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Early- vs late-onset subcortical vascular cognitive impairment

Authors
Jang, Young KyoungKwon, HunkiKim, Yeo JinJung, Na YeonLee, Jin SanLee, JuyounChin, JuheeIm, KihoJeon, SeunLee, Jong MinSeong, Joon-KyoungKim, Jeong HunKim, SeonwooChoe, Yearn SeongLee, Kyung-HanKim, Sung TaeKim, Jae SeungLee, Jae HongNa, Duk L.Seo, Sang WonKim, Hee Jin
Issue Date
9-2월-2016
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Citation
NEUROLOGY, v.86, no.6, pp.527 - 534
Indexed
SCIE
SCOPUS
Journal Title
NEUROLOGY
Volume
86
Number
6
Start Page
527
End Page
534
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/89535
DOI
10.1212/WNL.0000000000002357
ISSN
0028-3878
Abstract
Objective:To evaluate the differences between early-onset subcortical vascular cognitive impairment (EO-SVCI) and late-onset subcortical vascular cognitive impairment (LO-SVCI) with regard to pathologic burden, structural changes, and cognitive function.Methods:We prospectively recruited 142 patients from a single referral center. Patients were divided into EO-SVCI (n = 30, age at onset <65 years) and LO-SVCI (n = 112, age at onset 65 years) groups. All patients underwent neuropsychological tests, 3T brain MRI, and [C-11] Pittsburgh compound B (PiB)-PET. We compared pathologic burden such as small vessel disease and amyloid burden; structural changes such as structural network, cortical thickness, and hippocampal volume; and cognitive function between EO-SVCI and LO-SVCI.Results:EO-SVCI patients had more lacunes, while LO-SVCI patients had higher PiB standardized uptake value ratios. EO-SVCI patients exhibited more severe structural network disruptions in the frontal area, while LO-SVCI patients exhibited more severe cortical and hippocampal atrophy. Although disease severity did not differ between the 2 groups, frontal-executive dysfunction was more severe in EO-SVCI patients.Conclusions:EO-SVCI patients showed more vascular related factors, while LO-SVCI patients exhibited more Alzheimer disease-related characteristics. The greater number of lacunes in EO-SVCI might account for the more severe frontal network disruption and frontal-executive dysfunction, while the greater amyloid burden in LO-SVCI might account for the more severe cortical and hippocampal atrophy. Our findings suggest that the age at onset is a crucial factor that determines distinct features in SVCI patients, such as pathologic burden, structural changes, and cognitive function.
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