scholarly journals Association of the Irregular 3-Dimensional Shape of White Matter Hyperintensities with Cognitive Function

2021 ◽  
pp. 1-8
Author(s):  
Ji Won Han ◽  
Hyunna Lee ◽  
Subin Lee ◽  
Haejin Kim ◽  
Grace Eun Kim ◽  
...  
Keyword(s):  
Cognitive Function ◽  
White Matter ◽  
White Matter Hyperintensities ◽  
Shape Index ◽  
Cognitive Test ◽  
Linear Regression Models ◽  
Multinomial Regression ◽  
Subcortical Vascular Dementia ◽  
Poor Cognitive Function ◽  
Multinomial Regression Model

<b><i>Introduction:</i></b> The irregular shapes of white matter hyperintensities (WMHs) are associated with poor cognitive function, diabetes, or lacunes. However, the association between the WMH shape and dementia remains understudied. We investigated the association between the calculated shape index of WMH and the diagnosis of dementia and cognitive function. <b><i>Methods:</i></b> The inverse sphericity index (ISI<sub>WMH</sub>) and volume of WMHs (VOL<sub>WMH</sub>) were compared among 82 participants with normal cognition, 82 with Alzheimer’s dementia (AD), and 82 with subcortical vascular dementia (SVD). We examined the associations of ISI<sub>WMH</sub> and VOL<sub>WMH</sub> with the modified Hachinski Ischemic Score (mHIS), diagnosis of AD and SVD, and cognitive test scores, using linear, multinomial, or hierarchical linear regression models. <b><i>Results:</i></b> The mHIS was associated with both ISI<sub>WMH</sub> (β = 0.326, <i>p</i> &#x3c; 0.001) and VOL<sub>WMH</sub> (β = 0.299, <i>p</i> &#x3c; 0.001). Both ISI<sub>WMH</sub> and VOL<sub>WMH</sub> were associated with the SVD diagnosis (odds ratio [OR] = 2.685, <i>p</i> = 0.002, ISI<sub>WMH</sub>; OR = 2.597, <i>p</i> = 0.005, VOL<sub>WMH</sub>), but not with AD. The SVD diagnosis was better explained when the multinomial regression model included both ISI<sub>WMH</sub> and VOL<sub>WMH</sub> instead of VOL<sub>WMH</sub> alone (χ<sup>2</sup> = 20.768, df = 2, <i>p</i> &#x3c; 0.001). The Trail Making Test-D (TMT-D) scores of the SVD patients were associated with both ISI<sub>WMH</sub> (β = 0.308) and VOL<sub>WMH</sub> (β = 0.293). <b><i>Conclusion:</i></b> An irregular WMH shape may be associated with the high cerebrovascular component of cognitive impairment and the diagnosis and low cognitive flexibility of SVD, which may improve the prediction of SVD diagnosis when used in combination with WMH volume.

Relation of a Socioeconomic Index with Cognitive Function and Neuroimaging in Hypertensive Individuals

2021 ◽  
pp. 1-12
Author(s):  
Regina Silva Paradela ◽  
Naomi Vidal Ferreira ◽  
Mariana Penteado Nucci ◽  
Brenno Cabella ◽  
Luiza Menoni Martino ◽  
...  
Keyword(s):  
Cognitive Function ◽  
White Matter ◽  
Cognitive Performance ◽  
White Matter Hyperintensities ◽  
Social Inequalities ◽  
Parietal Lobe ◽  
Brain Volume ◽  
Linear Regression Models ◽  
Socioeconomic Index ◽  
The Relationship

Background: Socioeconomic factors are important contributors to brain health. However, data from developing countries (where social inequalities are the most prominent) are still scarce, particularly about hypertensive individuals. Objective: To evaluate the relationship between socioeconomic index, cognitive function, and cortical brain volume, as well as determine whether white matter hyperintensities are mediators of the association of the socioeconomic index with cognitive function in hypertensive individuals. Methods: We assessed 92 hypertensive participants (mean age = 58±8.6 years, 65.2%female). Cognitive evaluation and neuroimaging were performed and clinical and sociodemographic data were collected using questionnaires. A socioeconomic index was created using education, income, occupation (manual or non-manual work), and race. The associations of the socioeconomic index with cognitive performance and brain volume were investigated using linear regression models adjusted for age, sex, time of hypertension since diagnosis, and comorbidities. A causal mediation analysis was also conducted. Results: Better socioeconomic status was associated with better visuospatial ability, executive function, and global cognition. We found associations between a better socioeconomic index and a higher parietal lobe volume. White matter hyperintensities were also not mediators in the relationship between the socioeconomic index and cognitive performance. Conclusion: Socioeconomic disadvantages are associated with worse cognitive performance and brain volume in individuals with hypertension.

