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Updated: Jul 10, 2026
Investigating Long-term Synaptic Plasticity in Interlamellar Hippocampus CA1 by Electrophysiological Field Recording
Published on: August 11, 2019
Hippocampal volume is an independent predictor of cognitive performance in CADASIL
Mike O'Sullivan1, Elmar Ngo, Anand Viswanathan
1Neurologische Klinik, Klinikum Grosshadern, Ludwig Maximilians University, Marchioninstrasse 15, 81377 Munich, Germany. michael.osullivan@med.uni-muenchen.de
Insights
Hippocampal atrophy, a brain change, is linked to cognitive decline in vascular dementia. This study in CADASIL patients shows reduced hippocampal volume predicts cognitive impairment, independent of other vascular damage.
Area of Science:
- Neurology
- Neuroimaging
- Cognitive Science
Background:
- Vascular cognitive impairment (VCI) is associated with hippocampal changes, but their significance and link to ischemic mechanisms are debated.
- CADASIL (Cerebral Autosomal-Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy) provides a model for pure VCI due to hereditary small vessel disease.
Purpose of the Study:
- To investigate the role and relationship of hippocampal volume (HV) changes with ischemic mechanisms in VCI.
- To assess the association between HV and cognitive function in a large cohort of CADASIL patients.
Main Methods:
- Magnetic Resonance Imaging (MRI) and cognitive assessments were performed on 144 CADASIL patients.
- Dementia status was determined using DSM-IV criteria; global cognitive function was assessed with the Mini-Mental State Examination (MMSE) and Mattis Dementia Rating Scale (MDRS).
- Hippocampal volume (HV) was measured and correlated with age, brain volume, lacunar lesion volume, white matter lesions, and microhemorrhages.
Main Results:
- HV showed significant correlations with age (r=-0.33), overall brain volume (r=0.39), and lacunar lesion volume (r=-0.23).
- Patients with dementia exhibited significantly reduced HV compared to non-demented individuals (2272+/-333 mm³ vs. 2642+/-349 mm³).
- HV independently predicted cognitive function (MMSE: r=0.30, MDRS: r=0.40), even when accounting for vascular lesions and brain atrophy.
Conclusions:
- Hippocampal atrophy is a significant factor contributing to cognitive impairment in vascular dementia.
- These findings support the view that hippocampal degeneration plays a crucial role in cognitive decline, similar to its role in degenerative diseases.
Abstract:
Recent evidence suggests that hippocampal changes are present in vascular cognitive impairment but their importance and relationship with ischaemic mechanisms remain controversial. To investigate these issues we performed MRI and cognitive assessment in a large cohort (n=144) of patients with CADASIL, a hereditary small vessel disease and model of pure vascular cognitive impairment. Dementia status was ascribed according to DSM-IV and global cognitive function assessed with the Minimental State Examination (MMSE) and Mattis Dementia Rating Scale (MDRS). Hippocampal volume (HV) correlated with age (r=-0.33, p<0.001), brain volume (r=0.39, p<0.001) and lacunar lesion volume (r=-0.23, p=0.008), but not white matter lesions or microhaemorrhages. HV was reduced in dementia (2272+/-333 mm(3) versus 2642+/-349 mm(3), p<0.001) in the whole cohort and the subgroup progressing to dementia before age 60. HV correlated with MMSE (r=0.30, p<0.001), MDRS (r=0.40, p<0.001) and in a multivariate model predicted cognition independent of typical vascular lesions and whole brain atrophy. These findings strengthen the view that hippocampal atrophy is an important pathway of cognitive impairment in vascular as well as degenerative disease.
