Cerebral changes and cognitive impairment after an ischemic heart disease: a multimodal MRI study.
Brain Imaging and Behavior. 2015-11-20; 10(3): 893-900
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1. Brain Imaging Behav. 2016 Sep;10(3):893-900. doi: 10.1007/s11682-015-9483-4.
Cerebral changes and cognitive impairment after an ischemic heart disease: a
multimodal MRI study.
Bernard C(1)(2)(3), Catheline G(4)(5)(6), Dilharreguy B(4)(5), Couffinhal T(7),
Ledure S(8), Lassalle-Lagadec S(4)(5), Callaert D(4)(5), Allard M(4)(5)(6), Sibon
(1)Univ. Bordeaux, INCIA, UMR 5287, F-33400, Talence, France.
(2)CNRS, INCIA, UMR 5287, F-33400, Talence, France. .
(3)INCIA UMR 5287 CNRS, Univ. Bordeaux, Equipe de Neuroimagerie et Cognition
Humaine, 146 rue Léo Saignat, zone Nord-Case 22, 33076, Bordeaux, cedex, France.
(4)Univ. Bordeaux, INCIA, UMR 5287, F-33400, Talence, France.
(5)CNRS, INCIA, UMR 5287, F-33400, Talence, France.
(6)EPHE, Bordeaux, France.
(7)Univ Bordeaux, Centre Hospitalier Universitaire de Bordeaux, Centre
d’Exploration, de Prévention et de Traitement de l’Athérosclérose (CEPTA),
(8)Univ Bordeaux, Centre Hospitalier Universitaire de Bordeaux, Unité
Neurovasculaire, Pôle de Neurosciences Cliniques, Hôpital Pellegrin, 33076,
Three to 6 months after an acute coronary syndrome (ACS), cognitive impairment is
observed in more than 30 % of the patients, mainly in executive functioning. The
aim of this study was to investigate, using multimodal MRI, cerebral
anatomo-functional substratum of executive dysfunction. Thirty-three patients
were recruited 4 ± 1 months after a first ACS. Executive functions were evaluated
with the Trail-Making-Test-B (TMTB) at baseline (ie 4 ± 1 months after ACS) and
6 months later (ie 10 ± 1 months after ACS). Using both time-points, we
identified 3 groups of patients according to normative data based on age, gender
and education level: 15 ‘cognitively normal’ patients without impairment at each
follow-up, 10 ‘transient impaired’ patients with an impairment only at baseline
and 8 ‘impairing’ patients with an impairment only at follow-up. We explored, in
the whole-brain, the structural integrity using Voxel-Based Morphometry and
Tract-Based Spatial Statistics and the resting-state functional connectivity
using Network-Based Statistics. No structural difference was observed between
impaired and cognitively normal patients. At the functional level, compared to
the ‘cognitively normal’ group, the ‘transient impaired’ patients presented an
increased functional connectivity in a network centered on middle-orbito-frontal
regions, whereas the ‘impairing’ patients presented only a non-significant
decrease of functional connectivity. Executive dysfunction in ACS patients is
associated to functional but no structural characteristics, particularly to an
increased functional connectivity in cognitive networks in transient impaired
patients. Further studies with larger sample size are needed to confirm these
results and to determine if these patients could be at higher risk for developing
permanent cognitive disorders.
PMID: 26589710 [Indexed for MEDLINE]