{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T16:24:36Z","timestamp":1791735876910,"version":"4.3.4"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T00:00:00Z","timestamp":1679616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Aging Neurosci."],"abstract":"Objectives<\/jats:title>Cerebral small vessel disease (SVD) is commonly observed among elderly individuals with cognitive impairment and has been recognized as a vascular contributor to dementia and behavioral and psychological symptoms (BPS), however, the relationship between BPS and SVD burden remains unclear.<\/jats:p><\/jats:sec>Methods<\/jats:title>We prospectively recruited 42 patients with mild cognitive impairment (MCI) or mild dementia from the memory clinic in our hospital, who were assigned to either a clinical dementia rating (CDR) of 0.5 or 1.0, respectively. The presence of BPS was determined through interviews with caregivers. The patients underwent brain MRI and three types of SVD scores, total, cerebral amyloid angiopathy (CAA), and modified CAA, were assigned. Patients were also evaluated through various neuropsychological assessments.<\/jats:p><\/jats:sec>Results<\/jats:title>The CDR was significantly higher in patients with BPS (p<\/jats:italic>\u2009=\u20090.001). The use of antihypertensive agents was significantly higher in patients without BPS (p<\/jats:italic>\u2009=\u20090.038). The time taken to complete trail making test set-A was also significantly longer in patients with BPS (p<\/jats:italic>\u2009=\u20090.037). There was no significant difference in total SVD and CAA-SVD score (p<\/jats:italic>\u2009=\u20090.745, and 0.096) and the modified CAA-SVD score was significantly higher in patients with BPS (p<\/jats:italic>\u2009=\u20090.046). In addition, the number of total CMBs and lobar CMBs was significantly higher in patients with BPS (p<\/jats:italic>\u2009=\u20090.001 and 0.001). Receiver operating characteristic curves for BPS showed that for modified CAA-SVD, a cutoff score of 3.5 showed 46.7% sensitivity and 81.5% specificity. Meanwhile, for the total number of cerebral microbleeds (CMBs), a cut-off score of 2.5 showed 80.0% sensitivity and 77.8% specificity and for the number of lobar CMBs, a cut-off score of 2.5 showed 73.3% sensitivity and 77.8% specificity.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Overall, patients with BPS showed worse CDRs, reduced psychomotor speed, higher modified CAA-SVD scores, larger numbers of total and lobar CMBs. We propose that severe modified CAA scores and higher numbers of total and lobar CMBs are potential risk factors for BPS in patients with mild dementia or MCI. Therefore, by preventing these MRI lesions, the risk of BPS may be mitigated.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnagi.2023.1143834","type":"journal-article","created":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T05:03:56Z","timestamp":1679634236000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Association between behavioral and psychological symptoms and cerebral small vessel disease MRI findings in memory clinic patients"],"prefix":"10.3389","volume":"15","author":[{"given":"Masaki","family":"Shinohara","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kana","family":"Matsuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichiro","family":"Ii","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken-ichi","family":"Tabei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoko","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinori","family":"Hirata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidehiro","family":"Ishikawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirofumi","family":"Matsuyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keita","family":"Matsuura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayuki","family":"Maeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidekazu","family":"Tomimoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Shindo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,3,24]]},"reference":[{"key":"ref1","first-page":"567","article-title":"Normative data on tests for frontal lobe functions: trail making test, verbal fluency, Wisconsin card sorting test (Keio version)","volume":"56","author":"Abe","year":"2004","journal-title":"No to shinkei"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"933958","DOI":"10.3389\/fnagi.2022.933958","article-title":"Detecting apathy in patients with cerebral small vessel disease","volume":"14","author":"Cai","year":"2022","journal-title":"Front. Aging Neurosci."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"714","DOI":"10.1016\/S1474-4422(22)00208-3","article-title":"The Boston criteria version 2.0 for cerebral amyloid angiopathy: a multicentre, retrospective, Mri\u2013neuropathology diagnostic accuracy study","volume":"21","author":"Charidimou","year":"2022","journal-title":"Lancet Neurol."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"994","DOI":"10.1001\/jamaneurol.2016.0832","article-title":"Total magnetic resonance imaging burden of small vessel disease in cerebral amyloid Angiopathy: an imaging-pathologic study of concept validation","volume":"73","author":"Charidimou","year":"2016","journal-title":"JAMA Neurol."