2-4 group and the PVH 0-1 group. Conclusion; Silent ischemic brain lesions such as SBI and PVH may have significant influence on decline of cognitive functions and progression of brain atrophy even in healthy elderly people. To investigate the influence of silent ischemic brain lesions (silent brain infarction (SBI) and periventricular hyperintensity (PVH) on cognitive function and brain atrophy, we studied MRI and cognitive tests in 27 healthy elderly people (above 65 years old) for 6 years. We examined Okabe's Scale for verbal intelligence, Koh's Block Design Test for performance intelligence and Zung's Self-rating Depression Scale (SDS). On MRI, lesions with high intensity on T2-weighted image and low intensity on T1-weighted image, and which were larger than 3 mm were diagnosed as SBI. The PVH was classified into 5 grades (0-4), and we divided the subjects into the PVH 0-1 group and the PVH 2-4 group. We evaluated brain atrophy using the ventricular area index (VAI) (the ratio of ventricular area to intracranial area at the level of lateral ventricle) on MRI by NIH image 1.55 (Macintosh). The SBI group and the PVH 2-4 group showed significant decline in Okabe's Score, and Koh's IQ, increase in SDS and VAI during six years. On the other hand, the non-SBI and the PVH 0-1 group showed a decline only in Okabe's score, and an increase in VAI. The rate of change in VAI was significantly higher in the subjects with SBI than those without it. However, there was no significant difference in the VAI change rate between the PVH 2-4 group and the PVH 0-1 group. Silent ischemic brain lesions such as SBI and PVH may have significant influence on decline of cognitive functions and progression of brain atrophy even in healthy elderly people. |
| Author | Kobayashi, Shotai Oguro, Hiroaki Yamaguchi, Shuhei Okada, Kazunori |
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| References | 9) Hunt AL, Orrison WW, Yeo RA, et al.: Clinical significance of MRI white matter lesions in the elderly. Neurology 1989; 39: 1470-1474. 21) 藤川徳美, 山脇成人, 藤田康延, 柴田庸子, 東方田芳邦: 初老期, 老年期うつ状態と潜在性脳梗塞の関係についての臨床的研究-MRIを用いての検討-. 精神神経誌 1992; 94: 851-863. 12) Ylikoski R, Ylikoski A, Erkinjuntti T, Sulkava R, Raininko R, Tilvis R: White matter changes in healthy elderly persons correlate with attension and speed of mental processing. Arch Neurol 1993; 50: 818-824. 13) Fukui T, Sugita K, Sato Y, Takeuchi T, Tsukagoshi H: Cognitive functions in subjects with incidental cerebral hyperintensities. Eur Neurol 1994; 34: 272-276. 6) 岡部祥平: 老年期精神障害の検査. 臨床老年医学大系第7巻. 精神心理. 情報開発研究所 1983年; 83-102. 19) Yamaguchi S, Kobayashi S, Okada K, Koide H, Bokura H, Tsuchiya H, et al.; Cognitive decline associated with worsening of white matter lesions: a 6 year follow-up study. Journal of Stroke and Cerebrovascular Diseases 1996; 6: 106-109. 23) Bondareff W, Raval J, Woo B, Hauser DL, Colletti PM: Magnetic resonance imaging and the severity of dementia in older adults. Arch Gen Psychiatry 1990; 47: 47-51. 4) Bracco L, Campani D, Baratti E, Lippi A, Inzitari D, Pracucci G, et al.: Relation between MRI features and dementia in cerebrovascular disease patients with leukoaraiosis: a longitudinal study. J Neurol Sci 1993; 120: 131-136. 22) Kobari M, Meyer JS, Ichijo M: Leuko-araiosis, cerebral atrophy, and cerebral perfusion in normal aging. Arch Neurol 1990; 47: 161-165. 15) DeCarli C, Murphy DG, Tranh M, Grady CL, Haxby JV, Gillette JA, et al.: The effect of white matter hyperintensity volume on brain structure, cognitive performance, and cerebral metabolism of glucose in 51 healthy adults. Neurology 1995; 45: 2077-2084. 