TY - JOUR
T1 - Cholinergic circuitry functioning in patients with vascular cognitive impairment - No dementia
AU - Bella, Rita
AU - Cantone, Mariagiovanna
AU - Lanza, Giuseppe
AU - Ferri, Raffaele
AU - Vinciguerra, Luisa
AU - Puglisi, Valentina
AU - Pennisi, Manuela
AU - Ricceri, Riccardo
AU - Di Lazzaro, Vincenzo
AU - Pennisi, Giovanni
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Background An impairment of central cholinergic activity, as evaluated non-invasively by the short-latency afferent inhibition (SAI) of motor responses evoked by transcranial magnetic stimulation (TMS), was observed in patients with Alzheimer's disease (AD) and amnestic Mild Cognitive Impairment. Conversely, the involvement of central cholinergic neurotransmission in vascular dementia (VaD) is still under debate and data on Vascular Cognitive Impairment - No Dementia (VCI-ND) at risk for future VaD are lacking. Objective To test for the first time SAI in patients with VCI-ND. Methods Single-pulse TMS measures of cortical excitability and SAI were evaluated in 25 VCI-ND patients with subcortical ischemic lesions and 20 age-matched healthy controls. Functional status, neuropsychological tests evaluating frontal lobe abilities, and white matter lesions (WMLs) load were assessed. Results A significant difference was found between patients and controls for the mean SAI, although this result did not resist after the Bonferroni correction. In the whole group of patients and controls, SAI showed a correlation with worse scores at the Montreal Cognitive Assessment (r = 0.376, p <0.01). SAI also positively correlated with the total vascular burden (r = 0.345, p <0.05) but not with the WML severity. Conclusions Central cholinergic pathway does not seem to be involved in VCI-ND, and the current results differ from those reported in primary cholinergic forms of dementia, such as AD. SAI might represent a valuable additional tool in the differential diagnosis of the dementing processes and in identifying potential responders to cholinergic agents.
AB - Background An impairment of central cholinergic activity, as evaluated non-invasively by the short-latency afferent inhibition (SAI) of motor responses evoked by transcranial magnetic stimulation (TMS), was observed in patients with Alzheimer's disease (AD) and amnestic Mild Cognitive Impairment. Conversely, the involvement of central cholinergic neurotransmission in vascular dementia (VaD) is still under debate and data on Vascular Cognitive Impairment - No Dementia (VCI-ND) at risk for future VaD are lacking. Objective To test for the first time SAI in patients with VCI-ND. Methods Single-pulse TMS measures of cortical excitability and SAI were evaluated in 25 VCI-ND patients with subcortical ischemic lesions and 20 age-matched healthy controls. Functional status, neuropsychological tests evaluating frontal lobe abilities, and white matter lesions (WMLs) load were assessed. Results A significant difference was found between patients and controls for the mean SAI, although this result did not resist after the Bonferroni correction. In the whole group of patients and controls, SAI showed a correlation with worse scores at the Montreal Cognitive Assessment (r = 0.376, p <0.01). SAI also positively correlated with the total vascular burden (r = 0.345, p <0.05) but not with the WML severity. Conclusions Central cholinergic pathway does not seem to be involved in VCI-ND, and the current results differ from those reported in primary cholinergic forms of dementia, such as AD. SAI might represent a valuable additional tool in the differential diagnosis of the dementing processes and in identifying potential responders to cholinergic agents.
KW - Acetylcholine
KW - Cortical excitability
KW - Executive dysfunction
KW - Transcranial magnetic stimulation
KW - Vascular dementia
KW - White matter lesions
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U2 - 10.1016/j.brs.2015.09.013
DO - 10.1016/j.brs.2015.09.013
M3 - Article
AN - SCOPUS:84961125534
VL - 9
SP - 225
EP - 233
JO - Brain Stimulation
JF - Brain Stimulation
SN - 1935-861X
IS - 2
ER -