 |
|
Effects of Subcortical Cerebral Infarction on Cortical Glucose Metabolism and Cognitive Function
Lawrence T. Kwan, BS;
Bruce R. Reed, PhD;
Jamie L. Eberling, PhD;
Norbert Schuff, PhD;
Jody Tanabe, MD;
David Norman, MD;
Michael W. Weiner, MD;
William J. Jagust, MD
Arch Neurol. 1999;56:809-814.
Background The mechanism of dementia in subcortical cerebral infarction is incompletely understood.
Objective To determine how cognitive function is related to cortical metabolism in patients with subcortical infarction and a continuum of cognitive impairment.
Methods We used positron emission tomography (PET) and the glucose metabolic tracer fludeoxyglucose F 18 to study 8 patients with subcortical stroke and normal cognitive function (S-CN), 5 patients with subcortical stroke and cognitive impairment (S-CI) who did not have dementia, 8 patients with subcortical stroke and dementia (S-D), and 11 controls with no cognitive impairment or stroke. A subset of patients had absolute regional cerebral metabolic rate of glucose (CMRglc) determined, while in all subjects regional tracer uptake normalized to whole brain tracer uptake was calculated. PET data were analyzed by constructing volumes of interest using coregistered magnetic resonance imaging data and correcting the PET data for atrophy.
Results Global CMRglc was significantly lower in the patients with S-D than in the control and S-CN groups, with S-CI rates intermediate to those of the S-D and S-CN groups. Absolute regional CMRs of glucose were similar in the S-D and S-CI groups and in the control and S-CN groups. The regional pattern, however, showed lower right frontal regional CMRglc ratios in all stroke groups compared with the controls. There were modest correlations between performance on the Mini-Mental State Examination and whole brain CMRglc when all 4 groups were included.
Conclusions These results demonstrate that subcortical infarction produces global cerebral hypometabolism, which is related to the clinical status of the patients. In addition, specific frontal lobe hypometabolism also appears to be a feature of subcortical infarction. Taken together, both global and regional effects on cortical function mediate the production of clinical symptoms in patients with subcortical strokes.
From the Center for Functional Imaging, Lawrence Berkeley National Laboratory, Berkeley, Calif (Mr Kwan and Drs Reed, Eberling, and Jagust); Department of Veterans Affairs, Martinez, Calif (Drs Reed and Jagust); Department of Neurology, University of California, Davis (Mr Kwan and Drs Reed and Jagust); Departments of Veterans Affairs Medical Center, Magnetic Resonance Unit (Drs Schuff, Tanabe, and Weiner), Radiology (Drs Schuff, Tanabe, Norman, and Weiner), Psychiatry (Dr Weiner), and Neurology (Dr Weiner), University of California, San Francisco.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Genetics of Vascular Cognitive Impairment: The Opportunity and the Challenges
Leblanc et al.
Stroke 2006;37:248-255.
ABSTRACT
| FULL TEXT
Effects of White Matter Lesions and Lacunes on Cortical Function
Reed et al.
Arch Neurol 2004;61:1545-1550.
ABSTRACT
| FULL TEXT
White matter lesions impair frontal lobe function regardless of their location
Tullberg et al.
Neurology 2004;63:246-253.
ABSTRACT
| FULL TEXT
Cortical Microinfarcts and Demyelination Significantly Affect Cognition in Brain Aging
Kovari et al.
Stroke 2004;35:410-414.
ABSTRACT
| FULL TEXT
Different patterns of N-acetylaspartate loss in subcortical ischemic vascular dementia and AD
Schuff et al.
Neurology 2003;61:358-364.
ABSTRACT
| FULL TEXT
Cognitive Impairment Is Related to Cerebral Lactate in Patients With Carotid Artery Occlusion and Ipsilateral Transient Ischemic Attacks
Bakker et al.
Stroke 2003;34:1419-1424.
ABSTRACT
| FULL TEXT
Brain function and cognition in a community sample of elderly Latinos
Jagust et al.
Neurology 2002;59:378-383.
ABSTRACT
| FULL TEXT
Quantitative MRI findings and cognitive impairment among community dwelling elderly subjects
Koga et al.
J. Neurol. Neurosurg. Psychiatry 2002;72:737-741.
ABSTRACT
| FULL TEXT
Prolonged Cerebral Transit Time in CADASIL: A Transcranial Ultrasound Study
Liebetrau et al.
Stroke 2002;33:509-512.
ABSTRACT
| FULL TEXT
Performance on the Mattis Dementia Rating Scale in Patients with Vascular Dementia: Relationships to Neuroimaging Findings
Paul et al.
J Geriatr Psychiatry Neurol 2001;14:33-36.
ABSTRACT
Frontal Lobe Hypometabolism Predicts Cognitive Decline in Patients With Lacunar Infarcts
Reed et al.
Arch Neurol 2001;58:493-497.
ABSTRACT
| FULL TEXT
Small Concomitant Vascular Lesions Do Not Influence Rates of Cognitive Decline in Patients With Alzheimer Disease
Lee et al.
Arch Neurol 2000;57:1474-1479.
ABSTRACT
| FULL TEXT
Effect of estrogen on cerebral glucose metabolism in postmenopausal women
Eberling et al.
Neurology 2000;55:875-877.
ABSTRACT
| FULL TEXT
Early Exclusive Use of the Affected Forelimb After Moderate Transient Focal Ischemia in Rats : Functional and Anatomic Outcome Editorial Comment: Functional and Anatomic Outcome
Bland et al.
Stroke 2000;31:1144-1152.
ABSTRACT
| FULL TEXT
When Do Strokes Cause Dementia?: Effects of Subcortical Cerebral Infarction on Cortical Glucose Metabolism and Cognitive Function
Foster and Hickenbottom
Arch Neurol 1999;56:778-779.
FULL TEXT
|