1) Schmidt R, Fazekas F, Koch M, Kapellar P, Augustin M, Offenbacher H, et al.: Magnetic Resonance Imaging cerebral abnormalities and Neuropsychologic test performance in elderly hypertensive subjects. A casecontrol study. Arch Neurol 1995; 52: 905-910. 2) Van Swieten JC, Geyskes GG, Derix MMA, Peeck BM, Ramos LMP, van Latum JC, et al.: Hypertension in the elderly is associated with white matter lesions and cognitive decline. Ann Neurol 1991; 30: 825-830. 18) 小林祥泰: 無症候性脳梗塞と認知機能. 老年期痴呆研究会誌 1997; 10: 171-174. 11) Junque C, Pujol J, Vendrell P, Bruna O, Joder M, Ribas JC, et al.: Leukoaraiosis on magnetic resonance imaging and speed of mental processing. Arch Neurol 1990; 47: 151-156. 10) O'Brien JT, Desmond P, Ames D, Schweitzer I, Tress B: Magnetic resonance imaging correlates of memory impairment in the healthy elderly: association with medial temporal lobe atrophy but not white matter lesions. Int. J. Geriat. Psychiatry 1997; 12: 369-374. 17) Fukuda H, Kobayashi S, Okada K, Tsunematsu T: Frontal white matter lesions and dementia in lacunar infarction. Stroke 1990; 21: 1143-1149. 16) Ishii N, Nishihara Y, Imamura T: Why do frontal lobe syndromes predominance in vascular dementia with lacunes? Neurology 1986; 36: 340-345. 20) 小林祥泰, 小出博巳, 山下一也, 卜蔵浩和, 山口修平: 自覚症状からみた潜在性脳梗塞様病変. 脳卒中 1993; 15: 189-195. 5) Matsubayashi K, Shimada K, Kawamoto A, Ozawa T: Incidental brain lesions on magnetic resonance imaging and neurobehavioral functions in the apparently healthy elderly. Stroke 1992; 23: 175-180. 7) Zung WWK: A self-rating depression scale. Arch Gen Psychiatry 1965; 12: 63-70. 3) 小林祥泰: 医学と医療の最前線 無症候性脳梗塞の臨床的意義. 日内会誌 1995; 84: 960-964. 14) Breteler MM, van Amerongen NM, van Swieten JC, Claus JJ, Grobbee DE, van Gijn J: Cognitive correlates of ventricular enlargement and cerebral white matter lesions on magnetic resonance imaging. The Rotterdam Study. Stroke 1994; 25: 1109-1115. 8) Bokura H, Kobayashi S, Yamaguchi S: Distinguishing silent lacunar infarction from enlarged Virchow-Robin spaces: a magnetic resonance imaging and pathological study. J Neurol 1998; 245: 116-122. |
| References_xml | – reference: 18) 小林祥泰: 無症候性脳梗塞と認知機能. 老年期痴呆研究会誌 1997; 10: 171-174. – reference: 23) Bondareff W, Raval J, Woo B, Hauser DL, Colletti PM: Magnetic resonance imaging and the severity of dementia in older adults. Arch Gen Psychiatry 1990; 47: 47-51. – reference: 21) 藤川徳美, 山脇成人, 藤田康延, 柴田庸子, 東方田芳邦: 初老期, 老年期うつ状態と潜在性脳梗塞の関係についての臨床的研究-MRIを用いての検討-. 精神神経誌 1992; 94: 851-863. – reference: 9) Hunt AL, Orrison WW, Yeo RA, et al.: Clinical significance of MRI white matter lesions in the elderly. Neurology 1989; 39: 1470-1474. – reference: 16) Ishii N, Nishihara Y, Imamura T: Why do frontal lobe syndromes predominance in vascular dementia with lacunes? Neurology 1986; 36: 340-345. – reference: 15) DeCarli C, Murphy DG, Tranh M, Grady CL, Haxby JV, Gillette JA, et al.: The effect of white matter hyperintensity volume on brain structure, cognitive performance, and cerebral metabolism of glucose in 51 healthy adults. Neurology 1995; 45: 2077-2084. – reference: 1) Schmidt R, Fazekas F, Koch M, Kapellar P, Augustin M, Offenbacher H, et al.: Magnetic Resonance Imaging cerebral abnormalities and Neuropsychologic test performance in elderly hypertensive subjects. A casecontrol study. Arch Neurol 1995; 52: 905-910. – reference: 8) Bokura H, Kobayashi S, Yamaguchi S: Distinguishing silent lacunar infarction from enlarged Virchow-Robin spaces: a magnetic resonance imaging and pathological study. J Neurol 1998; 245: 116-122. – reference: 22) Kobari M, Meyer