ORIGINAL

Neurological Sciences

, Volume 25, Issue 4, pp 192- 197

First online:

The role of brain infarcts and hippocampal atrophy in subcortical ischaemic vascular dementia

  • G. GainottiAffiliated withInstitute of Neurology, Catholic University Policlinico Gemelli Email author 
  • , A. AcciarriAffiliated withInstitute of Neurology, Catholic University Policlinico Gemelli
  • , A. BizzarroAffiliated withInstitute of Neurology, Catholic University Policlinico Gemelli
  • , C. MarraAffiliated withInstitute of Neurology, Catholic University Policlinico Gemelli
  • , C. MasulloAffiliated withInstitute of Neurology, Catholic University Policlinico Gemelli
  • , S. MisciagnaAffiliated withInstitute of Neurology, Catholic University Policlinico Gemelli
  • , T. TartaglioneAffiliated withInstitute of Radiology, Catholic University
  • , A. ValenzaAffiliated withInstitute of Neurology, Catholic University Policlinico Gemelli
  • , C. ColosimoAffiliated withInstitute of Radiology, Catholic University

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Abstract.

We investigated if, in patients with vascular lesions, the variable that best discriminated demented from non–demented patients was the severity of the vascular pathology or the degree of hippocampal atrophy. A total of 39 patients multiple subcortical infarcts, who could be considered as possible vascular dementia with small vessel pathology, with underwent a neuropsychological study and brain magnetic resonance imaging (MRI) DSM IV criteria supported by neuropsychological data were used to distinguish demented from non–demented patients. The MRI study took into account the degree of hippocampal atrophy (hippocampal height and interuncal distance) and the severity of vascular pathology (number of brain infarcts). The distribution of lesions and a factor analysis showed that hippocampal atrophy is a better predictor of dementia than the number of brain infarcts. Multiple subcortical infarcts alone are probably not able to cause clinical dementia but the presence of vascular lesions increases the expression of concomitant Alzheimer’s disease.

Key words

Multi–infarct dementia Alzheimer’s disease Brain infarcts Hippocampal atrophy