22. European Stroke Conference 12 Brain imaging B 16:50 - 17:00 Thalamic lacunes in regions with connectivity to the prefrontal cortex are associated with impaired processing speed in cerebral small vessel disease. P. Benjamin1, A. Lawrence2, B. Patel3, A. Chung4, A.D. Mackinnon5, C. Lambert6, R.G. Mor-ris7, T.R. Barrick8, H.S. Markus9 St Georges University of London, London, UNITED KINGDOM1,St Georges University of London, London, UNITED KINGDOM2, St Georges University of London, London, UNITED KINGDOM3, St Georges University of London, London, UNITED KINGDOM4, St Georges University of London, London, UNITED KINGDOM5, St Georges University of London, Lon-don, UNITED KINGDOM6, Kings College Institute of Psychiatry, London, UNITED KING-DOM7, St Georges University of London, London, UNITED KINGDOM8, St Georges Univer-sity of London, London, UNITED KINGDOM9 Background: Cerebral small vessel disease (SVD) is an important cause of cognitive impair-ment. Lacunar infarcts and white matter hyperintensities are the cardinal features of SVD. The impact of lacunar infarcts on cognition remains unclear. The aims of our study were to: 1) De-termine the relationship between lacunar infarct count and total lacune volume with cognition. 2) Determine the spatial distribution of lacunes and define the specific cognitive impact of la-cune location, particularly the role of thalamic lacunes. Methods: Data from the prospective SCANS study of patients with symptomatic lacunar stroke and radiological leukoaraiosis were used (n=120). Multimodal MRI and neuropsychological testing was performed. Lacunes were identified and mapped using an automated technique. Lacune volume was calculated from the resulting maps, and lacune location automatically de-termined by projection onto atlases including an atlas which segments the thalamus based on its connectivity to the cortex, producing a “Connectivity Defined Region” (CDR). Results: In multiple regression analysis, controlling for WMH volume and brain volume, larg-er lacune number and increased lacune volume were associated with worse executive function (number: beta=-0.22, p<0.005; volume: beta=-0.1, p<0.03) and processing speed (number: beta=-0.26, p<0.002; volume: beta=-0.23, p<0.006). Thalamic lacunes, in particular lacunes in the thalamic CDR with connections to the pre-frontal cortex were associated with impaired pro-cessing speed (Bonferroni corrected p=0.005). Conclusion: Lacunar infarcts are an important marker of cognitive impairment in symptomatic SVD. The finding of lacunes in the medial dorsal region of the thalamus associated with im-paired information processing speed, provide support for the role of disruption of cortico-bas-al- thalamic networks as a mechanism of cognitive impairment in small vessel disease. 68 © 2013 S. Karger AG, Basel Scientific Programme
Karger_ESC London_2013
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