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Impact of regional cortical and subcortical changes on processing speed in cerebral small vessel disease.
[cadasil]
Slowed
processing
speed
is
common
in
elderly
subjects
and
frequently
related
to
cerebral
small
vessel
disease
.
Previous
studies
have
demonstrated
associations
between
processing
speed
and
subcortical
ischemic
lesions
as
well
as
cortical
alterations
but
the
precise
functional
-anatomical
relationships
remain
poorly
understood
.
Here
we
assessed
the
impact
of
both
cortical
and
subcortical
changes
on
processing
speed
by
measuring
regional
cortical
thickness
and
regional
lesion
volumes
within
distinct
white
-matter
tracts
.
To
limit
confounding
effects
from
age-related
pathologies
we
studied
patients
with
CADASIL
,
a
genetic
small
vessel
disease
.
General
linear
model
analysis
revealed
significant
associations
between
cortical
thickness
in
the
medial
frontal
and
occipito-
temporal
cortex
and
processing
speed
.
Bayesian
network
analysis
showed
a
robust
conditional
dependency
between
the
volume
of
lacunar
lesions
in
the
left
anterior
thalamic
radiation
and
cortical
thickness
of
the
left
medial
frontal
cortex
,
and
between
thickness
of
the
left
medial
frontal
cortex
and
processing
speed
,
whereas
there
was
no
direct
dependency
between
lesion
volumes
in
the
left
anterior
thalamic
radiation
and
processing
speed
.
Our
results
suggest
that
the
medial
frontal
cortex
has
an
intermediate
position
between
lacunar
lesions
in
the
anterior
thalamic
radiation
and
deficits
in
processing
speed
.
In
contrast
,
we
did
not
observe
such
a
relationship
for
the
occipito-
temporal
region
.
These
findings
reinforce
the
key
role
of
frontal
-subcortical
circuits
in
cognitive
impairment
resulting
from
cerebral
small
vessel
disease
.