Specific Cognitive–Psychopathological Phenotypes in Patients With Early Stages of Subcortical Vascular Neurocognitive Disorders: A Hospital-Based Case–Control Study

Abstract

Background:

Diagnosis of subcortical vascular neurocognitive disorders’ (ScVNCDs) is currently based on neuropsychological and neuroimaging approaches; nevertheless, clinical features, apart from cognitive impairments (CI), may provide additional information about ScVNCD phenotypes. We aimed to determine whether CI and neuropsychiatric symptoms (NPS) form such clinical phenotypes in the mild and early stage of major ScVNCD.

Methods:

Our sample included 88 cognitively normal elderly individuals, 100 patients with mild ScVNCD, and 60 patients with early major ScVNCD. All participants had neuropsychological, neuropsychiatric, neurological, and functional evaluations. The prevalence of NPS was based on the neuropsychiatric inventory. The statistical analyses included parametric and nonparametric tests and multivariate regression.

Results:

The severity of executive dysfunction increased through stages of ScVNCD progression (P < .0001). The NPS with significant predictive value for mild ScVNCD membership was depression (odds ratio [OR] = 7.4), whereas for early major ScVNCD were depression (OR = 5.5) and apathy (OR = 7.6). Those distinguishing NPS and impairments of executive tests’ performance significantly correlated (P < .05) in patients with mild/major ScVNCD.

Conclusion:

Significant correlation between pathognomonic cognitive and NPS in compared groups suggest that dysexecutive-depressive syndrome can be the main phenotype in mild ScVNCD, while dysexecutive-depressive-apathetic syndrome in the early stage of major ScVNCD. Obtained cognitive–psychopathological phenotypes may allow a better comprehension of the ScVNCD pathophysiology and improve the diagnostic and therapeutic approach.