JS, Ichijo M: Leuko-araiosis, cerebral atrophy, and cerebral perfusion in normal aging. Arch Neurol 1990; 47: 161-165. – reference: 19) Yamaguchi S, Kobayashi S, Okada K, Koide H, Bokura H, Tsuchiya H, et al.; Cognitive decline associated with worsening of white matter lesions: a 6 year follow-up study. Journal of Stroke and Cerebrovascular Diseases 1996; 6: 106-109. – reference: 2) Van Swieten JC, Geyskes GG, Derix MMA, Peeck BM, Ramos LMP, van Latum JC, et al.: Hypertension in the elderly is associated with white matter lesions and cognitive decline. Ann Neurol 1991; 30: 825-830. – reference: 3) 小林祥泰: 医学と医療の最前線 無症候性脳梗塞の臨床的意義. 日内会誌 1995; 84: 960-964. – reference: 14) Breteler MM, van Amerongen NM, van Swieten JC, Claus JJ, Grobbee DE, van Gijn J: Cognitive correlates of ventricular enlargement and cerebral white matter lesions on magnetic resonance imaging. The Rotterdam Study. Stroke 1994; 25: 1109-1115. – reference: 7) Zung WWK: A self-rating depression scale. Arch Gen Psychiatry 1965; 12: 63-70. – reference: 13) Fukui T, Sugita K, Sato Y, Takeuchi T, Tsukagoshi H: Cognitive functions in subjects with incidental cerebral hyperintensities. Eur Neurol 1994; 34: 272-276. – reference: 20) 小林祥泰, 小出博巳, 山下一也, 卜蔵浩和, 山口修平: 自覚症状からみた潜在性脳梗塞様病変. 脳卒中 1993; 15: 189-195. – reference: 11) Junque C, Pujol J, Vendrell P, Bruna O, Joder M, Ribas JC, et al.: Leukoaraiosis on magnetic resonance imaging and speed of mental processing. Arch Neurol 1990; 47: 151-156. – reference: 6) 岡部祥平: 老年期精神障害の検査. 臨床老年医学大系第7巻. 精神心理. 情報開発研究所 1983年; 83-102. – reference: 10) O'Brien JT, Desmond P, Ames D, Schweitzer I, Tress B: Magnetic resonance imaging correlates of memory impairment in the healthy elderly: association with medial temporal lobe atrophy but not white matter lesions. Int. J. Geriat. Psychiatry 1997; 12: 369-374. – reference: 17) Fukuda H, Kobayashi S, Okada K, Tsunematsu T: Frontal white matter lesions and dementia in lacunar infarction. Stroke 1990; 21: 1143-1149. – reference: 12) Ylikoski R, Ylikoski A, Erkinjuntti T, Sulkava R, Raininko R, Tilvis R: White matter changes in healthy elderly persons correlate with attension and speed of mental processing. Arch Neurol 1993; 50: 818-824. – reference: 5) Matsubayashi K, Shimada K, Kawamoto A, Ozawa T: Incidental brain lesions on magnetic resonance imaging and neurobehavioral functions in the apparently healthy elderly. Stroke 1992; 23: 175-180. – reference: 4) Bracco L, Campani D, Baratti E, Lippi A, Inzitari D, Pracucci G, et al.: Relation between MRI features and dementia in cerebrovascular disease patients with leukoaraiosis: a longitudinal study. J Neurol Sci 1993; 120: 131-136. |
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| Snippet | Methods; To investigate the influence of silent ischemic brain lesions (silent brain infarction (SBI) and periventricular hyperintensity (PVH)) on cognitive... To investigate the influence of silent ischemic brain lesions (silent brain infarction (SBI) and periventricular hyperintensity (PVH) on cognitive function and... |
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| SubjectTerms | Aged Atrophy Brain - pathology Brain atrophy Cerebral Infarction - pathology Cerebral Infarction - psychology Cognition Cognitive function Female Humans Longitudinal Studies Magnetic Resonance Imaging Male Periventricular hyperintensity Pilot Projects Silent brain infarction |
| Title | A Six Year Follow-up Study on the Influence of Silent Ischemic Brain Lesions on Cognitive Function and Brain Atrophy in Elderly People |
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