Clinical and immune markers of age-dependent cerebral microangiopathy

The aim of the study was to investigate the pattern of cognitive impairment and immune status of patients with MRI changes corresponding to CMA.

Material and methods. 65 patients with CMA according to the MRI criteria were examined. Depending on the degree of white matter hyperintensity (Fazekas scale), patients were divided into 2 groups: Group 1 — 40 patients with Fazekas stage 2; Group 2 — 25 patients with Fazekas stage 3. The control group consisted of 24 patients of the corresponding age category without MRI signs of CMA. Cognitive function was investigated using MoCA and additional tests to assess memory, executive function, attention, perception and praxis. Laboratory diagnostics included assessment of interleukin concentrations (IL), monocyte chemoattractant proteins (MCP-1/CCL2, MCP-2/CCL8, MCP-3/CCL-7, MCP-4/CCL13), macrophage inflammatory protein-1d (MIP-1d /CCL15), myeloid progenitor inhibitory factor — 1, (MPIF-1/CCL23) and tumor necrosis factor alpha (TNFα).

Results. Compared to the control group, patients in groups 1 and 2 showed more pronounced cognitive dysfunction, lacunar lesions, prevalence of hypertension and obesity, in the 2nd group of patients — prevalence of MRI — signs of CMA, decreased memory, perception and executive functions. Increased level of IL-16 in patients of both groups, higher concentrations of MCP-1/CCL2, MCP-2/CCL8, and MIP-1 d/CCL15, IL-6, IL-1b and TNFα were found in the 2nd group compared to the 1st and the control groups.

Conclusion. Progression of cerebral microangiopathy objectified by MRI data is accompanied by increasing cognitive deficit mainly in the mnestic and executive spheres. The results of the study allow us to consider increased IL-16 production as an indicator of CMA progression, and the expression of IL-1b, IL-6, TNFα, MCP-1/CCL2, MCP-2/ CCL8 and MIP-1d/CCL15 as biomarkers of athero- and angiogenesis in patients with severe cerebral microangiopathy.

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