Dement Neurocogn Disord.
2012 Jun;11(2):67-73. 10.12779/dnd.2012.11.2.67.
The Correlation of the White Matter Lesions and Lacunar Infarcts in Patients with Vascular Cognitive Impairment
- Affiliations
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- 1Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. jhlee@amc.seoul.kr
- 2Department of Neurosurgery, Seoul National University College of Medicine, Seongnam, Korea.
- KMID: 2172238
- DOI: http://doi.org/10.12779/dnd.2012.11.2.67
Abstract
- BACKGROUND
Cerebral white matter lesions (WMLs) and lacunar infarcts (LIs) are mostly caused by small vessel disease (SVD). Whereas the main pathomechanism behind LIs is SVD, a variety of mechanisms could be responsible for WMLs. We tried to investigate the relationship between WMLs and LIs and the impact of subtypes of WMLs on its relationship.
METHODS
We assessed 128 subjects with vascular cognitive impairment with subcortical vascular lesion (VCI-S). LI number and WML volume were determined on T1-, T2-weighted images and fluid-attenuated inversion recovery images using a semiquantitative visual scale. Cognitive function and daily functional impairment were assessed with Mini-Mental State Examination (MMSE) and the Seoul-Instrumental Activities of Daily Living (S-IADL).
RESULTS
Of the 128 patients, 106 (82.8%) had Alzheimer's disease with WML and 22 (17.2%) had subcortical vascular dementia. Seventy patients (54.7%) had at least one lacune. A univariate Poisson model showed that history of hypertension, history of stroke and WML volume (periventricular and deep subcortical) were associated with LIs. A multivariate Poisson model showed that increased WML volume of both types and history of hypertension were associated with LIs. Neither S-IADL score nor MMSE was significantly associated with WML volume of both types.
CONCLUSIONS
We found that LIs were associated with WMLs regardless of their types in patients with VCI-S. These findings may suggest that periventricular and deep subcortical WMLs share the same vascular pathomechanism of SVD as LIs.
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