One-year follow-up or neuropsychology, MRI, rCBF and glucose metabolism (rMRGlu) in cerebral microangiopathy

Background: MRI shows lacunar infarctions (LI), deep white matter lesions ( DWML) and atrophy in cerebral microangiopathy, which is said to lead to vas cular dementia. in a first trial series on 57 patients with confirmed pure cerebral microangiopathy (without concomitant macroangiopathy), neuropsycho logical impairment and (where present) brain atrophy correlated with decrea sed rCBF and rMRGlu. LI and DWML did not correlate with either neuropsychol ogical impairment or decreased rCBF/rMRGlu. This study was done one year la ter ta detect changes in any of the study parameters. Methods: 26 patients were re-examined far rCBF, rMRGlu, LI, DWML, atrophy and neuropsychological performance (7 cognitive, 3 mnestic, 4 attentiveness tests). Using a speci al head holder for exact repositioning, rCBF (SPECT) and rMRGlu (PET) were measured and imaged slice by slice. White matter/cortex were quantified usi ng MRI-defined ROIs. Results. After one year the patients did not show sign ificant decreases in rCBF or rMRGlu either in cortex or in white matter (p >0.05), nor did any patient show LI, DWML or atrophy changes an MRI. There were no significant neuropsychological decreases (p >0.05). Conclusions: Ce rebral microangiopathy aught to show progressive neuropsychological, functi onal (rCBF, rMRGlu) and morphological deterioration over periods >1 year. I t is unlikely that direct conical damage (e.g., incomplete infarction) is r esponsible for neuropsychological impairment since one-year follow-up of ou r patients revealed no progression of brain atrophy or any other cortical d amage.