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Cerebral changes and cognitive impairment after an ischemic heart disease: a multimodal MRI study

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Abstract

Three to 6 months after an acute coronary syndrome (ACS), cognitive impairment is observed in more than 30 % of the patients, mainly in executive functioning. The aim of this study was to investigate, using multimodal MRI, cerebral anatomo-functional substratum of executive dysfunction. Thirty-three patients were recruited 4 ± 1 months after a first ACS. Executive functions were evaluated with the Trail-Making-Test-B (TMTB) at baseline (ie 4 ± 1 months after ACS) and 6 months later (ie 10 ± 1 months after ACS). Using both time-points, we identified 3 groups of patients according to normative data based on age, gender and education level: 15 ‘cognitively normal’ patients without impairment at each follow-up, 10 ‘transient impaired’ patients with an impairment only at baseline and 8 ‘impairing’ patients with an impairment only at follow-up. We explored, in the whole-brain, the structural integrity using Voxel-Based Morphometry and Tract-Based Spatial Statistics and the resting-state functional connectivity using Network-Based Statistics. No structural difference was observed between impaired and cognitively normal patients. At the functional level, compared to the ‘cognitively normal’ group, the ‘transient impaired’ patients presented an increased functional connectivity in a network centered on middle-orbito-frontal regions, whereas the ‘impairing’ patients presented only a non-significant decrease of functional connectivity. Executive dysfunction in ACS patients is associated to functional but no structural characteristics, particularly to an increased functional connectivity in cognitive networks in transient impaired patients. Further studies with larger sample size are needed to confirm these results and to determine if these patients could be at higher risk for developing permanent cognitive disorders.

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Acknowledgments

The authors are grateful to P. Perez, methodological coordinator, J. Asselineau and R. Sitta, biostatisticians from the USMR (Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique) at the University hospital of Bordeaux in France for their methodological advices.

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Authors and Affiliations

  1. Univ. Bordeaux, INCIA, UMR 5287, F-33400, Talence, France

    Charlotte Bernard, Gwénaëlle Catheline, Bixente Dilharreguy, Saioa Lassalle-Lagadec, Dorothée Callaert, Michèle Allard & Igor Sibon

  2. CNRS, INCIA, UMR 5287, F-33400, Talence, France

    Charlotte Bernard, Gwénaëlle Catheline, Bixente Dilharreguy, Saioa Lassalle-Lagadec, Dorothée Callaert, Michèle Allard & Igor Sibon

  3. EPHE, Bordeaux, France

    Gwénaëlle Catheline & Michèle Allard

  4. Univ Bordeaux, Centre Hospitalier Universitaire de Bordeaux, Centre d’Exploration, de Prévention et de Traitement de l’Athérosclérose (CEPTA), Pessac, France

    Thierry Couffinhal

  5. Univ Bordeaux, Centre Hospitalier Universitaire de Bordeaux, Unité Neurovasculaire, Pôle de Neurosciences Cliniques, Hôpital Pellegrin, 33076, Bordeaux, France

    Sylvain Ledure & Igor Sibon

  6. INCIA UMR 5287 CNRS, Univ. Bordeaux, Equipe de Neuroimagerie et Cognition Humaine, 146 rue Léo Saignat, zone Nord-Case 22, 33076, Bordeaux, cedex, France

    Charlotte Bernard

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  1. Charlotte Bernard
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Correspondence to Charlotte Bernard.

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The authors have no financial interests to declare.

Informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, and the applicable revisions at the time of the investigation. Informed consent was obtained from all patients for being included in the study.

Funding

Local funding (2007/31) was obtained for patient recruitment, MRI acquisition and patients follow-up.

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Bernard, C., Catheline, G., Dilharreguy, B. et al. Cerebral changes and cognitive impairment after an ischemic heart disease: a multimodal MRI study. Brain Imaging and Behavior 10, 893–900 (2016). https://doi.org/10.1007/s11682-015-9483-4

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