Transcranial Doppler ultrasound in vascular cognitive impairment-no dementia

Although cerebral white matter lesions (WMLs) are considered as a risk factor for vascular dementia, data on their impact on cerebral hemodynamics are scarce. We test and compare transcranial Doppler (TCD) features in WML patients with or without associated cognitive impairment. A sample of non-deme...

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Bibliographic Details
Published in:PloS one 2019-04, Vol.14 (4), p.e0216162-e0216162
Main Authors: Vinciguerra, Luisa, Lanza, Giuseppe, Puglisi, Valentina, Pennisi, Manuela, Cantone, Mariagiovanna, Bramanti, Alessia, Pennisi, Giovanni, Bella, Rita
Format: Article
Language:English
Subjects:
Activities of daily living
Aged
Blood
Blood flow
Blood vessels
Brain
Clopidogrel
Cognitive ability
Cognitive disorders
Cognitive Dysfunction - diagnostic imaging
Correlation
Dementia
Dementia disorders
Dementia, Vascular - diagnostic imaging
Diagnosis
Doppler effect
Elderly
Elderly patients
Electric properties
Female
Flow velocity
Frontal lobe
Geriatrics
Hemodynamics
Humans
Impairment
Lesions
Linear Models
Male
Medical imaging
Neuropsychological Tests
NMR
Nuclear magnetic resonance
Older people
Patient satisfaction
Risk analysis
Risk factors
Substantia alba
Systematic review
Transcranial Doppler ultrasonography
Ultrasonography, Doppler, Transcranial
Ultrasound
Vascular dementia
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Summary:Although cerebral white matter lesions (WMLs) are considered as a risk factor for vascular dementia, data on their impact on cerebral hemodynamics are scarce. We test and compare transcranial Doppler (TCD) features in WML patients with or without associated cognitive impairment. A sample of non-demented elderly patients with WMLs was consecutively recruited. Mean blood flow velocity (MBFV), pulsatility index (PI), peak systolic blood flow velocity (PSV), end-diastolic blood flow velocity (EDV), and resistivity index (RI) were recorded from the middle cerebral artery bilaterally. Global cognitive functioning, frontal lobe abilities, functional status, and WML severity were also assessed. 161 patients satisfying the clinical criteria for vascular cognitive impairment-no dementia (VCI-ND) were age-matched with 97 presenting WMLs without any cognitive deficit. VCI-ND patients exhibited a decrease in MBFV and EDV, as well as an increase in PI, RI, and PSV. Moreover, a significant correlation between all TCD parameters and the severity of executive dysfunction was observed, whereas PI, RI, and EDV were significantly correlated with the WML load. VCI-ND showed a hemodynamic pattern indicative of cerebral hypoperfusion and enhanced vascular resistance. These changes may be considered as the TCD correlate of VCI-ND due to microcirculation pathology. TCD provides useful indices of the occurrence and severity of small vessel disease and executive dysfunction in elderly patients at risk of future dementia.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0216162