Third Ventricle Width Assessed by Transcranial Sonography as Predictor of Long-Term Cognitive Impairment

Article type: Research Article

Authors: Crespo-Cuevas, Ane Miren^a | López-Cancio, Elena^{a; b; *} | Cáceres, Cynthia^c | González, Anna^c | Ispierto, Lourdes^a | Hernández-Pérez, María^a | Mataró, María^{d; e; f} | Planas, Anna^a | Canento, Tamara^a | Martín, Lorena^a | Arenillas, Juan Francisco^g | Alvarez, Ramiro^a | Vilas, Dolores^{a; *}

Affiliations: [a] Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain | [b] Department of Neurology, Hospital Universitario Central de Asturias, Oviedo, Spain | [c] Department of Neurosciences, Neuropsychology Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain | [d] Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain | [e] Institut de Neurociències, University of Barcelona, Barcelona, Spain | [f] Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain | [g] Neurology Service, Hospital Clínico Universitario de Valladolid, Valladolid, Spain

Correspondence: [*] Correspondence to: Dolores Vilas Rolán, MD, PhD, Department of Neurosciences, Neurodegenerative Diseases Unit, Hospital Universitari Germans Trias i Pujol, Carretera Canyet s/n, 08916, Barcelona, Badalona, Spain. Tel.: +34 934978862/934978819; E-mail: dvilas.germanstrias@gencat.cat and Elena López-Cancio, MD, PhD, Department of Neurology, Hospital Universitario Central de Asturias, Av. Roma, s/n, 33011 Oviedo, Asturias, Spain. E-mail: elenacancio@gmail.com.

Abstract: Background:Non-invasive biomarkers of cognitive impairment are needed. We aim to evaluate transcranial sonographic markers as predictors of cognitive impairment in a prospective cohort. Objective:To study the changes in the third ventricle diameter and the SN echogenicity between the baseline and the control visit, as well as its association with cognitive performance and the diagnosis of cognitive impairment in a prospective cohort. Methods:From the longitudinal population-based Asymptomatic Intracranial Atherosclerosis Study, we selected those subjects that received a complete transcranial sonography (TCS) and extensive cognitive testing, both at baseline and follow-up. We evaluated third ventricle (IIIv) width, echogenicity of substantia nigra (SN), and temporal changes of these parameters. Results:We included 289 participants with a median follow-up time of 7.16 years. Those subjects who developed cognitive decline (n = 23, 7.96%) had a larger IIIv at baseline than those who did not (0.54±0.14 cm versus 0.41±0.15 cm; p = 0.001). A cut-off point of 0.465 cm for the IIIv width was identified as an independent predictor of long-term cognitive impairment after adjustment for age, gender, educational level, and vascular risk score. Change in IIIv diameter after follow-up was not associated with diagnosis of cognitive impairment. The area of SN and the presence of hyperechogenicity of the SN remained stable over time and was not associated with the diagnosis of cognitive impairment. Conclusion:IIIv width assessed by TCS emerged as an independent predictor of long-term cognitive impairment.

Keywords: Cognitive decline, dementia, sonography, third ventricle, transcranial

DOI: 10.3233/JAD-190949

Journal: Journal of Alzheimer's Disease, vol. 73, no. 2, pp. 741-749, 2020