Influence of White Matter Hyperintensities on Baseline and Longitudinal Amyloid-β in Cognitively Normal Individuals

2021 ◽  
pp. 1-11
Author(s):  
Fennie Choy Chin Wong ◽  
Seyed Ehsan Saffari ◽  
Chathuri Yatawara ◽  
Kok Pin Ng ◽  
Nagaendran Kandiah ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Executive Function ◽  
White Matter ◽  
White Matter Hyperintensities ◽  
Small Vessel Disease ◽  
Amyloid Β ◽  
Intracranial Volume ◽  
Linear Regression Models ◽  
Cognitively Normal

Background: The associations between small vessel disease (SVD) and cerebrospinal amyloid-β1-42 (Aβ1-42) pathology have not been well-elucidated. Objective: Baseline (BL) white matter hyperintensities (WMH) were examined for associations with month-24 (M24) and longitudinal Aβ1-42 change in cognitively normal (CN) subjects. The interaction of WMH and Aβ1-42 on memory and executive function were also examined. Methods: This study included 72 subjects from the Alzheimer’s Disease Neuroimaging Initiative. Multivariable linear regression models evaluated associations between baseline WMH/intracranial volume ratio, M24 and change in Aβ1-42 over two years. Linear mixed effects models evaluated interactions between BL WMH/ICV and Aβ1-42 on memory and executive function. Results: Mean age of the subjects (Nmales = 36) = 73.80 years, SD = 6.73; mean education years = 17.1, SD = 2.4. BL WMH was significantly associated with M24 Aβ1-42 (p = 0.008) and two-year change in Aβ1-42 (p = 0.006). Interaction between higher WMH and lower Aβ1-42 at baseline was significantly associated with worse memory at baseline and M24 (p = 0.003). Conclusion: BL WMH was associated with M24 and longitudinal Aβ1-42 change in CN. The interaction between higher WMH and lower Aβ1-42 was associated with poorer memory. Since SVD is associated with longitudinal Aβ1-42 pathology, and the interaction of both factors is linked to poorer cognitive outcomes, the mitigation of SVD may be correlated with reduced amyloid pathology and milder cognitive deterioration in Alzheimer’s disease.

scholarly journals Sexual Assault and White Matter Hyperintensities Among Midlife Women

2021 ◽  
Author(s):  
Rebecca Thurston ◽  
Karen Jakubowski ◽  
Minjie Wu ◽  
Howard Aizenstein ◽  
Yuefang Chang ◽  
...  
Keyword(s):  
White Matter ◽  
Sexual Assault ◽  
Traumatic Stress ◽  
White Matter Hyperintensities ◽  
Small Vessel Disease ◽  
Midlife Women ◽  
Traumatic Experiences ◽  
Linear Regression Models ◽  
Post Traumatic Stress ◽  
Post Traumatic

Abstract Background Traumatic experiences have been linked to poor mental and physical health. However, there has been little examination of their relationship to neuroimaging markers of cerebrovascular risk. White matter hyperintensities (WMHs) are markers of brain small vessel disease. WMHs can be detected decades before the onset of dementia and other disorders and can serve as early markers for these brain disorders. We tested whether traumatic experiences were associated with brain WMH volume among midlife women. Methods In the MsBrain study, 145 women (mean age = 59 years) without cardiovascular disease, stroke, or dementia were recruited. Women completed questionnaires [trauma checklist, depression, post-traumatic stress measures]; physical measures [body mass index (BMI), blood pressure (BP)]; phlebotomy; actigraphy sleep measurement, and 3 Tesla magnetic resonance brain imaging for WMHs. Cross-sectional associations between traumatic experiences and WMH volume were assessed in linear regression models. Covariates were age, race/ethnicity, education, BMI, BP, lipids, preeclampsia, sleep, and additionally depressive and post-traumatic stress disorder symptoms. Results 68% of women endorsed at least one of the traumas assessed. The most common trauma was sexual assault (23% of women). Women with trauma exposure had greater WMH volume than women without trauma [B(SE) = .24 (.09), p = .01, multivariable]. The single trauma most associated with WMH was sexual assault [B(SE) = .25 (.11), p = .02, multivariable]. Results persisted adjusting for depressive or post-traumatic stress symptoms. Conclusions A trauma history, particularly sexual assault, was associated with greater WMH volume controlling for covariates, including depressive and post-traumatic symptoms. Sexual assault may place women at risk for poor brain health.

scholarly journals Regional white matter hyperintensities: aging, Alzheimer's disease risk, and cognitive function

