Association between subcortical vascular lesion location and cognition: a voxel-based and tract-based lesion-symptom mapping study. The SMART-MR study

J Matthijs Biesbroek; Hugo J Kuijf; Yolanda van der Graaf; Koen L Vincken; Albert Postma; Willem P T M Mali; Geert J Biessels; Mirjam I Geerlings; SMART Study Group

doi:10.1371/journal.pone.0060541

Association between subcortical vascular lesion location and cognition: a voxel-based and tract-based lesion-symptom mapping study. The SMART-MR study

PLoS One. 2013 Apr 8;8(4):e60541. doi: 10.1371/journal.pone.0060541. Print 2013.

Authors

J Matthijs Biesbroek¹, Hugo J Kuijf, Yolanda van der Graaf, Koen L Vincken, Albert Postma, Willem P T M Mali, Geert J Biessels, Mirjam I Geerlings; SMART Study Group

Affiliation

¹ Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands.

Abstract

Introduction: Lacunar lesions (LLs) and white matter lesions (WMLs) affect cognition. We assessed whether lesions located in specific white matter tracts were associated with cognitive performance taking into account total lesion burden.

Methods: Within the Second Manifestations of ARTerial disease Magnetic Resonance (SMART-MR) study, cross-sectional analyses were performed on 516 patients with manifest arterial disease. We applied an assumption-free voxel-based lesion-symptom mapping approach to investigate the relation between LL and WML locations on 1.5 Tesla brain MRI and compound scores of executive functioning, memory and processing speed. Secondly, a multivariable linear regression model was used to relate the regional volume of LLs and WMLs within specific white matter tracts to cognitive functioning.

Results: Voxel-based lesion-symptom mapping identified several clusters of voxels with a significant correlation between WMLs and executive functioning, mostly located within the superior longitudinal fasciculus and anterior thalamic radiation. In the multivariable linear regression model, a statistically significant association was found between regional LL volume within the superior longitudinal fasciculus and anterior thalamic radiation and executive functioning after adjustment for total LL and WML burden.

Conclusion: These findings identify the superior longitudinal fasciculus and anterior thalamic radiation as key anatomical structures in executive functioning and emphasize the role of strategically located vascular lesions in vascular cognitive impairment.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Brain / blood supply
Brain / physiopathology
Cognition*
Executive Function
Female
Humans
Intracranial Arterial Diseases / diagnosis*
Intracranial Arterial Diseases / physiopathology*
Linear Models
Magnetic Resonance Imaging*
Male
Middle Aged

Grants and funding

This study was supported by a programme grant from The Netherlands Heart Foundation (NHF: project no 2007B027). The work of JM Biesbroek was supported by a Neuroscience & Cognition grant from Utrecht University. The work of GJ Biessels was supported by VIDI grant 91711384 from ZonMw, The Netherlands Organisation for Health Research and Development, and by grant 2010T073 from the Netherlands Heart Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.