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      Mnemonic function in small vessel disease and associations with white matter tract microstructure

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          Abstract

          Cerebral small vessel disease (SVD) is associated with deficits in working memory, with a relative sparing of long-term memory; function may be influenced by white matter microstructure. Working and long-term memory were examined in 106 patients with SVD and 35 healthy controls. Microstructure was measured in the uncinate fasciculi and cingula. Working memory was more impaired than long-term memory in SVD, but both abilities were reduced compared to controls. Regression analyses found that having SVD explained the variance in memory functions, with additional variance explained by the cingula (working memory) and uncinate (long-term memory). Performance can be explained in terms of integrity loss in specific white matter tract associated with mnemonic functions.

          Highlights

          • Working and long-term memory are both impaired in SVD compared to healthy adults.

          • SVD explained a significant proportion of the variance in both mnemonic functions.

          • Variance in working memory was explained by microstructure of the cingula.

          • Variance in long-term memory was explained by microstructure of the uncinate.

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          Most cited references28

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          Working Memory: Theories, Models, and Controversies

          I present an account of the origins and development of the multicomponent approach to working memory, making a distinction between the overall theoretical framework, which has remained relatively stable, and the attempts to build more specific models within this framework. I follow this with a brief discussion of alternative models and their relationship to the framework. I conclude with speculations on further developments and a comment on the value of attempting to apply models and theories beyond the laboratory studies on which they are typically based.
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            Robust determination of the fibre orientation distribution in diffusion MRI: non-negativity constrained super-resolved spherical deconvolution.

            Diffusion-weighted (DW) MR images contain information about the orientation of brain white matter fibres that potentially can be used to study human brain connectivity in vivo using tractography techniques. Currently, the diffusion tensor model is widely used to extract fibre directions from DW-MRI data, but fails in regions containing multiple fibre orientations. The spherical deconvolution technique has recently been proposed to address this limitation. It provides an estimate of the fibre orientation distribution (FOD) by assuming the DW signal measured from any fibre bundle is adequately described by a single response function. However, the deconvolution is ill-conditioned and susceptible to noise contamination. This tends to introduce artefactual negative regions in the FOD, which are clearly physically impossible. In this study, the introduction of a constraint on such negative regions is proposed to improve the conditioning of the spherical deconvolution. This approach is shown to provide FOD estimates that are robust to noise whilst preserving angular resolution. The approach also permits the use of super-resolution, whereby more FOD parameters are estimated than were actually measured, improving the angular resolution of the results. The method provides much better defined fibre orientation estimates, and allows orientations to be resolved that are separated by smaller angles than previously possible. This should allow tractography algorithms to be designed that are able to track reliably through crossing fibre regions.
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              Classification and natural history of clinically identifiable subtypes of cerebral infarction.

              We describe the incidence and natural history of four clinically identifiable subgroups of cerebral infarction in a community-based study of 675 patients with first-ever stroke. Of 543 patients with a cerebral infarct, 92 (17%) had large anterior circulation infarcts with both cortical and subcortical involvement (total anterior circulation infarcts, TACI); 185 (34%) had more restricted and predominantly cortical infarcts (partial anterior circulation infarcts, PACI); 129 (24%) had infarcts clearly associated with the vertebrobasilar arterial territory (posterior circulation infarcts, POCI); and 137 (25%) had infarcts confined to the territory of the deep perforating arteries (lacunar infarcts, LACI). There were striking differences in natural history between the groups. The TACI group had a negligible chance of good functional outcome and mortality was high. More than twice as many deaths were due to the complications of immobility than to direct neurological sequelae of the infarct. Patients in the PACI group were much more likely to have an early recurrent stroke than were patients in other groups. Those in the POCI group were at greater risk of a recurrent stroke later in the first year after the index event but had the best chance of a good functional outcome. Despite the small anatomical size of the infarcts in the LACI group, many patients remained substantially handicapped. The findings have important implications for the planning of stroke treatment trials and suggest that various therapies could be directed specifically at the subgroups.
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                Author and article information

                Contributors
                Journal
                Neuropsychologia
                Neuropsychologia
                Neuropsychologia
                Pergamon Press
                0028-3932
                1873-3514
                1 September 2017
                September 2017
                : 104
                : 1-7
                Affiliations
                [a ]Department of Psychology, Goldsmiths University of London, New Cross, London SE14 6NW, United Kingdom
                [b ]Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 1TN, United Kingdom
                [c ]Institute of Cardiovascular and Cell Sciences, St George's University of London, Cranmer Terrace, London SW17 0RE, United Kingdom
                [d ]King's College Institute of Psychiatry, Psychology & Neuroscience, London SE5 8AF, United Kingdom
                Author notes
                [* ]Corresponding author. r.charlton@ 123456gold.ac.uk
                Article
                S0028-3932(17)30280-4
                10.1016/j.neuropsychologia.2017.07.027
                5637155
                28750873
                9a8bc9ae-919b-42b0-a236-de07268503e8
                © 2017 The Authors

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                : 19 October 2016
                : 21 July 2017
                : 23 July 2017
                Categories
                Article

                Neurology
                long-term memory,working memory,cingulum,uncinate,ageing,small vessel disease
                Neurology
                long-term memory, working memory, cingulum, uncinate, ageing, small vessel disease

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