Rita Bella1, Mariagiovanna Cantone2, Giuseppe Lanza2, Raffaele Ferri2, Luisa Vinciguerra1, Valentina Puglisi1, Manuela Pennisi3, Riccardo Ricceri1, Vincenzo Di Lazzaro4, Giovanni Pennisi5. 1. Department of Medical and Surgical Sciences and Advanced Technologies, Section of Neurosciences, University of Catania, Catania, Italy. 2. Department of Neurology I.C., "Oasi" Institute for Research on Mental Retardation and Brain Aging (I.R.C.C.S.), Troina (EN), Italy. 3. Spinal Unit, Emergency Hospital "Cannizzaro", Catania, Italy. 4. Institute of Neurology, Campus Bio Medico University, Rome, Italy. 5. Department of Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy. Electronic address: pennigi@unict.it.
Abstract
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.
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-NDpatients 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.
Authors: Olivia K L Hamilton; Ellen V Backhouse; Esther Janssen; Angela C C Jochems; Caragh Maher; Tuula E Ritakari; Anna J Stevenson; Lihua Xia; Ian J Deary; Joanna M Wardlaw Journal: Alzheimers Dement Date: 2020-11-13 Impact factor: 16.655