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22. European Stroke Conference 451 Small vessel stroke and white matter disease Comparison of clinical, functional and cognitive features between two groups of patients with MCI of degenerative or vascular origin. Preliminary data from the “Investigation on MCI Study”. R. Valenti1, E. Salvadori2, A. Del Bene3, S. Padiglioni4, A. Ginestroni5, B. Nacmias6, L. Pantoni7, L. Bracco8, M. Mascalchi9, S. Sorbi10, D. Inzitari11 Department of Neurological and Psychiatric Sciences, University of Florence, Florence, Italy, Florence, ITALY1, Department of Neurological and Psychiatric Sciences, University of Florence, Florence, Italy, Florence, ITALY2, Department of Neurological and Psychiatric Sciences, Univer-sity of Florence, Florence, Italy, Florence, ITALY3, Department of Neurological and Psychiatric Sciences, University of Florence, Florence, Italy, Florence, ITALY4, Department of Neurological and Psychiatric Sciences, University of Florence, Florence, Italy, Florence, ITALY5, Department of Neurological and Psychiatric Sciences, University of Florence, Florence, Italy, Florence, ITALY6, Department of Neurological and Psychiatric Sciences, University of Florence, Florence, Italy, Flor-ence, 7, Department of Neurological and Psychiatric Sciences, University of Florence, Florence, Ita-ly, Florence, ITALY8, Department of Neurological and Psychiatric Sciences, University of Florence, Florence, Italy, Florence, ITALY9,Department of Neurological and Psychiatric Sciences, University of Florence, Florence, Italy, Florence, 10, Department of Neurological and Psychiatric Sciences, Uni-versity of Florence, Florence, Italy, Florence,ITALY11 Background: Mild cognitive impairment (MCI) is a transitional status between the cognitive decline of normal aging and dementia, and can be supported by different types of brain lesions (vascular or atrophic). Clinical and neuropsychological markers differentiating between the two conditions are still incompletely elucidated. Objective: We aimed to study clinical and cognitive factors selective-ly differentiating degenerative (deg-MCI) from vascular MCI (vas-MCI). Methods: To be included, patients have to be classified as affected by MCI (Winblad criteria) with evidence on MRI of white matter changes of moderate to severe degrees for the vas-MCI, or cortical atrophy of moderate to severe degrees for the deg-MCI. Two groups of MCI patients, matched by age and gender, under-went an extensive clinical, mood, and neuropsychological assessment. Results: We enrolled 60 pa-tients: 30 deg-MCI and 30 vas-MCI. Family history of dementia was significantly more prevalent in the deg-MCI group (67% vs 33%, p=.019), while hypercholesterolemia (13% vs 67%, p<.001), heart disease (3% vs 27%, p=.026), stroke (3% vs 37%, p=.002), migraine (23% vs 53%, p=.033), psychiatric disorders (40% vs 73%, p=.018), gait disorders (10% vs 70%, p<.001), and urinary dis-turbances (20% vs 50%, p=.029) were more common in the vas-MCI group. Controlling for educa-tion, functional status, cognitive performance and depression, the logistic regression model showed that story recall test resulted independently associated with deg-MCI (OR=1.9; 95% CI=1.3-3.0, p=.003), while depression severity with vas-MCI (OR=9.5; 95% CI=1.1-85.8, p=.045). Conclusion: Family history for dementia, vascular risk factors, and gait and urinary disturbances are confirmed to be distinctive features of deg-MCI and vas-MCI. The strongest differential markers are a deficit of episodic memory and depressive disturbance. This information may be useful to the setting of clini-cal- functional screening of patients with different MCI types. 526 © 2013 S. Karger AG, Basel Scientific Programme 452 Small vessel stroke and white matter disease The association of the Average Real Blood Pressure Variability with MRI markers of cerebral small vessel disease in first-ever lacunar stroke patients P. Klarenbeek1, R.J. van Oostenbrugge2, J. Staals3 Maastricht University Medical Centre, Maastricht, THE NETHERLANDS1, Maastricht Uni-versity Medical Centre, Maastricht, THE NETHERLANDS2, Maastricht University Medical Centre, Maastricht, THE NETHERLANDS3 Background In recent years, much research has been performed regarding blood pressure (BP) indices that are derived of ambulatory BP monitoring. Especially BP variability has gained much attention. Vari-ability is often quantified by the standard deviation (SD) of measurements. A novel measure of BP variability is the average real variability (ARV). It predicts future cardiovascular events and is asso-ciated with target organ damage in kidney or heart. However data about the association of ARV with cerebral damage, in particular MRI markers of cerebral small vessel disease (a BP related vasculop-athy) are lacking. Methods We performed 24-hour ambulatory BP monitoring and brain MRI in 129 first-ever lacunar stroke patients. BP variability was measured by SD and ARV, both derived from the 24-hour BP data. In lo-gistic regression analyses, we investigated the association of SD and ARV (both as continuous vari-ables and in tertiles) with the presence of different MRI markers of cerebral small vessel disease. Results Asymptomatic lacunar infarcts, white matter lesions, enlarged basal ganglia perivascular spaces and deep cerebral microbleeds were present in 82 (63%), 41 (32%), 83 (64%) and 24 (19%) patients re-spectively. 24-hour systolic and diastolic BP levels were associated with the presence of asymptom-atic lacunar infarcts, enlarged perivascular spaces and deep cerebral microbleeds, but not with white matter lesions. Systolic and diastolic SD and ARV were not associated with any of the MRI markers of cerebral small vessel disease. Conclusion We found no association of 24-hour BP variability, calculated as ARV or SD, with MRI markers of cerebral small vessel disease. Our study suggests that 24-hour BP variability has no additional value over standard 24-hour BP in cerebral small vessel disease, although results might have been influ-enced by use of antihypertensives that influence variability.


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