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Neuroimaging determinants of cognitive impairment in the memory clinic: how important is the vascular burden?

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Abstract

While neurodegenerative and vascular neurocognitive disorder (NCD) often co-occur, the contribution of vascular lesions, especially stroke lesions identified on MRI, to global cognition in a real-life memory clinic population remains unclear. The main objective of this retrospective study was to determine NCD neuroimaging correlates: the GM atrophy pattern and vascular lesions (especially stroke lesion localization by voxel-based lesion-symptom mapping, VLSM) in a memory clinic. We included 336 patients with mild or major NCD who underwent cerebral MRI and a neuropsychological assessment. The GM atrophy pattern (obtained by voxel-based morphometry, VBM) and the stroke lesion localization (obtained by VLSM) associated with G5 z-score (a global cognitive score), were included as independent variables with other neuroimaging and clinical indices in a stepwise linear regression model. The mean age was 70.3 years and the mean MMSE score 21.3. On MRI, 75 patients had at least one stroke lesion. The G 5 z-score was associated with GM density in the pattern selected by the VBM analysis (R2 variation = 0.166, p < 0.001) and the presence of a stroke lesion in the region selected by the VSLM analysis (mainly in the right frontal region; R2 variation = 0.018, p = 0.008). The interaction between the two factors was insignificant (p = 0.374). In conclusion, in this first study combining VBM and VLSM analysis in a memory clinic, global cognition was associated with a specific GM atrophy pattern and the presence of a stroke lesion mainly in the right frontal region.

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Data availability

The conditions of our ethics approval do not permit public archiving of full data. Readers seeking access to full data should contact the corresponding author (DA) at the Department of Neurology, University of Picardy. Access will be granted to named individuals in accordance with ethical procedures governing the reuse of sensitive data.

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Authors and Affiliations

  1. Department of Neurology, Amiens University Medical Center, Amiens University Hospital, 80054, Amiens, France

    Daniela Andriuta, Alexandre Perron, Elisa Ouin, Ines Masmoudi, Martine Roussel & Olivier Godefroy

  2. Laboratoire de Neurosciences Fonctionnelles Et Pathologies (UR UPJV 4559), Jules Verne University of Picardy, Amiens, France

    Daniela Andriuta, Alexandre Perron, Elisa Ouin, Ines Masmoudi, Martine Roussel, Ardalan Aarabi & Olivier Godefroy

  3. Department of Neurology, Versailles – Le Chesnay Medical Center, Le Chesnay-Rocquencourt, France

    Emmanuel Wiener

  4. Department of Neurology, La Reunion University Medical Center, Site South Saint-Pierre, Saint-Pierre, La Reunion, France

    William Thibaut

  5. Department of Neurology, Bretagne Atlantique Medical Center, Vannes, France

    Jeanne Martin

  6. Department of Radiology, Amiens University Medical Center, Amiens, France

    Jean-Marc Constans

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  1. Daniela Andriuta
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Contributions

Daniela Andriuta: data acquisition, data and image analysis, statistics, and first draft of the manuscript. Emmanuel Wiener: data acquisition, image analysis, and revision of the manuscript. Alexandre Perron: data acquisition, image analysis, and revision of the manuscript. Elisa Ouin: data acquisition, image analysis, and revision of the manuscript. Ines Masmoudi: data acquisition and revision of the manuscript. William Thibaut: image analysis and revision of the manuscript. Jeanne Martin: image analysis and revision of the manuscript. Martine Roussel: data acquisition, data analysis, and revision of the manuscript. Jean-Marc Constans: image acquisition and revision of the manuscript. Ardalan Aarabi: revision of the manuscript. Olivier Godefroy: data and image analysis, statistics, study design, and revision of the manuscript. All co-authors agree with the conditions noted on the Authorship Agreement Form.

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Correspondence to Daniela Andriuta.

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The authors report no disclosures of relevance to the manuscript. Daniela Andriuta reports funding (travel and meetings) from Biogen, Roche, Teva, Novartis, Bristol-Myers Squibb, Genzyme, and Sanofi outside the submitted work. Emmanuel Wiener reports no disclosures. Alexandre Perron reports funding (travel and meetings) from Biogen, Roche, Teva, Novartis, Bristol-Myers Squibb, Genzyme, and Sanofi outside the submitted work. Elisa Ouin reports no disclosures. Ines Masmoudi reports funding (travel, meetings and boards) funding Biogen, Roche, Teva, Novartis, Bristol-Myers Squibb, Genzyme, Merck, Janssen, Pfizer and Sanofi. William Thibaut reports no disclosures. Jeanne Martin reports fundings (travel, meetings and fees payed for service to a company) from LFB biomédicaments, Biogen, UCB Pharma SA, and Jazz Pharmaceuticals outside the submitted work. Martine Roussel reports no disclosures. Jean-Marc Constans reports no disclosures. Ardalan Aarabi reports no disclosures. Olivier Godefroy reports no disclosures.

Ethical approval

Ethical approval was obtained from the local institutional review board (CNIL: N° PI2020-843-0144). The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Andriuta, D., Wiener, E., Perron, A. et al. Neuroimaging determinants of cognitive impairment in the memory clinic: how important is the vascular burden?. J Neurol 271, 504–518 (2024). https://doi.org/10.1007/s00415-023-12009-1

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