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Fotiadis, P.; Pasi, M.; Charidimou, A.; Warren, A.D.; Schwab, K.M.; Rosand, J.; ... ; Alzheimers Dis Neuroimaging Initia (2021)

Decreased Basal Ganglia Volume in Cerebral Amyloid Angiopathy

Article / Letter to editor
Background and Purpose Cerebral amyloid angiopathy (CAA) is a common pathology of the leptomeningeal and cortical small vessels associated with hemorrhagic and non-hemorrhagic brain injury. Given previous evidence for CAA-related loss of cortical thickness and white matter volume, we hypothesized that CAA might also cause tissue loss in the basal ganglia. Methods We compared basal ganglia volumes expressed as a percentage of total intracranial volume (pBGV) of non-demented patients with sporadic and hereditary CAA to age-matched healthy control (HC) and Alzheimer's disease (AD) cohorts.Results Patients with sporadic CAA had lower pBGV (n=80, 1.16%+/- 0.14%) compared to HC (n=80, 1.30%+/- 0.13%, P<0.0001) and AD patients (n=80, 1.23%+/- 0.11%, P=0.001). Similarly, patients with hereditary CAA demonstrated lower pBGV (n=25, 1.26%+/- 0.17%) compared to their matched HC (n=25, 1.36%+/- 0.15%, P=0.036). Using a measurement of normalized basal ganglia width developed for analysis of...Show moreBackground and Purpose Cerebral amyloid angiopathy (CAA) is a common pathology of the leptomeningeal and cortical small vessels associated with hemorrhagic and non-hemorrhagic brain injury. Given previous evidence for CAA-related loss of cortical thickness and white matter volume, we hypothesized that CAA might also cause tissue loss in the basal ganglia. Methods We compared basal ganglia volumes expressed as a percentage of total intracranial volume (pBGV) of non-demented patients with sporadic and hereditary CAA to age-matched healthy control (HC) and Alzheimer's disease (AD) cohorts.Results Patients with sporadic CAA had lower pBGV (n=80, 1.16%+/- 0.14%) compared to HC (n=80, 1.30%+/- 0.13%, P<0.0001) and AD patients (n=80, 1.23%+/- 0.11%, P=0.001). Similarly, patients with hereditary CAA demonstrated lower pBGV (n=25, 1.26%+/- 0.17%) compared to their matched HC (n=25, 1.36%+/- 0.15%, P=0.036). Using a measurement of normalized basal ganglia width developed for analysis of clinical-grade magnetic resonance images, we found smaller basal ganglia width in patients with CAA-related lobar intracerebral hemorrhage (ICH; n=93, 12.35 +/- 1.47) compared to age-matched patients with hypertension-related deep ICH (n=93, 13.46 +/- 1.51, P<0.0001) or HC (n=93, 15.45 +/- 1.22, P<0.0001). Within the sporadic CAA research cohort, decreased basal ganglia volume was independently correlated with greater cortical gray matter atrophy (r=0.45, P<0.0001), increased basal ganglia fractional anisotropy (r=-0.36, P=0.001), and worse performance on language processing (r=0.35, P=0.003), but not with cognitive tests of executive function or processing speed.Conclusions These findings suggest an independent effect of CAA on basal ganglia tissue loss, indicating a novel mechanism for CAA-related brain injury and neurologic dysfunction.Show less
Cerebral amyloid angiopathy
Basal ganglia
Atrophy
Diffusion
Cognition
All authors
Fotiadis, P.; Pasi, M.; Charidimou, A.; Warren, A.D.; Schwab, K.M.; Rosand, J.; Grond, J. van der; Buchem, M.A. van; Viswanathan, A.; Gurol, M.E.; Greenberg, S.M.; Alzheimers Dis Neuroimaging Initia
Date
2021-05-01
Journal
Journal of Stroke
Volume
23
Issue
2
Pages
223 - 233
DOI
doi:10.5853//jos.2020.04280