2014 ◽  
Vol 35 (4) ◽  
pp. 769-776 ◽  
Author(s):  
Alex C. Birdsill ◽  
Rebecca L. Koscik ◽  
Erin M. Jonaitis ◽  
Sterling C. Johnson ◽  
Ozioma C. Okonkwo ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Function ◽  
White Matter ◽  
White Matter Hyperintensities ◽  
Disease Risk

scholarly journals APOE ε4, white matter hyperintensities, and cognition in Alzheimer and Lewy body dementia

Neurology ◽  
2019 ◽  
Vol 93 (19) ◽  
pp. e1807-e1819 ◽  
Author(s):  
Saira Saeed Mirza ◽  
Usman Saeed ◽  
Jo Knight ◽  
Joel Ramirez ◽  
Donald T. Stuss ◽  
...  
Keyword(s):  
White Matter ◽  
Executive Functions ◽  
White Matter Hyperintensities ◽  
Neuropsychological Test ◽  
Neuropsychological Testing ◽  
Lewy Bodies ◽  
Lewy Body Dementia ◽  
Factor Scores ◽  
Linear Regression Models ◽  
Cognitive Domains

ObjectiveTo determine if APOE ε4 influences the association between white matter hyperintensities (WMH) and cognitive impairment in Alzheimer disease (AD) and dementia with Lewy bodies (DLB).MethodsA total of 289 patients (AD = 239; DLB = 50) underwent volumetric MRI, neuropsychological testing, and APOE ε4 genotyping. Total WMH volumes were quantified. Neuropsychological test scores were included in a confirmatory factor analysis to identify cognitive domains encompassing attention/executive functions, learning/memory, and language, and factor scores for each domain were calculated per participant. After testing interactions between WMH and APOE ε4 in the full sample, we tested associations of WMH with factor scores using linear regression models in APOE ε4 carriers (n = 167) and noncarriers (n = 122). We hypothesized that greater WMH volume would relate to worse cognition more strongly in APOE ε4 carriers. Findings were replicated in 198 patients with AD from the Alzheimer's Disease Neuroimaging Initiative (ADNI-I), and estimates from both samples were meta-analyzed.ResultsA significant interaction was observed between WMH and APOE ε4 for language, but not for memory or executive functions. Separate analyses in APOE ε4 carriers and noncarriers showed that greater WMH volume was associated with worse attention/executive functions, learning/memory, and language in APOE ε4 carriers only. In ADNI-I, greater WMH burden was associated with worse attention/executive functions and language in APOE ε4 carriers only. No significant associations were observed in noncarriers. Meta-analyses showed that greater WMH volume was associated with worse performance on all cognitive domains in APOE ε4 carriers only.ConclusionAPOE ε4 may influence the association between WMH and cognitive performance in AD and DLB.

An Exploratory Study of Pathways from White Matter Hyperintensities to Cognitive Impairment through Depressive Symptoms Using Structural Equation Modeling: A Cross Sectional Study in Patients with Dementia

2020 ◽  
Vol 26 (7) ◽  
pp. 679-689
Author(s):  
Chang Hyun Lee ◽  
Do Hoon Kim
Keyword(s):  
Cognitive Impairment ◽  
Structural Equation Modeling ◽  
Depressive Symptoms ◽  
Cognitive Function ◽  
White Matter ◽  
Structural Equation ◽  
White Matter Hyperintensities ◽  
Mediating Effect ◽  
Equation Modeling ◽  
Cross Sectional

AbstractObjective:The aim of this study was to model the relationships among white matter hyperintensities (WMHs), depressive symptoms, and cognitive function and to examine the mediating effect of depressive symptoms on the relationship between WMHs and cognitive impairment.Methods:We performed structural equation modeling using cross-sectional data from 1158 patients from the Clinical Research for Dementia of South Korea (CREDOS) registry who were diagnosed with mild-to-moderate dementia. Periventricular white matter hyperintensities (PWMHs) and deep white matter hyperintensities (DWMHs) were obtained separately on the protocol of magnetic resonance imaging (MRI). Depression and cognitive function were assessed using the Korean Form of the Geriatric Depression Scale (KGDS) and the Seoul Neuropsychological Screening Battery (SNSB), respectively.Results:The model that best reflected the relationships among the variables was the model in which DWMHs affected cognitive function directly and indirectly through the depressive symptoms; on the other hand, PWMHs only directly affected cognitive function.Conclusions:This study presents the mediation model including the developmental pathway from DWMHs to cognitive impairment through depressive symptoms and suggests that the two types of WMHs may affect cognitive impairment through different pathways.

