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Erschienen in: Journal of Neurology 11/2015

01.11.2015 | Review

Cerebral small vessel disease, cognitive reserve and cognitive dysfunction

verfasst von: Daniela Pinter, Christian Enzinger, Franz Fazekas

Erschienen in: Journal of Neurology | Ausgabe 11/2015

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Abstract

The concept of cognitive reserve describes differences between individuals in the ability to compensate age-related brain changes or pathology as a result of greater intellectual enrichment. Cerebral small vessel disease (CSVD) is a common age-related vascular disease of the brain associated with slowly accumulating tissue damage and represents a leading cause of functional loss, disability and cognitive decline in the elderly. The promotion of cognitive reserve might be a valuable possibility to moderate the negative impact of accumulating brain changes associated with CSVD on cognitive function and thus limit the functional consequences of CSVD. We here review existing studies investigating this topic in CSVD and provide conceptual considerations why future research is needed. Relevant studies were identified using the electronic databases PubMed and MEDLINE. Six studies including 7893 subjects were found that all focused on a single feature of CSVD only, i.e., white matter hyperintensities (WMH). We also included one study investigating 247 CADASIL patients. In general, they confirm that higher cognitive reserve (i.e., educational attainment) attenuates the negative impact of WMH on cognition. Further studies should attempt to replicate this association for all features of CSVD and to expand the concept to other areas of functional loss like disordered gait. Finally intervention studies will be needed to define when and how we can still increase our cognitive reserve and what kind and magnitude of protective effects this may offer.
Literatur
2.
Zurück zum Zitat Thompson CS, Hakim AM (2009) Living beyond our physiological means: small vessel disease of the brain is an expression of a systemic failure in arteriolar function: a unifying hypothesis. Stroke 40:e322–e330CrossRefPubMed Thompson CS, Hakim AM (2009) Living beyond our physiological means: small vessel disease of the brain is an expression of a systemic failure in arteriolar function: a unifying hypothesis. Stroke 40:e322–e330CrossRefPubMed
4.
Zurück zum Zitat Wardlaw JM, Smith C, Dichgans M (2013) Mechanisms of sporadic cerebral small vessel disease: insights from neuroimaging. Lancet Neurol 12:483–497CrossRefPubMed Wardlaw JM, Smith C, Dichgans M (2013) Mechanisms of sporadic cerebral small vessel disease: insights from neuroimaging. Lancet Neurol 12:483–497CrossRefPubMed
9.
Zurück zum Zitat Launer LJ (2003) Epidemiology of white-matter lesions. Int Psychogeriatr 15(Suppl 1):99–103CrossRefPubMed Launer LJ (2003) Epidemiology of white-matter lesions. Int Psychogeriatr 15(Suppl 1):99–103CrossRefPubMed
10.
Zurück zum Zitat Liao D, Cooper L, Cai J (1997) The prevalence and severity of white matter lesions, their relationship with age, ethnicity, gender, and cardiovascular disease risk factors: the ARIC Study. Neuroepidemiology 16:149–162CrossRefPubMed Liao D, Cooper L, Cai J (1997) The prevalence and severity of white matter lesions, their relationship with age, ethnicity, gender, and cardiovascular disease risk factors: the ARIC Study. Neuroepidemiology 16:149–162CrossRefPubMed
11.
Zurück zum Zitat De Groot JC, de Leeuw FE, Oudkerk M et al (2000) Cerebral white matter lesions and cognitive function: the Rotterdam Scan Study. Ann Neurol 47:145–151CrossRefPubMed De Groot JC, de Leeuw FE, Oudkerk M et al (2000) Cerebral white matter lesions and cognitive function: the Rotterdam Scan Study. Ann Neurol 47:145–151CrossRefPubMed
12.
Zurück zum Zitat De Leeuw FE, de Groot JC, Achten E et al (2001) Prevalence of cerebral white matter lesions in elderly people: a population based magnetic resonance imaging study: the Rotterdam Scan Study. J Neurol Neurosurg Psychiatry 70:9–14PubMedCentralCrossRefPubMed De Leeuw FE, de Groot JC, Achten E et al (2001) Prevalence of cerebral white matter lesions in elderly people: a population based magnetic resonance imaging study: the Rotterdam Scan Study. J Neurol Neurosurg Psychiatry 70:9–14PubMedCentralCrossRefPubMed
