Arteriolosclerosis CSVD: a common cause of dementia and stroke and its association with cognitive function and total
Min Hua1, Ai-Jin Ma1, Zhi-Qing Liu1
1Department of Neurology, Wujin Hospital Affiliated to Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China.
Insights
Arteriolosclerosis cerebral small vessel disease (CSVD) is linked to cognitive decline and increased MRI burden. Deep cerebral atrophy independently predicts cognitive impairment, while hypertension is associated with higher MRI burden in CSVD patients.
Area of Science:
- Neurology
- Radiology
- Gerontology
Background:
- Arteriolosclerosis cerebral small vessel disease (CSVD) is a prevalent condition affecting brain health.
- Understanding factors influencing cognitive function and disease burden is crucial for patient management.
Purpose of the Study:
- To investigate factors associated with cognitive function in arteriolosclerosis CSVD.
- To explore predictors of total MRI burden in patients with arteriolosclerosis CSVD.
Main Methods:
- Retrospective analysis of 146 arteriolosclerosis CSVD patients from 2014-2022.
- Evaluation of cognitive function, Barthel Index (BI), and brain MRI findings (WMH, atrophy).
- Logistic regression models used to identify associated factors for cognitive function and MRI burden.
Main Results:
- 108 patients (74.0%) exhibited cognitive dysfunction; 83 (56.8%) had moderate-to-severe daily life dependence (BI ≤ 60).
- Deep cerebral atrophy was independently associated with cognitive impairment (P=0.024).
- Hypertension was independently associated with total MRI burden (P=0.001).
Conclusions:
- Deep cerebral atrophy is an independent risk factor for cognitive dysfunction in arteriolosclerosis CSVD.
- Hypertension is an independent risk factor for increased total MRI burden in this patient group.
- Arteriolosclerosis CSVD progression impacts cognitive function and disease burden over time.
Objective:
Arteriolosclerosis cerebral small vessel disease (CSVD) is a common type of CSVD. This study aimed to explore the factors associated with cognitive function and total MRI burden related to the disease.
Methods:
The demographic characteristics, clinical manifestations, cognitive function score, Barthel Index (BI), blood test index, and follow-up results of arteriolosclerosis CSVD patients treated for the first time in our hospital from January 2014 to August 2022 were collected. White matter hyperintensity (WMH) Fazekas score, total MRI burden, and cerebral atrophy grade were evaluated according to brain MRI findings. Factors associated with CSVD cognitive function were analyzed by binary logistic regression. The correlative factors related to the total MRI burden of CSVD were analyzed by ordered multiple logistic regression.
Results:
A total of 146 patients were included in this study, of which 132 cases (90.4%) had hypertension. There were 108 patients (74.0%) with cognitive dysfunction, 97 patients (66.4%) with balance and gait disorders, and 83 patients (56.8%) with moderate-to-severe dependence in daily life (BI ≤ 60 points). Of 146 patients, 79 (54.1%) completed clinical and imaging follow-ups for a median of 3 years. The number of patients with cognitive impairment and BI ≤ 60 points after follow-up significantly increased compared with the first admission (P < 0.001). There were also significant differences in total MRI burden (P = 0.001), WMH Fazekas score, and cerebral atrophy grade (P < 0.001). Mean age (P = 0.012), median deep WMH Fazekas score (P = 0.028), and median deep (P < 0.001) and superficial (P =0.002) cerebral atrophy grade of patients with cognitive impairment at first admission were all higher than those with non-cognitive impairment. Multivariate analysis showed that deep cerebral atrophy was independently and significantly associated with cognitive impairment of CSVD (P = 0.024), and hypertension was significantly and independently associated with total MRI burden (P = 0.001).
Conclusion:
The disease course of arteriolosclerosis CSVD may be related to cognitive function and total MRI burden. Deep cerebral atrophy was an independent risk factor for cognitive dysfunction in arteriolosclerosis CSVD, and hypertension was an independent risk factor for total MRI burden.
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