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KMID : 1100220040030010029
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Dementia and Neurocognitive Disorders
2004 Volume.3 No. 1 p.29 ~ p.36
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Implication of Cerebral Steno-Occlusive Lesions in Patients with Subcortical Vascular Dementia
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Yu Kyung-Ho
Lee Byung-Chul
Ma Hyeo-Il
Kim Yun-Jung
Jeong Jee-Hyang
Na Duk-Lyul
Kang Yeon-Wook
VADAPET Study Group
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Abstract
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Background and Objective : Subcortical vascular dementia(SVD) incorporates small vessel disease as the primary vascular etiology, represents in MRI by lacunar infact and deep white matter lesions. In clinical practice, a number of SVD patients present with various vascular risk factors for large artery disease (LAD) i.e., old age, hypertension, and diabetes. However the current diagnosis criteria for SVD did not include angiographic findings as a key feature. Therefore we tried to find out the frequency of large artery disease in SVD and to elucidate whether the presence of LAD affects clinico-radioligical manifestations of SVD.
Methods: Thirty three patients fulfilling ´Research criteria for SVD´ by Erkinjuntti from 17 study centers were recruited. Of these 33 patients, 21 who underwent comprehensive neuropsychological test battery MRI, ^(18)FDG-PET, and MR angiography were classified into two subgroups according to the patterns of MRI abnormality: white matter dominant (WM) type (n=5) and multiple lacunar (LC) type (n=16). Clinical and neuropsychological profile and ^(18)FDG-PET findings of 21 SVD patients with and without LAD were compared.
Results: Twelve(57%) of 21 SVD patients had mild stenotic lesions in intracranial large arteries: 4 in middle cerebral artery, 8 in posterior cerebral artery, and 4 in vertebrobasilar artery. There were no differences in vascular risk factors, characteristics of cognitive dysfunctions, and ^(18)FDG-PET finding between SVD with and without LAD.
Conclusions: Our results showed that the presence of mild degree of large artery stenosis did not affects the clinical, neuropsychological profile and cerebral metabolisms in PET. Therefore, the current ´Research criteria for SVaD´ by Erkinjuntti could be used to diagnosis SVD as a homeogenous clinical group regardless of angiographic abnormalities.
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KEYWORD
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Subcortical Vascular Dementia, PET, Magnetic resonance angtography
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