Cognitive Profile and its Association with Neuroimaging Markers of Non-Demented Cerebral Amyloid Angiopathy Patients in a Stroke Unit

Article type: Research Article

Authors: Xiong, Li^{a; b; *} | Davidsdottir, Sigurros^c | Reijmer, Yael D.^a | Shoamanesh, Ashkan^d | Roongpiboonsopit, Duangnapa^{a; e} | Thanprasertsuk, Sekh^f | Martinez-Ramirez, Sergi^a | Charidimou, Andreas^a | Ayres, Alison M.^a | Fotiadis, Panagiotis^a | Gurol, Edip^a | Blacker, Deborah L.^c | Greenberg, Steven M.^a | Viswanathan, Anand^a

Affiliations: [a] Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA | [b] Department of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, China | [c] Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA | [d] Department of Neurology, McMaster University / Population Health Research Institute, Canada | [e] Department of Medicine, Naresuan University, Phitsanulok, Thailand | [f] Department of Medicine, Chulalongkorn University, Bangkok, Thailand

Correspondence: [*] Correspondence to: Dr. Li Xiong, MD, PhD, 175 Cambridge Street suite 300, Boston, MA, 02114, USA. Tel.: +1 617 643 2713; Fax: +1 617 643 3939; E-mail: lxiong2@partners.org.

Abstract: Background: Cerebral amyloid angiopathy (CAA) is increasingly recognized as a cause of cognitive impairment in the elderly, but the cognitive profile in patients with the disease has not been well characterized. Objective: To characterize the neuropsychological profile of CAA patients without dementia and to determine the association between cognitive performance in different domains and neuroimaging lesions characteristic of CAA. Methods: Fifty-eight non-demented CAA patients were compared to 138 cognitively normal subjects using a standard neuropsychological test battery. Total brain volume (TBV), white matter hyperintensities, number of lobar cerebral microbleeds, hippocampal volume, and cortical superficial siderosis in all CAA patients were assessed. The association between these neuroimaging markers and neuropsychological performance in different cognitive domains in the CAA group were analyzed. Results: Patients with CAA had significantly worse performance on all individual neuropsychological domains tested, when compared to the cognitive normal group. The cognitive decline of CAA patients was most noticeable in tests for processing speed with a Z score of –1.92±1.56 (mean±SD), then followed by executive function (–0.93±1.01), episodic memory (–0.87±1.29), semantic fluency (–0.73±1.06), and attention (–0.42±0.98). TBV of the CAA patients was correlated with processing speed (β= 0.335, p = 0.03) and executive function (β= 0.394, p = 0.01). Conclusions: Non-demented patients with CAA had cognitive deficits in multiple areas. Lower TBV was related to slower processing speed and worse executive function.

Keywords: Brain atrophy, cerebral amyloid angiopathy, cerebral microbleeds, clinical neuropsychology, cognitive impairment, hippocampal atrophy, intracranial hemorrhage, white matter hyperintensities

DOI: 10.3233/JAD-150890

Journal: Journal of Alzheimer's Disease, vol. 52, no. 1, pp. 171-178, 2016