Title:Differential Influence of Carotid Stenosis and White Matter Disease on Motor and Cognitive Activation
Volume: 12
Issue: 6
Author(s): M. C. Polidori, V. Calistri, C. Mainero, E. Tinelli, A. Aceti, M. Pontico, S. Tardioli, M. Santini, M. Fiorelli, M. A. Panico, F Speziale, M. D. Caramia, R. -J. Schulz and F. Caramia
Affiliation:
Keywords:
Cognitive impairment, healthy ageing, intima-media thickness, vascular diseases, vitamins.
Abstract: Background: Cognitive and motor performance can be supported, especially in older subjects, by different
types of brain activations, which can be accurately studied by functional magnetic resonance imaging (fMRI). Vascular
risk factors (VRFs) are extremely important in the development of cognitive impairment, but few studies have focused on
the fMRI cortical activation characteristics of healthy subjects with and without silent cerebrovascular disease including
white matter hyperintensities (WMH) and carotid stenosis (CS) performing cognitive tasks. Methods: Thirty-five volunteers
with and without asymptomatic unilateral carotid stenosis above 70% and variable degrees of WMH underwent performance
of a simple motor and cognitive task during an fMRI session. Results: While the performance of the motor task
resulted in a cortical activation dependent of age but not of WMH and carotid stenosis, performance of the cognitive task
was accompanied by a significantly increased activation independently correlated with age, presence of WMH as well as
of carotid stenosis. Conclusions: in this study, cognitive domains regulating attention and working memory appear to be
activated with a pattern influenced by the presence of carotid stenosis as well as by white matter hyperintensities. The impairment
of these cognitive abilities is of high relevance in Alzheimer’s disease pathology. The fMRI pattern shown in patients
with asymptomatic but significant carotid stenosis might be related to chronic cerebrovascular hypoperfusion, a
critical pathophysiological mechanisms in AD. In these patients, carotid endoarterectomy should be considered also for
AD prevention and might be recommended.
