Volumetric magnetic resonance imaging correlates of the National Institute of Neurological Disorders and Stroke–Canadian Stroke Network vascular cognitive impairment neuropsychology protocols

Abstract

Background: Vascular cognitive impairment (VCI) refers to the entire spectrum of cognitive dysfunction attributable to vascular changes in the brain. The objective of this study is to evaluate magnetic resonance imaging (MRI) correlates of performance on the National Institute of Neurological Disorders and Stroke–Canadian Stroke Network (NINDS–CSN) VCI neuropsychology protocols. Method: Fifty ischemic stroke patients and 50 normal elderly persons completed the VCI protocols and MRI. Relationships between the four cognitive domains (executive/activation, language, visuospatial, and memory) and three protocol (60-, 30-, and 5-min) summary scores with MRI measures of volumes of white matter hyperintensities (WMH) and global brain and hippocampal atrophy were assessed using linear regression. Results: All cognitive domain scores were associated with WMH volume and, with the exception of language domain, with global atrophy. Additional relationships were found between executive/activation and language domains with left hippocampal volume, visuospatial domain with right hippocampal volume, and memory domain with bilateral hippocampal volumes. All protocol summary scores showed comparable relationships with WMH and hippocampal volumes, with additional relationships found between the 60- and 30-min protocols with global brain volume. Conclusions: Performance on the NINDS–CSN VCI protocols reflects underlying volumetric brain changes implicated in cognitive dysfunctions in VCI.

Keywords:

• Vascular cognitive impairment
• Cognitive assessment
• Neuropsychology
• Stroke
• Magnetic resonance imaging

Acknowledgements

We would like to thank our research assistant Pauline Kwan for study coordination.

Additional information

Funding

Supported by the Health and Health Services Research Fund, Food and Health Bureau, Government of the Hong Kong Special Administrative Region [Reference number 06070231]; National Institute of Health and Ageing [Reference number 1R01 NS057514]; and Neurology Research Fund of the Chinese University of Hong Kong.