Transcranial Doppler Ultrasound in Vascular Cognitive Impairment-No Dementia

Background: although cerebral white matter lesions (WMLs) are considered as a risk factor for vascular dementia, data on their impact on cerebral hemodynamic are scarce. We test and compare Transcranial Doppler (TCD) features in WMLs patients with or without associated cognitive impairment. Methods: a sample of non-demented elderly patients with WMLs were consecutively recruited. Mean blood flow velocity (MBFV), pulsatility index (PI), peak systolic blood flow velocity (PSV), end-diastolic blood flow velocity (EDV), and resistivity index (RI) were recorded from the middle cerebral artery bilaterally. Global cognitive functioning, frontal lobe abilities, functional status, mood evaluation and WMLs severity were also assessed. Results: 161 patients satisfying the clinical criteria for vascular cognitive impairment-no dementia (VCI-ND) were age-matched with 97 controls with WMLs but without any cognitive deficit. Compared to controls, VCI-ND patients exhibited a decrease of MBFV and EDV, as well as an increase of PI, RI, and PSV. Moreover, a significant correlation between all TCD parameters and severity of executive dysfunction was observed, whereas PI, RI, and EDV significantly correlated with WMLs load and MBFV was independently associated to depressive symptoms. Conclusions: VCI-ND showed a hemodynamic pattern of cerebral hypoperfusion and enhanced vascular resistances. These changes may be considered as the TCD correlate of VCI-ND due to microcirculation pathology. TCD provided useful indexes of occurrence and severity of small-vessel disease and executive dysfunction in elderly patients at risk for future dementia. Trial registration number: N/A