Cognitive and Neuroimaging Markers of Vascular Cognitive Impairment

Lowry, Ellen (2022) Cognitive and Neuroimaging Markers of Vascular Cognitive Impairment. Doctoral thesis, University of East Anglia.

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Abstract

Detection of incipient cognitive impairment and dementia pathophysiology is critical to identifying preclinical populations and target potentially disease modifying interventions towards them. There are currently concerted efforts for such detection in Alzheimer’s disease (AD). By contrast, the examination of cognitive markers and their relationship to biomarkers for vascular cognitive impairment (VCI) is far less established, despite VCI being highly prevalent and often concomitantly presenting with AD. Critically, vascular risk factors are currently associated with the most viable treatment options via pharmacological and non-pharmacological intervention, hence developing selective and sensitive methods for the identification of vascular factors have important implications for modifying dementia disease trajectories. As outlined in Chapter one, this thesis focuses on uncovering spatial navigation deficits in established and preclinical VCI and investigates potential brain dysconnectivity in the frontoparietal regions and overlapping navigation systems. Chapter two reveals egocentric orientation deficits in established VCI to distinguish it from AD. In Chapter three, the VCI case study, RK, who previously displayed spatial navigation deficits is followed up three years after initial diagnosis. Results suggest an ongoing egocentric orientation deficit whilst there are improvements in cognitive scores assessed using conventional neuropsychological assessments. Diffusion tensor imaging (DTI) analysis suggests reduced superior longitudinal fasciculus (SLF) integrity to parietal segments. Chapter four shows that a novel test battery of navigation and ERP components capture deficits that precede the onset of general cognitive decline assessed by typical neuropsychological assessment in preclinical VCI. Taken together, this research advances our conceptual understanding of the pathological changes to cognition that characterise VCI and at-risk individuals.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Social Sciences > School of Psychology
Depositing User:	Chris White
Date Deposited:	15 Feb 2023 12:05
Last Modified:	15 Feb 2023 12:05
URI:	https://ueaeprints.uea.ac.uk/id/eprint/91138
DOI:

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