Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
Alzheimers Dement. 2024 Nov;20(11):7518-7528. doi: 10.1002/alz.14171. Epub 2024 Oct 10.
Cerebral amyloid angiopathy (CAA) is a main cause of cognitive dysfunction in the elderly. We investigated specific cognitive profiles, cognitive function in the stage before intracerebral hemorrhage (ICH), and the association between magnetic resonance imaging (MRI) based cerebral small vessel disease (cSVD) burden in CAA because data on these topics are limited.
We included Dutch-type hereditary CAA (D-CAA) mutation carriers with and without ICH, patients with sporadic CAA (sCAA), and age-matched controls. Cognition was measured with a standardized test battery. Linear regression was performed to assess the association between MRI-cSVD burden and cognition.
D-CAA ICH- mutation carriers exhibited poorer global cognition and executive function compared to age-matched controls. Patients with sCAA performed worse across all cognitive domains compared to D-CAA ICH+ mutation carriers and age-matched controls. MRI-cSVD burden is associated with decreased processing speed.
CAA is associated with dysfunction in multiple cognitive domains, even before ICH, with increased MRI-cSVD burden being associated with slower processing speed.
Cognitive dysfunction is present in early disease stages of cerebral amyloid angiopathy (CAA) before the occurrence of symptomatic intracerebral hemorrhage (sICH). Presymptomatic Dutch-type CAA (D-CAA) mutation carriers show worse cognition than age-matched controls. More early awareness of cognitive dysfunction in CAA before first sICH is needed. Increased cerebral small vessel disease CAA-burden on magnetic resonance imaging is linked to a decrease in processing speed.
脑淀粉样血管病（CAA）是老年人认知功能障碍的主要原因。我们研究了特定的认知特征、脑出血（ICH）前的认知功能以及磁共振成像（MRI）基于脑小血管疾病（cSVD）负担与 CAA 之间的关联，因为这些主题的数据有限。
我们纳入了荷兰型遗传性 CAA（D-CAA）突变携带者（有或无 ICH）、散发性 CAA（sCAA）患者和年龄匹配的对照组。使用标准化测试组来测量认知能力。进行线性回归以评估 MRI-cSVD 负担与认知之间的关联。
D-CAA ICH-突变携带者的整体认知和执行功能较年龄匹配的对照组差。sCAA 患者在所有认知领域的表现均较 D-CAA ICH+突变携带者和年龄匹配的对照组差。MRI-cSVD 负担与处理速度下降相关。
CAA 与多种认知领域的功能障碍相关，甚至在 ICH 之前，MRI-cSVD 负担增加与处理速度减慢相关。
认知功能障碍存在于脑淀粉样血管病（CAA）的早期疾病阶段，在出现症状性脑出血（sICH）之前。无症状的荷兰型 CAA（D-CAA）突变携带者的认知能力比年龄匹配的对照组差。在首次发生 sICH 之前，需要更早地认识到 CAA 中的认知功能障碍。MRI 上 CAA 负担的脑小血管疾病增加与处理速度下降有关。
