期刊
NEUROLOGY
卷 86, 期 6, 页码 527-534出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/WNL.0000000000002357
关键词
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资金
- Basic Research Program of the National Research Foundation (NRF) of South Korea
- Ministry of Education [NRF-2013R1A1A2065365]
- Ministry for Health and Welfare Affairs [HIC120713]
- Korean Science and Engineering Foundation (KOSEF) NRL program - Korean government (MEST) [20110028333]
- Samsung Medical Center Clinical Research Development Program [CRL108011, CRS 110-14-1]
- Korea Ministry of Environment (MOE) Environmental Health Action Program [2014001360002]
- National Research Foundation of Korea (NRF) - Korea government (MSIP) [NRF-2015R1C1A2A01053281]
- Original Technology Research Program for Brain Science through the National Research Foundation of Korea (NRF) - Korean government (MSIP) [2014M3C7A1064752]
- Ministry of Health & Welfare, Republic of Korea [HI14C2746]
Objective:To evaluate the differences between early-onset subcortical vascular cognitive impairment (EO-SVCI) and late-onset subcortical vascular cognitive impairment (LO-SVCI) with regard to pathologic burden, structural changes, and cognitive function.Methods:We prospectively recruited 142 patients from a single referral center. Patients were divided into EO-SVCI (n = 30, age at onset <65 years) and LO-SVCI (n = 112, age at onset 65 years) groups. All patients underwent neuropsychological tests, 3T brain MRI, and [C-11] Pittsburgh compound B (PiB)-PET. We compared pathologic burden such as small vessel disease and amyloid burden; structural changes such as structural network, cortical thickness, and hippocampal volume; and cognitive function between EO-SVCI and LO-SVCI.Results:EO-SVCI patients had more lacunes, while LO-SVCI patients had higher PiB standardized uptake value ratios. EO-SVCI patients exhibited more severe structural network disruptions in the frontal area, while LO-SVCI patients exhibited more severe cortical and hippocampal atrophy. Although disease severity did not differ between the 2 groups, frontal-executive dysfunction was more severe in EO-SVCI patients.Conclusions:EO-SVCI patients showed more vascular related factors, while LO-SVCI patients exhibited more Alzheimer disease-related characteristics. The greater number of lacunes in EO-SVCI might account for the more severe frontal network disruption and frontal-executive dysfunction, while the greater amyloid burden in LO-SVCI might account for the more severe cortical and hippocampal atrophy. Our findings suggest that the age at onset is a crucial factor that determines distinct features in SVCI patients, such as pathologic burden, structural changes, and cognitive function.
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