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3 results

  • The INECO Frontal Screening for the Evaluation of Executive Dysfunction in Cerebral Small Vessel Disease: Evidence from Quantitative MRI in a CADASIL Cohort from Colombia

  • Dorothee Schoemaker, Yesica Zuluaga, Anand Viswanathan, Markus Shrimer, Heirangi Torrico-Teave, Lina Velilla, Carolina Ospina, Gloria Garcia Ospina, Francisco Lopera, Joseph F. Arboleda-Velasquez, Yakeel T. Quiroz
  • Journal:
    Journal of the International Neuropsychological Society / Volume 26 / Issue 10 / November 2020
    Published online by Cambridge University Press:
    03 June 2020, pp. 1006-1018
  • Objectives:

    Executive dysfunction is a predominant cognitive symptom in cerebral small vessel disease (SVD). The Institute of Cognitive Neurology Frontal Screening (IFS) is a well-validated screening tool allowing the rapid assessment of multiple components of executive function in Spanish-speaking individuals. In this study, we examined performance on the IFS in subjects with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), an inherited condition leading to the early onset of SVD. We further explored associations between performance on the IFS and magnetic resonance imaging (MRI) markers of SVD.

    Methods:

    We recruited 24 asymptomatic CADASIL subjects and 23 noncarriers from Colombia. All subjects underwent a research MRI and a neuropsychological evaluation, including the IFS. Structural MRI markers of SVD were quantified in each subject, together with an SVD Sum Score representing the overall burden of cerebrovascular alterations. General linear model, correlation, and receiver operating characteristic curve analyses were used to explore group differences on the IFS and relationships with MRI markers of SVD.

    Results:

    CADASIL subjects had a significantly reduced performance on the IFS Total Score. Performance on the IFS correlated with all quantified markers of SVD, except for brain atrophy and perivascular spaces enlargement. Finally, while the IFS Total Score was not able to accurately discriminate between carriers and noncarriers, it showed adequate sensitivity and specificity in detecting the presence of multiple MRI markers of SVD.

    Conclusions:

    These results suggest that the IFS may be a useful screening tool to assess executive function and disease severity in the context of SVD.

  • 21 - The growing need for alternative clinical trial designs for multiple sclerosis

  • from Section II - Clinical trial methodology
  • Edited by Jeffrey A. Cohen, Richard A. Rudick
  • Book:
    Multiple Sclerosis Therapeutics
    Published online:
    05 December 2011
    Print publication:
    20 October 2011, pp 253-260

  • Summary

    Double inversion recovery (DIR) is an inversion recovery sequence which applies two consecutive inversion pulses leading to a simultaneous attenuation of the cerebrospinal fluid (CSF) and white matter which improves the contrast between gray and white matter. Quantitative magnetic resonance imaging (MRI) techniques are able to detect and to quantify primary and secondary gray matter abnormalities and provide further insights into disease progression and contribution of these changes to clinical outcome measures. Proton MR spectroscopy (1H-MRS) is frequently used for the evaluation of normal appearing brain tissue in multiple sclerosis (MS). Diffusion tensor imaging (DTI) assesses the random movement of water molecules within the brain tissue. Magnetization transfer (MT) imaging is based on a magnetization interaction between free water protons and protons bound to macromolecular structures. T1- and T2-relaxation time (RT) measurements allow the assessment and quantification of white matter and gray matter damage in various neurodegenerative and neuro-inflammatory diseases.

  • Effects of hypoxia on the brain: Neuroimaging and neuropsychological findings following carbon monoxide poisoning and obstructive sleep apnea

  • SHAWN D. GALE, RAMONA O. HOPKINS
  • Journal:
    Journal of the International Neuropsychological Society / Volume 10 / Issue 1 / January 2004
    Published online by Cambridge University Press:
    06 February 2004, pp. 60-71

  • Hypoxia damages multiple organ systems especially those with high oxygen utilization such as the central nervous system. The purpose of this study was to compare the neuropathological and neuropsychological effects of hypoxia in patients with either carbon monoxide poisoning or obstructive sleep apnea. Neuroimaging revealed evidence of hippocampal atrophy in both groups although a linear relationship between hippocampal volume and memory performance was found only for selected tests and only in the sleep apnea group. There were significant correlations between hippocampal volume and performance on measures related to nonverbal/information processing. Generalized brain atrophy, as measured by the ventricle-to-brain ratio, was more common in the carbon monoxide poisoning group compared to the obstructive sleep apnea group. Performance on tests of executive function improved following treatment with nasal continuous positive airway pressure treatment in the obstructive sleep apnea group but there was no associated improvement in general intellectual function. We found that hypoxia due to obstructive sleep apnea and CO poisoning resulted in neuropathological changes and neuropsychological impairments. The observed group differences provide insight into the relationship between etiology of injury, neuropathological changes, and clinical presentation. (JINS, 2004, 10, 60–71.)