14.
Zurück zum Zitat Vernooij M, van der Lugt A, Ikram M et al (2008) Prevalence and risk factors of cerebral microbleeds: the Rotterdam Scan Study. Neurology 70:1208–1214CrossRefPubMed Vernooij M, van der Lugt A, Ikram M et al (2008) Prevalence and risk factors of cerebral microbleeds: the Rotterdam Scan Study. Neurology 70:1208–1214CrossRefPubMed
15.
Zurück zum Zitat Gouw AA, Van der Flier WM, van Straaten ECW et al (2006) Simple versus complex assessment of white matter hyperintensities in relation to physical performance and cognition: the LADIS study. J Neurol 253:1189–1196. doi:10.1007/s00415-006-0193-5 CrossRefPubMed Gouw AA, Van der Flier WM, van Straaten ECW et al (2006) Simple versus complex assessment of white matter hyperintensities in relation to physical performance and cognition: the LADIS study. J Neurol 253:1189–1196. doi:10.​1007/​s00415-006-0193-5 CrossRefPubMed
16.
Zurück zum Zitat Poggesi A, Pantoni L, Inzitari D et al (2011) 2001-2011: A Decade of the LADIS (Leukoaraiosis And DISability) Study: What Have We Learned about White Matter Changes and Small-Vessel Disease? Cerebrovasc Dis 32:577–588. doi:10.1159/000334498 CrossRefPubMed Poggesi A, Pantoni L, Inzitari D et al (2011) 2001-2011: A Decade of the LADIS (Leukoaraiosis And DISability) Study: What Have We Learned about White Matter Changes and Small-Vessel Disease? Cerebrovasc Dis 32:577–588. doi:10.​1159/​000334498 CrossRefPubMed
18.
Zurück zum Zitat Enzinger C, Smith S, Fazekas F et al (2006) Lesion probability maps of white matter hyperintensities in elderly individuals: results of the Austrian stroke prevention study. J Neurol 253:1064–1070. doi:10.1007/s00415-006-0164-5 CrossRefPubMed Enzinger C, Smith S, Fazekas F et al (2006) Lesion probability maps of white matter hyperintensities in elderly individuals: results of the Austrian stroke prevention study. J Neurol 253:1064–1070. doi:10.​1007/​s00415-006-0164-5 CrossRefPubMed
19.
Zurück zum Zitat Inzitari D, Pracucci G, Poggesi A et al (2009) Changes in white matter as determinant of global functional decline in older independent outpatients: three year follow-up of LADIS (leukoaraiosis and disability) study cohort. BMJ 339:b2477–b2477. doi:10.1136/bmj.b2477 PubMedCentralCrossRefPubMed Inzitari D, Pracucci G, Poggesi A et al (2009) Changes in white matter as determinant of global functional decline in older independent outpatients: three year follow-up of LADIS (leukoaraiosis and disability) study cohort. BMJ 339:b2477–b2477. doi:10.​1136/​bmj.​b2477 PubMedCentralCrossRefPubMed
21.
Zurück zum Zitat Katzman R, Terry R, DeTeresa R et al (1988) Clinical, pathological, and neurochemical changes in dementia: a subgroup with preserved mental status and numerous neocortical plaques. Ann Neurol 23:138–144. doi:10.1002/ana.410230206 CrossRefPubMed Katzman R, Terry R, DeTeresa R et al (1988) Clinical, pathological, and neurochemical changes in dementia: a subgroup with preserved mental status and numerous neocortical plaques. Ann Neurol 23:138–144. doi:10.​1002/​ana.​410230206 CrossRefPubMed
22.
Zurück zum Zitat Valenzuela MJ (2008) Brain reserve and the prevention of dementia. Curr Opin Psychiatry 21:296–302CrossRefPubMed Valenzuela MJ (2008) Brain reserve and the prevention of dementia. Curr Opin Psychiatry 21:296–302CrossRefPubMed
23.
Zurück zum Zitat Guo LH, Alexopoulos P, Wagenpfeil S, Kurz A, Perneczky R, Alzheimer’s disease neuroimaging initiative (2013) Brain size and the compensation of Alzheimer's disease symptoms: a longitudinal cohort study. Alzheimers Dement 9(5):580–586. doi:10.1016/j.jalz.2012.10.002 CrossRefPubMed Guo LH, Alexopoulos P, Wagenpfeil S, Kurz A, Perneczky R, Alzheimer’s disease neuroimaging initiative (2013) Brain size and the compensation of Alzheimer's disease symptoms: a longitudinal cohort study. Alzheimers Dement 9(5):580–586. doi:10.​1016/​j.​jalz.​2012.​10.​002 CrossRefPubMed
27.
Zurück zum Zitat Levi Y, Rassovsky Y, Agranov E et al (2013) Cognitive reserve components as expressed in traumatic brain injury. J Int Neuropsychol Soc 19:664–671CrossRefPubMed Levi Y, Rassovsky Y, Agranov E et al (2013) Cognitive reserve components as expressed in traumatic brain injury. J Int Neuropsychol Soc 19:664–671CrossRefPubMed
32.
