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Leukoaraiosis and pulse-wave encephalopathy: observations with phase-contrast MRI in mild cognitive impairment

M-C Henry-Feugeas1, C Roy, G Baron

  • 1Department of Radiology, Bichat-Claude-Bernard University Hospital, AP-HP, 46, rue Henri-Huchard, 75877 Paris cedex 18, France. marie-cecile.henry-feugeas@bch.aphp.fr

Journal of Neuroradiology = Journal De Neuroradiologie
|March 3, 2009
PubMed
Abstract

Insights

Leukoaraiosis in mild cognitive impairment may indicate arterial stiffness and impaired intracranial compliance. These vascular changes suggest a pulse wave encephalopathy contributing to cognitive decline.

Area of Science:

  • Neurology
  • Cardiovascular Science
  • Medical Imaging

Background:

  • Mild cognitive impairment (MCI) is associated with cerebrovascular changes.
  • Leukoaraiosis (LA) is a common finding in elderly individuals and may impact cognitive function.
  • The pathogenic role of arterial pulsatility buffering breakdown in LA within MCI requires further investigation.

Purpose of the Study:

  • To investigate the hypothesis that impaired buffering of arterial pulsations contributes to leukoaraiosis (LA) in mild cognitive impairment (MCI).
  • To assess the relationship between arterial stiffness, intracranial compliance, and the presence of LA in MCI patients.

Main Methods:

  • Seventy-one MCI patients underwent combined structural and dynamic MRI, including phase contrast sequences.
  • Arterial pulsatility (IP) and cerebrospinal fluid/venous flow indicators (Icsf/veins) were measured to assess large artery stiffness and intracranial compliance.
  • Cerebral blood flow and venous outflow were quantified and compared between groups with and without significant LA.

Main Results:

  • Patients with LA showed increased arterial pulsatility (IP) and reduced deep venous outflow and Icsf/veins.
  • A significant interaction was found between IP and Icsf/veins in predicting LA.
  • High IP combined with either high or low Icsf/veins, and low IP with low Icsf/veins, were all associated with a significantly increased odds of LA presence.

Conclusions:

  • Leukoaraiosis in MCI may represent an arteriosclerotic or resistive pulse wave encephalopathy.
  • Findings suggest that altered arterial dynamics and intracranial compliance are linked to LA in MCI.
  • The study highlights the potential role of vascular factors in the pathogenesis of MCI-related white matter changes.

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