Neuropsychological profile and vascular risk factors in patients with cerebral microangiopathy

• Published in: Annaly kliničeskoj i èksperimentalʹnoj nevrologii (Online) Vol. 12; no. 4; pp. 5 - 15
• Main Authors: Larisa A. Dobrynina, Zukhra Sh. Gadzhieva, Lyudmila A. Kalashnikova, Bulat M. Akhmetzyanov, Elena I. Kremneva, Marina V. Krotenkova, Dmitry Yu. Lagoda, Maryam R. Zabitova, Anna A. Poddubskaya, Alexandr B. Berdalin
• Format: Journal Article
• Language: English
• Published: Research Center of Neurology 01.12.2018
• Subjects: cerebral microangiopathy; small vessel disease; strive criteria; vascular cognitive impairment
• ISSN: 2075-5473; 2409-2533
• DOI: 10.25692/ACEN.2018.4.1

Introduction. Cerebral microangiopathy (CMA) is one of the leading causes of cognitive impairment (CI). Recently proposed international standards for MRI diagnosis of SVD in aging and neurodegeneration (STRIVE, 2013) are aimed at standardization of SVD research. Objective: to clarify the severity and structure of CI and their relationships with vascular risk factors in SVD diagnosed with the STRIVE criteria. Material and methods: Ninety-six patients with with SVD and cognitive complaints (31 men and 65 women, mean age 61.0 6.6 years) were exmanied. The severity of CI was assessed with the MoCA scale: patients with MoCA26 points who were independent in their daily life were graded as having mild CI (MCI), and those who was dependent were graded as having dementia; in patients with MoCA26, the assessment of separate cognitive functions (CF) was made. The type of CI was determined according to isolated or predominantly impaired CF, and in case of equal impairment of several CFs the type was cassifide as mixed. Impairment of CF was assessed by a deviation from the normal test parameters: 1.5, mild and 2,5, severe. Results. The severity structure of CI was as follows: dementia, 15.5%, MCI, 66.7% and subjective CI, 17.7%. Neuropsychological profile of MCI included: isolated (21.3%) and predominantly (24.3%) executive dysfunction, predominantly amnestic dysfunction (28.3%), and mixed dysfunction (26.1%); in dementia we observed mixed dysfunction (80%), predominantly executive dysfunction (13.3%) and predominantly amnestic dysfunction (6.7%). A tendency to increase in the CI severity with age was revealed. Among the risk factors, only grade 3 arterial hypertension was significant for the development of dementia. Conclusions: Dementia in SVD patients aged 4669 is characterized by mainly mixed profile of CI and associated with grade 3 arterial hypertension. MCI is characterized by variability of the CI types and the lack of a clear link with vascular risk factors, which justifies the need for clarifying the causes and risk factors of SVD and mechanisms of the development of CI.