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"CD004034","DOI":"10.1002\/14651858.CD004034.pub4","article-title":"Pharmacological treatment of hypertension in people without prior cerebrovascular disease for the prevention of cognitive impairment and dementia","volume":"5","author":"Cunningham","year":"2021","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1016\/j.archger.2010.05.004","article-title":"Can impairment in memory, language and executive functions predict neuropsychiatric symptoms in Alzheimer's disease (ad)? Findings from a cross-sectional study","volume":"52","author":"Garc\u00eda-Alberca","year":"2011","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1002\/alz.12765","article-title":"Neuropathological correlates of neuropsychiatric symptoms in dementia","author":"Gibson","year":"2022","journal-title":"Alzheimer's Dement."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1759","DOI":"10.1212\/WNL.0b013e3181c34a7d","article-title":"The microbleed anatomical rating scale (Mars): reliability of a tool to map brain microbleeds","volume":"73","author":"Gregoire","year":"2009","journal-title":"Neurology"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1662","DOI":"10.1002\/alz.12637","article-title":"The apathy, gait impairment, and executive dysfunction (aged) triad vascular variant","volume":"18","author":"Hachinski","year":"2022","journal-title":"Alzheimers Dement."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1192\/bjp.140.6.566","article-title":"A new clinical scale for the staging of dementia","volume":"140","author":"Hughes","year":"1982","journal-title":"Br. J. Psychiatry"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1887","DOI":"10.1007\/s00415-019-09350-9","article-title":"Cortical microinfarcts in patients with multiple lobar microbleeds on 3 T Mri","volume":"266","author":"Ii","year":"2019","journal-title":"J. Neurol."},{"key":"ref12","first-page":"146","article-title":"Dementia associated mental and behavioural disturbances in elderly people in the community: findings from the first Nakayama study","volume":"75","author":"Ikeda","year":"2004","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1010","DOI":"10.1161\/STROKEAHA.119.028202","article-title":"Cortical microinfarcts detected by 3-tesla magnetic resonance imaging","volume":"51","author":"Ishikawa","year":"2020","journal-title":"Stroke"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"h369","DOI":"10.1136\/bmj.h369","article-title":"Assessment and management of behavioral and psychological symptoms of dementia","volume":"350","author":"Kales","year":"2015","journal-title":"BMJ"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1906","DOI":"10.1016\/j.clnu.2022.06.035","article-title":"Longitudinal association between nutritional status and behavioral and psychological symptoms of dementia in older women with mild cognitive impairment and early-stage Alzheimer's disease","volume":"41","author":"Kishino","year":"2022","journal-title":"Clin. Nutr."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"2995","DOI":"10.1161\/STROKEAHA.113.002545","article-title":"Ambulatory blood pressure in patients with lacunar stroke: association with total Mri burden of cerebral small vessel disease","volume":"44","author":"Klarenbeek","year":"2013","journal-title":"Stroke"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1167","DOI":"10.2174\/1567205018666210212160902","article-title":"The contribution of cerebral vascular neuropathology to mild stage of Alzheimer's dementia using the Nacc database","volume":"17","author":"Liu","year":"2020","journal-title":"Curr. Alzheimer Res."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"591","DOI":"10.3233\/JAD-150612","article-title":"Different patterns of correlation between Grey and white matter integrity account for behavioral and psychological symptoms in Alzheimer\u2019s disease","volume":"50","author":"Makovac","year":"2016","journal-title":"J. Alzheimers Dis."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"e042550","DOI":"10.1136\/bmjopen-2020-042550","article-title":"Investigation of hypertensive arteriopathy-related and cerebral amyloid angiopathy-related small vessel disease scores in patients from a memory clinic: a prospective single-Centre study","volume":"11","author":"Matsuda","year":"2021","journal-title":"BMJ Open"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1016\/j.jalz.2011.03.005","article-title":"The diagnosis of dementia due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease","volume":"7","author":"Mckhann","year":"2011","journal-title":"Alzheimers Dement."},{"key":"ref21","first-page":"82","article-title":"Usefulness of a Japanese version of the mini-mental state test in neurological patients","volume":"1","author":"Mori","year":"1985","journal-title":"Jpn J Neuropsychol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1001\/archneur.65.8.1091","article-title":"Staging dementia using clinical dementia rating scale sum of boxes scores: a Texas Alzheimer's research consortium study","volume":"65","author":"O'Bryant","year":"2008","journal-title":"Arch. Neurol."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1162","DOI":"10.1177\/0271678X20957604","article-title":"Brain amyloid and vascular risk are related to distinct white matter hyperintensity patterns","volume":"41","author":"P\u00e5lhaugen","year":"2021","journal-title":"J. Cereb. Blood Flow Metab."