Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Feb;39(2):397-402.
doi: 10.1161/STROKEAHA.107.491795. Epub 2007 Dec 20.

Subcortical lacunes are associated with executive dysfunction in cognitively normal elderly

Catherine L Carey  1 , Joel H Kramer, S Andrew Josephson, Dan Mungas, Bruce R Reed, Norbert Schuff, Michael W Weiner, Helena C Chui
Affiliations

Subcortical lacunes are associated with executive dysfunction in cognitively normal elderly

Catherine L Carey et al. Stroke. 2008 Feb.

Abstract

Background and purpose: The relationship between subcortical ischemic vascular disease (SIVD) and cognition in normal elderly is unclear, in part because of methodological inconsistencies across studies. To clarify this relationship, the current study investigated a well characterized cognitively normal elderly sample (>or=55 years) with quantitative MRI and psychometrically robust neuropsychological measures within a multivariate model. Converging evidence suggests that SIVD selectively impairs frontal-executive tasks by disrupting frontal-subcortical circuits. We therefore hypothesized that MRI markers of SIVD would be selectively associated with worse executive functioning.

Methods: We studied 94 participants who were cognitively and functionally normal. Volumetric measures of white matter signal hyperintensity (WMH), subcortical lacunes, hippocampal volume, and cortical gray matter were obtained to predict performance on composite measures of executive functioning and episodic memory.

Results: Hierarchical regression demonstrated that after controlling for demographic variables, MMSE, and total intracranial volume, the total number of subcortical lacunes was the only significant predictor, with a greater number of lacunes associated with poorer executive performance. Hippocampal volume best predicted episodic memory performance.

Conclusions: Results suggest that SIVD in the form of silent lacunes corresponds to poorer executive functioning even in otherwise normal elderly, which is consistent with the hypothesis that SIVD preferentially disrupts frontal-subcortical circuits. The clinical importance of these findings is highlighted by the fact that 33% of the normal elderly participants in this study had lacunar infarcts.

PubMed Disclaimer

Figures

Figure
Figure
Bivariate correlation between number of lacunes and executive performance (R2=0.20; P<0.0001).
See this image and copyright information in PMC

References

    1. Longstreth WT, Jr, Bernick C, Manolio TA, Bryan N, Jungreis CA, Price TR. Lacunar infarcts defined by magnetic resonance imaging of 3660 elderly people: The cardiovascular health study. Arch Neurol. 1998;55:1217–1225. - PubMed
    1. Price TR, Manolio TA, Kronmal RA, Kittner SJ, Yue NC, Robbins J, Anton-Culver H, O’Leary DH, Chs collaborative research group Silent brain infarction on magnetic resonance imaging and neurological abnormalities in community-dwelling older adults. The cardiovascular health study. Stroke. 1997;28:1158–1164. - PubMed
    1. Vermeer SE, Den Heijer T, Koudstaal PJ, Oudkerk M, Hofman A, Breteler MM. Incidence and risk factors of silent brain infarcts in the population-based rotterdam scan study. Stroke. 2003;34:392–396. - PubMed
    1. Breteler MM, van Amerongen NM, van Swieten JC, Claus JJ, Grobbee DE, van Gijn J, Hofman A, van Harskamp F. Cognitive correlates of ventricular enlargement and cerebral white matter lesions on magnetic resonance imaging. The rotterdam study. Stroke. 1994;25:1109–1115. - PubMed
    1. Liao D, Cooper L, Cai J, Toole J, Bryan N, Burke G, Shahar E, Nieto J, Mosley T, Heiss G. The prevalence and severity of white matter lesions, their relationship with age, ethnicity, gender, and cardiovascular disease risk factors: The aric study. Neuroepidemiology. 1997;16:149–162. - PubMed

Publication types