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Intracranial atherosclerosis on 7T MRI and cognitive functioning: The SMART-MR study
Maarten H T Zwartbol1, Anja G van der Kolk1, Rashid Ghaznawi1
1From the Department of Radiology (M.H.T.Z., A.G.v.d.K., R.G., J.H.) and Julius Center for Health Sciences and Primary Care (R.G., Y.v.d.G., M.I.G.), University Medical Center Utrecht and Utrecht University, the Netherlands.
Intracranial atherosclerosis (ICAS) specifically impacts memory and executive functions, particularly when affecting the posterior cerebral artery (PCA) and anterior cerebral artery (ACA) territories in patients with vascular disease.
Area of Science:
- Neurology
- Neuroimaging
- Cognitive Science
Background:
- Vascular disease is a common cause of cognitive decline.
- Intracranial atherosclerosis (ICAS) is a significant risk factor for stroke and may affect cognitive function.
- Understanding the specific impact of ICAS on cognition is crucial for patient management.
Purpose of the Study:
- To investigate the association between intracranial atherosclerosis (ICAS) burden and cognitive functioning in patients with a history of vascular disease.
- To determine if specific arteries affected by ICAS have a differential impact on cognitive domains.
Main Methods:
- Cross-sectional analysis of 130 patients from the SMART-MR study with 7T vessel wall MRI.
- ICAS burden was quantified using vessel wall lesions, summed by artery.
- Linear regression analyses assessed associations between ICAS burden and cognitive Z scores (memory, executive functioning, working memory, processing speed), adjusted for confounders.
Main Results:
- A total of 125 patients (96%) had at least one vessel wall lesion, with a mean ICAS burden of 8.5 ± 5.7.
- No significant association was found between overall ICAS burden and memory or other cognitive domains.
- ICAS burden in the posterior cerebral artery (PCA) was significantly associated with poorer memory and executive functioning.
- ICAS burden in the anterior cerebral artery (ACA) showed a trend towards association with poorer memory and executive functioning.
Conclusions:
- Cognitive functioning, specifically memory and executive functions, demonstrates an artery-specific vulnerability to intracranial atherosclerosis (ICAS).
- The posterior cerebral artery (PCA) and anterior cerebral artery (ACA) territories may be particularly susceptible due to the location of critical brain regions for these cognitive domains.
- These findings highlight the importance of considering the specific location of ICAS when assessing cognitive impairment in patients with vascular disease.
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