Trajectory Pattern of Cognitive Decline in Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy.
Journal
Neurology
ISSN: 1526-632X
Titre abrégé: Neurology
Pays: United States
ID NLM: 0401060
Informations de publication
Date de publication:
15 Jun 2022
15 Jun 2022
Historique:
received:
03
01
2022
accepted:
14
04
2022
entrez:
15
6
2022
pubmed:
16
6
2022
medline:
16
6
2022
Statut:
aheadofprint
Résumé
The course and pattern of cognitive decline in ischemic cerebral small vessel disease (cSVD) remains poorly characterized. We analysed the trajectory pattern of cognitive decline from age 25 to 75 years in CADASIL. We applied latent process mixed models to data obtained from CADASIL patients who were repeatedly scored during follow-up using 16 selected clinical scales or cognitive tests. The modelled evolutions of these scores obtained from 1243 observations in 265 patients recruited at the French National Referral Centre (50.1 years on average and 45.3% males) showed wide and heterogeneous variations in amplitude along the age-related progression of the disease. While the Backward Digit Span remained essentially stable, a linear deterioration of scores obtained using the Symbol Digit Numbers or Number of Errors of Trail Making Test B was detected from 25 to 75 years. In contrast, the largest score changes were observed at midlife using the Digit Cancellation Task. All other tests related to executive functions, memory performances, or global cognitive efficiency showed a rate of change accelerating especially at the advanced stage of the disease. Male gender, the presence of gait disorders or of some disability at baseline were found to predict earlier or large changes of 4 scores (Index of Sensitivity to Cueing, Delayed Total Recall, Initiation/Perseveration and Barthel Index) in a subgroup of individuals distinct form the rest of the sample. Cognitive alterations develop heterogeneously during the progression of CADASIL and vary largely according to the stage of the disease. These results suggest that not only the target population, study duration but also the stage of disease progression should be considered in preparing future clinical trials aimed at reducing cognitive decline in any such condition.
Sections du résumé
BACKGROUND AND OBJECTIVE
OBJECTIVE
The course and pattern of cognitive decline in ischemic cerebral small vessel disease (cSVD) remains poorly characterized. We analysed the trajectory pattern of cognitive decline from age 25 to 75 years in CADASIL.
METHODS
METHODS
We applied latent process mixed models to data obtained from CADASIL patients who were repeatedly scored during follow-up using 16 selected clinical scales or cognitive tests.
RESULTS
RESULTS
The modelled evolutions of these scores obtained from 1243 observations in 265 patients recruited at the French National Referral Centre (50.1 years on average and 45.3% males) showed wide and heterogeneous variations in amplitude along the age-related progression of the disease. While the Backward Digit Span remained essentially stable, a linear deterioration of scores obtained using the Symbol Digit Numbers or Number of Errors of Trail Making Test B was detected from 25 to 75 years. In contrast, the largest score changes were observed at midlife using the Digit Cancellation Task. All other tests related to executive functions, memory performances, or global cognitive efficiency showed a rate of change accelerating especially at the advanced stage of the disease. Male gender, the presence of gait disorders or of some disability at baseline were found to predict earlier or large changes of 4 scores (Index of Sensitivity to Cueing, Delayed Total Recall, Initiation/Perseveration and Barthel Index) in a subgroup of individuals distinct form the rest of the sample.
DISCUSSION
CONCLUSIONS
Cognitive alterations develop heterogeneously during the progression of CADASIL and vary largely according to the stage of the disease. These results suggest that not only the target population, study duration but also the stage of disease progression should be considered in preparing future clinical trials aimed at reducing cognitive decline in any such condition.
Identifiants
pubmed: 35705499
pii: WNL.0000000000200805
doi: 10.1212/WNL.0000000000200805
pmc: PMC9519251
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2022 American Academy of Neurology.
Références
Brain. 2006 Sep;129(Pt 9):2375-83
pubmed: 16844717
Lancet Neurol. 2009 Jul;8(7):643-53
pubmed: 19539236
Stat Med. 2016 Feb 10;35(3):382-98
pubmed: 26376900
Eur J Neurol. 2020 Aug;27(8):1588-1595
pubmed: 32348626
Nature. 1996 Oct 24;383(6602):707-10
pubmed: 8878478
Lancet Neurol. 2010 Jul;9(7):689-701
pubmed: 20610345
Neurology. 2000 Feb 22;54(4):827-32
pubmed: 10690971
Biometrics. 2006 Dec;62(4):1014-24
pubmed: 17156275
J Geriatr Psychiatry Neurol. 1991 Jan-Mar;4(1):18-25
pubmed: 2054047
Neurol Sci. 2013 Aug;34(8):1367-74
pubmed: 23161259
Int Psychogeriatr. 2003;15 Suppl 1:23-6
pubmed: 16191213
Neurobiol Aging. 2011 Dec;32(12):2172-82
pubmed: 20149485
Qual Life Res. 1996 Dec;5(6):521-31
pubmed: 8993098
Neurology. 1998 Aug;51(2):452-7
pubmed: 9710018
Ital J Neurol Sci. 1996 Aug;17(4):305-9
pubmed: 8915764
Brain. 2011 Aug;134(Pt 8):2366-75
pubmed: 21764819
Stroke. 2016 Jan;47(1):4-11
pubmed: 26578659
Vasc Health Risk Manag. 2012;8:407-13
pubmed: 22910531
Nat Protoc. 2006;1(5):2277-81
pubmed: 17406468
Neurology. 1999 Jul 13;53(1):126-31
pubmed: 10408548
Lancet. 1995 Oct 7;346(8980):934-9
pubmed: 7564728
J Clin Exp Neuropsychol. 1998 Aug;20(4):536-47
pubmed: 9892057
Nature. 2020 Nov;587(7832):87-91
pubmed: 33116309
Stat Med. 2007 Dec 20;26(29):5285-302
pubmed: 17542002
J Alzheimers Dis. 2020;77(1):291-300
pubmed: 32804128
Arch Clin Neuropsychol. 1989;4(4):393-8
pubmed: 14591136
J Clin Invest. 2000 Mar;105(5):597-605
pubmed: 10712431
Psychol Med. 1988 Aug;18(3):727-31
pubmed: 3186871
Neuroepidemiology. 2006;27(2):101-16
pubmed: 16943684
Int Psychogeriatr. 2003;15 Suppl 1:215-7
pubmed: 16191243
Stat Methods Med Res. 2014 Feb;23(1):74-90
pubmed: 22517270
Curr Alzheimer Res. 2013 Jul;10(6):642-53
pubmed: 23627757
J Am Geriatr Soc. 1992 Sep;40(9):922-35
pubmed: 1512391
Am J Psychiatry. 2005 Nov;162(11):2078-85
pubmed: 16263847
Assessment. 2003 Mar;10(1):56-65
pubmed: 12675384
Arch Gerontol Geriatr. 2019 Sep - Oct;84:103891
pubmed: 31228674
Cortex. 2017 Oct;95:92-103
pubmed: 28865241
J Alzheimers Dis. 2015;47(2):413-9
pubmed: 26401563
Brain Res Cogn Brain Res. 2000 Jun;9(3):339-42
pubmed: 10808144
Ann Neurol. 1998 Nov;44(5):731-9
pubmed: 9818928
Arch Phys Med Rehabil. 1979 Jan;60(1):14-7
pubmed: 420565
Arch Clin Neuropsychol. 1997;12(3):269-75
pubmed: 14588419
Neurology. 2006 May 23;66(10):1523-6
pubmed: 16717212