Zurück zum Zitat Ojala-Oksala J, Jokinen H, Kopsi V et al (2012) Educational history is an independent predictor of cognitive deficits and long-term survival in postacute patients with mild to moderate ischemic stroke. Stroke 43:2931–2935. doi:10.1161/STROKEAHA.112.667618 CrossRefPubMed Ojala-Oksala J, Jokinen H, Kopsi V et al (2012) Educational history is an independent predictor of cognitive deficits and long-term survival in postacute patients with mild to moderate ischemic stroke. Stroke 43:2931–2935. doi:10.​1161/​STROKEAHA.​112.​667618 CrossRefPubMed
34.
Zurück zum Zitat Dufouil C, Alpérovitch A, Tzourio C (2003) Influence of education on the relationship between white matter lesions and cognition. Neurology 60:831–836CrossRefPubMed Dufouil C, Alpérovitch A, Tzourio C (2003) Influence of education on the relationship between white matter lesions and cognition. Neurology 60:831–836CrossRefPubMed
35.
Zurück zum Zitat Nebes RD, Meltzer CC, Whyte EM, Scanlon JM, Halligan EM, Saxton JA, Houck PR, Boada FE, Dekosky ST (2006) The relation of white matter hyperintensities to cognitive performance in the normal old: education matters. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 13(3–4):326–340CrossRefPubMed Nebes RD, Meltzer CC, Whyte EM, Scanlon JM, Halligan EM, Saxton JA, Houck PR, Boada FE, Dekosky ST (2006) The relation of white matter hyperintensities to cognitive performance in the normal old: education matters. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 13(3–4):326–340CrossRefPubMed
36.
Zurück zum Zitat Saczynski J, Jonsdottir M, Sigurdsson S et al (2008) White matter lesions and cognitive performance: the role of cognitively complex leisure activity. J Gerontol 63:848–854CrossRef Saczynski J, Jonsdottir M, Sigurdsson S et al (2008) White matter lesions and cognitive performance: the role of cognitively complex leisure activity. J Gerontol 63:848–854CrossRef
39.
Zurück zum Zitat Duering M, Zieren N, Hervé D et al (2011) Strategic role of frontal white matter tracts in vascular cognitive impairment: a voxel-based lesion-symptom mapping study in CADASIL. Brain 134:2366–2375. doi:10.1093/brain/awr169 CrossRefPubMed Duering M, Zieren N, Hervé D et al (2011) Strategic role of frontal white matter tracts in vascular cognitive impairment: a voxel-based lesion-symptom mapping study in CADASIL. Brain 134:2366–2375. doi:10.​1093/​brain/​awr169 CrossRefPubMed
42.
43.
Zurück zum Zitat López ME, Aurtenetxe S, Pereda E et al (2014) Cognitive reserve is associated with the functional organization of the brain in healthy aging: a MEG study. Front Aging Neurosci 6:1–9. doi:10.3389/fnagi.2014.00125 López ME, Aurtenetxe S, Pereda E et al (2014) Cognitive reserve is associated with the functional organization of the brain in healthy aging: a MEG study. Front Aging Neurosci 6:1–9. doi:10.​3389/​fnagi.​2014.​00125
48.
Zurück zum Zitat Linortner P, Fazekas F, Schmidt R et al (2012) White matter hyperintensities alter functional organization of the motor system. Neurobiol Aging 33:1–8CrossRef Linortner P, Fazekas F, Schmidt R et al (2012) White matter hyperintensities alter functional organization of the motor system. Neurobiol Aging 33:1–8CrossRef
49.
Zurück zum Zitat Elbaz A, Vicente-Vytopilova P, Tavernier B et al (2013) Motor function in the elderly: evidence for the reserve hypothesis. Neurology 81:417–426PubMedCentralCrossRefPubMed Elbaz A, Vicente-Vytopilova P, Tavernier B et al (2013) Motor function in the elderly: evidence for the reserve hypothesis. Neurology 81:417–426PubMedCentralCrossRefPubMed
52.
53.
Zurück zum Zitat Zieren N, Duering M, Peters N et al (2013) Education modifies the relation of vascular pathology to cognitive function: cognitive reserve in cerebral autosomal dominant arteriopathy. Neurobiol Aging 34:400–407CrossRefPubMed Zieren N, Duering M, Peters N et al (2013) Education modifies the relation of vascular pathology to cognitive function: cognitive reserve in cerebral autosomal dominant arteriopathy. Neurobiol Aging 34:400–407CrossRefPubMed
Metadaten
Titel
Cerebral small vessel disease, cognitive reserve and cognitive dysfunction
verfasst von
Daniela Pinter
Christian Enzinger
Franz Fazekas
Publikationsdatum
01.11.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Journal of Neurology / Ausgabe 11/2015
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-015-7776-6

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