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1016\/S1474-4422(10)70104-6","article-title":"Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges","volume":"9","author":"Pantoni","year":"2010","journal-title":"Lancet Neurol."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1111\/j.1365-2796.2004.01388.x","article-title":"Mild cognitive impairment as a diagnostic entity","volume":"256","author":"Petersen","year":"2004","journal-title":"J. Intern. Med."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"2227","DOI":"10.1056\/NEJMcp0910237","article-title":"Clinical practice. Mild cognitive impairment","volume":"364","author":"Petersen","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"e0178886","DOI":"10.1371\/journal.pone.0178886","article-title":"High prevalence of cognitive impairment after intracerebral hemorrhage","volume":"12","author":"Planton","year":"2017","journal-title":"PLoS One"},{"key":"ref28","volume-title":"Coloured progressive matrices, sets a, A_B","author":"Raven","year":"1962"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"105568","DOI":"10.1016\/j.jstrokecerebrovasdis.2020.105568","article-title":"The association between cerebral small vessel disease and the gut microbiome: a cross-sectional analysis","volume":"30","author":"Saji","year":"2021","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1159\/000449245","article-title":"Improved Necker cube drawing-based assessment battery for constructional apraxia: the Mie constructional apraxia scale (Mcas)","volume":"6","author":"Satoh","year":"2016","journal-title":"Dement. Geriatr. Cogn. Dis. Extra"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1192\/bjp.bp.108.049619","article-title":"Prevalence, correlates and course of behavioural and psychological symptoms of dementia in the population","volume":"194","author":"Savva","year":"2009","journal-title":"Br. J. Psychiatry"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"973054","DOI":"10.3389\/fnagi.2022.973054","article-title":"Potential of brain age in identifying early cognitive impairment in subcortical small-vessel disease patients","volume":"14","author":"Shi","year":"2022","journal-title":"Front. Aging Neurosci."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"109","DOI":"10.3389\/fnagi.2020.00109","article-title":"Clinical features and experimental models of cerebral small vessel disease","volume":"12","author":"Shindo","year":"2020","journal-title":"Front. Aging Neurosci."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"e022089","DOI":"10.1161\/JAHA.121.022089","article-title":"Cerebral amyloid Angiopathy is associated with emotional dysregulation, impulse Dyscontrol, and apathy","volume":"10","author":"Smith","year":"2021","journal-title":"J. Am. Heart Assoc."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1228","DOI":"10.1212\/WNL.0000000000000837","article-title":"Stroke subtype, vascular risk factors, and total Mri brain small-vessel disease burden","volume":"83","author":"Staals","year":"2014","journal-title":"Neurology"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"e26749","DOI":"10.1097\/MD.0000000000026749","article-title":"The relation between antihypertensive treatment and progression of cerebral small vessel disease: a systematic review and meta-analysis of randomized controlled trials","volume":"100","author":"Su","year":"2021","journal-title":"Medicine (Baltimore)"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"794","DOI":"10.1212\/WNL.0000000000000732","article-title":"Posterior white matter disease distribution as a predictor of amyloid angiopathy","volume":"83","author":"Thanprasertsuk","year":"2014","journal-title":"Neurology"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1111\/ggi.12661","article-title":"White matter integrity and cognitive dysfunction: radiological and neuropsychological correlations","volume":"15","author":"Tomimoto","year":"2015","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref39","doi-asserted-by":"publisher","first-page":"684","DOI":"10.1016\/S1474-4422(19)30079-1","article-title":"Small vessel disease: mechanisms and clinical implications","volume":"18","author":"Wardlaw","year":"2019","journal-title":"Lancet Neurol."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1080\/01688638908400940","article-title":"The development and validation of a test battery for detecting and monitoring everyday memory problems","volume":"11","author":"Wilson","year":"1989","journal-title":"J. Clin. Exp. Neuropsychol."},{"key":"ref41","doi-asserted-by":"publisher","first-page":"688685","DOI":"10.3389\/fpsyt.2021.688685","article-title":"Diagnosis and assessment of apathy in elderly Chinese patients with cerebral small vessel disease","volume":"12","author":"Zh\u00e0o","year":"2021","journal-title":"Front. Psychiatry"}],"container-title":["Frontiers in Aging Neuroscience"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnagi.2023.1143834\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T05:04:00Z","timestamp":1679634240000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnagi.2023.1143834\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,24]]},"references-count":41,"alternative-id":["10.3389\/fnagi.2023.1143834"],"URL":"https:\/\/doi.org\/10.3389\/fnagi.2023.1143834","relation":{},"ISSN":["1663-4365"],"issn-type":[{"value":"1663-4365","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,24]]},"article-number":"1143834"}}