A silent spot: MRI reveals memory deficit

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  • Published: Jan 5, 2012
  • Author: David Bradley
  • Channels: MRI Spectroscopy
thumbnail image: A silent spot: MRI reveals memory deficit

Silent stroke

A new magnetic resonance study has linked so-called silent strokes that lead to small patches of dead brain cells with memory loss in elderly adults. The problem is thought to afflict one in four older adults with an important memory deficit.

In research supported by the US National Institutes of Health, new insights into how small spots of dead brain cells affect memory function in the elderly are revealed, with details being published in the 3rd January issue of the journal Neurology, published by the American Academy of Neurology.

Adam Brickman of the Taub Institute for Research on Alzheimer's Disease and the Aging Brain at Columbia University Medical Center in New York and colleagues Sonja Blum, Jose Luchsinger, Jennifer Manly, Nicole Schupf, Yaakov Stern, Brown TR, Decarli C, Small SA, Mayeux R focus on "normal" cognitive and structural changes that occur as we get older. They use MRI in their work to identify the specific parts of the brain that change or to reveal coordinated patterns of brain tissue that are apparently most vulnerable to the effects of aging. Brickman reveals that for MRI quantification, their work uses "traditional manual-tracing region-of-interest (ROI) approaches, ROI templates, white matter hyperintensity quantification protocols, voxel based morphometry, and novel multivariate/covariance analytic techniques."

In the present study, the team looked at a group of 658 people ages 65 and older who were considered free of dementia symptoms. They carried out MRI brain scans on the participants as well as giving them tests to measure memory, language, speed at processing information and visual perception. The study revealed that a total of 174 of the participants had suffered silent strokes. "The new aspect of this study of memory loss in the elderly is that it examines silent strokes and hippocampal shrinkage simultaneously," says Brickman. Memory deficit in the elderly is often thought of as being due to neurodegenerative changes in the hippocampus and related brain regions.

Aggressive regression

The researchers used multiple regression analysis to correlate cortical and subcortical infarcts, hippocampal and relative brain volume, with their measurements of cognitive performance. Essentially, they found that those study participants who had silent strokes scored much lower in memory tests than those without silent strokes. The correlation was present irrespective of the size of the hippocampus, the memory centre of the brain. A silent stroke is defined as a cerebral cardiovascular event that does not produce any of the common outward symptoms, such as palsy, speech problems and paralysis. Indeed, most people who have suffered a silent stroke are typically unaware that they have suffered a problem at all. However, despite the lack of outward identifiable symptoms silent strokes cause brain damage and are a significant risk factor for subsequent transient ischaemic attack and major stroke in the future.

"Presence of brain infarcts was associated with a smaller hippocampus. Smaller hippocampus volume was associated with poorer memory specifically. Brain infarcts were associated with poorer memory and cognitive performance in all other domains, which was independent of hippocampus volume," the team reports.

Implications in dementia

"Given that conditions like Alzheimer's disease are defined mainly by memory problems, our results may lead to further insight into what causes symptoms and the development of new interventions for prevention," says Brickman. "Since silent strokes and the volume of the hippocampus appeared to be associated with memory loss separately in our study, our results also support stroke prevention as a means for staving off memory problems," he adds.

 

The views represented in this article are solely those of the author and do not necessarily represent those of John Wiley and Sons, Ltd.

A new magnetic resonance study has linked so-called silent strokes that lead to small patches of dead brain cells with memory loss in elderly adults. The problem is thought to afflict one in four older adults with an important memory deficit. Photo from Brickman's web page
Brickman finds memory spots

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