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Introduction: Executive functions and processing speed have been regarded as core cognitive domains affected in cerebral small vessel disease (SVD). Executive functions, as an umbrella concept, consist of a variety of different subcomponents, yet in research these abilities are often evaluated with single tests or summary scores. Currently, it is unknown whether all executive abilities are equally affected by SVD brain changes and whether some tests are more sensitive in detecting deficits than others. We investigated the associations of white matter hyperintensity (WMH) volume with specific executive abilities (cognitive flexibility, response inhibition, working memory) and processing speed by using an extensive set of paper-and-pencil and computerised neuropsychological tests. Methods: In the Helsinki Small Vessel Disease Study, 152 subjects (age 65-75 years) with varying degrees of WMH but no clinical stroke or dementia were evaluated with quantitative automated MRI analysis and a comprehensive neuropsychological examination. Executive functions and processing speed measures included the Wechsler adult intelligence scale (WAIS-IV) Coding subtest, Stroop test, Hayling sentence completion test, Brixton spatial anticipation test, verbal fluency test, Wechsler memory scale (WMS-III) Digit span and Number-letter sequencing subtasks, and the more experimental Flexible attention test (FAT), Simon task and Sustained attention to response task (SART). Results: Linear regression analyses controlling for age, sex and education revealed significant associations between WMH volume and measures within all evaluated subdomains. However, marked differences were found between individual test Results: The strongest associations were observed for FAT Numbers and Number-letter task (computerised tests based on the Trail making test), FAT Visuospatial span, Simon task and verbal fluency (animals), while some of the widely used tests failed to reach significance. Discussion: WMH are related to significant deficits in processing speed and executive functions subdomains of flexibility, inhibition and working memory. The strength of associations within subdomains is nevertheless highly dependent on the evaluation method in use. Computerised tests providing precise measures of reaction times and response accuracy seem to outperform many of the conventional paper-and-pencil tests. These results have implications for observational studies and intervention trials, where the selection of sensitive outcome measures is crucial.

Introduction: Subjective cognitive complaints are common in patients with cerebral small vessel disease (SVD), yet their correspondence to informant evaluations, objective cognitive functions and severity of brain changes are poorly understood. We studied the associations of subjective and informant reports of cognitive difficulties (executive functions and memory) with findings from a comprehensive neuropsychological assessment and brain MRI (white matter hyperintensities, WMH volume) as well as depressive symptoms and functional abilities (instrumental activities of daily living, IADL). Methods: In the Helsinki SVD Study, 152 older adults with varying degrees of WMH but without stroke or dementia were classified as having normal cognition or mild cognitive impairment (MCI) based on Jak/Bondi neuropsychological criteria. The objective cognitive measures also included continuous domain scores for memory and executive functions. Cognitive complaints were evaluated with the subjective- and informant-versions of Prospective and Retrospective Memory Questionnaire (PRMQ) and Dysexecutive Questionnaire (DEX), functional abilities with the Amsterdam IADL Questionnaire and depressive symptoms with the Geriatric Depression Scale (GDS-15). Results: Subjective cognitive complaints correlated significantly with informant reports (r=0.40-0.50, p0.05). Instead, subjective DEX (OR 1.10, CI 95% 1.05-1.16, p

Objective: Subjective cognitive complaints are common in patients with cerebral small vessel disease (cSVD), yet their relationship with informant evaluations, objective cognitive functions and severity of brain changes are poorly understood. We studied the associations of subjective and informant reports with findings from comprehensive neuropsychological assessment and brain MRI. Method: In the Helsinki SVD Study, 152 older adults with varying degrees of white matter hyperintensities (WMH) but without stroke or dementia were classified as having normal cognition or mild cognitive impairment (MCI) based on neuropsychological criteria. The measures also included continuous domain scores for memory and executive functions. Cognitive complaints were evaluated with the subjective and informant versions of the Prospective and Retrospective Memory Questionnaire (PRMQ) and Dysexecutive Questionnaire (DEX); functional abilities with the Amsterdam Instrumental Activities of Daily Living Questionnaire (A-IADL); and depressive symptoms with the Geriatric Depression Scale (GDS-15). Results: Subjective cognitive complaints correlated significantly with informant reports (r=0.40–0.50, p

Aim and scope: A Gradient Echo Plural Contrast Imaging technique (GEPCI) is a post-processing method, which can be used to obtain quantitative T2* values and generate multiple synthetic contrasts from a single acquisition. However, scan duration and image reconstruction from k-space data present challenges in a clinical workflow. This study aimed at optimizing image reconstruction and acquisition duration to facilitate a post-processing method for synthetic image contrast creation in clinical settings. Materials and methods: This study consists of tests using the American College of Radiology (ACR) image quality phantom, two healthy volunteers, four mild traumatic brain injury patients and four small vessel disease patients. The measurements were carried out on a 3.0 T scanner with multiple echo times. Reconstruction from k-space data and DICOM data with two different coil-channel combination modes were investigated. Partial Fourier techniques were tested to optimize the scanning time. Conclusions: Sum of squares coil-channel combination produced artifacts in phase images, but images created with adaptive combination were artifact-free. The voxel-wise median signed difference of T2* between the vendor’s adaptive channel combination and k-space reconstruction modes was 2.9 ± 0.7 ms for white matter and 4.5 ± 0.6 ms for gray matter. Relative white matter/gray matter contrast of all synthetic images and contrast-to-noise ratio of synthetic T1-weighted images were almost equal between reconstruction modes. Our results indicate that synthetic contrasts can be generated from the vendor’s DICOM data with the adaptive combination mode without affecting the quantitative T2* values or white matter/gray matter contrast. Keywords: Magnetic resonance imaging, Image quality, Quantitative MRI, MRI reconstruction, T2* mapping, Synthetic contrasts

Single-lung ventilation using a double-lumen endobronchial tube is often performed for surgical procedures involving the thorax. Tracheobronchial rupture during use of an endobronchial tube is an uncommon and serious complication. We present the case of a patient undergoing a right pneumonectomy who experienced a bronchial rupture due to a double-lumen endobronchial tube. Institution of veno-venous extracorporeal membrane oxygenation allowed removal of the endobronchial tube, and the repair was successfully performed. We hope that this information can provide further insight into the management of such a complication.