scholarly journals White Matter Hyperintensities and Medication Adherence

2008 ◽  
Vol 10 (2) ◽  
pp. 121-127 ◽  
Author(s):  
Kathleen C. Insel ◽  
Sheryl L. Reminger ◽  
Chao-Pin Hsiao
Keyword(s):  
Blood Pressure ◽  
Medication Adherence ◽  
Cognitive Function ◽  
White Matter ◽  
White Matter Hyperintensities ◽  
Morphological Changes ◽  
Digit Span ◽  
Wisconsin Card Sorting Test ◽  
Cognitive Assessments ◽  
Prefrontal Function

White matter hyperintensities (WMH) are associated with hypertension, age, and cognitive function, but the association between WMH and medication adherence has not been examined. The intent of this investigation was to consider the potential implications of hypertension-related brain morphological changes on medication adherence and thereby improve understanding of the self-management consequences of hypertension. The associations between WMH, blood pressure, age, cognitive function (specifically assessments of prefrontal function), and medication adherence were examined in 16 middle-aged and older adults self-managing at least one prescribed antihypertensive agent. Magnetic resonance imaging using an axial fluid attenuated inversion recovery (FLAIR) sequence was used to assess the presence of WMH. Cognitive assessments included measures of executive function, working memory, attention, and immediate recall. Adherence was monitored for 8 weeks using electronic medication monitoring. More WMH were associated with poorer adherence (rs = —.25) and with higher systolic blood pressure (rs = .46), although these relationships were not statistically significant. WMH were associated with cognitive assessments in the expected direction including Digit Span Backward (rs = —.53, p < .05). Adherence was associated with immediate memory (rs = .54, p < .05) and inversely associated with failure to maintain set on the Wisconsin Card Sorting Test (WCST; r s = —.61, p < .05). These findings provide preliminary evidence for the association between WMH, assessments of prefrontal function, and medication adherence.

[P3-405]: RELATION BETWEEN COGNITIVE FUNCTION AND WHITE MATTER HYPERINTENSITIES: PRELIMINARY FINDINGS FROM TATA LONGITUDINAL STUDY OF AGING

2017 ◽  
Vol 13 (7S_Part_23) ◽  
pp. P1119-P1119
Author(s):  
Ranjini Garani Ramesh ◽  
Simran Purokayastha ◽  
Mahendra Javali ◽  
Suvarna Alladi ◽  
Naren Prahalada Rao
Keyword(s):  
Longitudinal Study ◽  
Cognitive Function ◽  
White Matter ◽  
White Matter Hyperintensities

scholarly journals Cerebral Microbleeds and White Matter Hyperintensities in Cognitively Healthy Elderly: A Cross-Sectional Cohort Study Evaluating the Effect of Arterial Stiffness

2015 ◽  
Vol 5 (2) ◽  
pp. 41-51 ◽  
Author(s):  
Anna-Märta Gustavsson ◽  
Erik Stomrud ◽  
Kasim Abul-Kasim ◽  
Lennart Minthon ◽  
Peter M. Nilsson ◽  
...  
Keyword(s):  
Cognitive Function ◽  
White Matter ◽  
Arterial Stiffness ◽  
White Matter Hyperintensities ◽  
Small Vessel Disease ◽  
Cerebral Microbleeds ◽  
Small Vessel ◽  
Cognitive Tests ◽  
Vessel Disease ◽  
Healthy Elderly

Background: Arterial stiffness reflects the ageing processes in the vascular system, and studies have shown an association between reduced cognitive function and cerebral small vessel disease. Small vessel disease can be visualized as white matter hyperintensities (WMH) and lacunar infarcts but also as cerebral microbleeds on brain magnetic resonance imaging (MRI). We aimed to investigate if arterial stiffness influences the presence of microbleeds, WMH and cognitive function in a population of cognitively healthy elderly. Methods: The study population is part of the Swedish BioFinder study and consisted of 208 individuals without any symptoms of cognitive impairment, who scored >27 points on the Mini-Mental State Examination. The participants (mean age, 72 years; 59% women) underwent MRI of the brain with visual rating of microbleeds and WMH. Arterial stiffness was measured with carotid-femoral pulse wave velocity (cfPWV). Eight cognitive tests covering different cognitive domains were performed. Results: Microbleeds were detected in 12% and WMH in 31% of the participants. Mean (±standard deviation, SD) cfPWV was 10.0 (±2.0) m/s. There was no association between the presence of microbleeds and arterial stiffness. There was a positive association between arterial stiffness and WMH independent of age or sex (odds ratio, 1.58; 95% confidence interval, 1.04-2.40, p < 0.05), but the effect was attenuated when further adjustments for several cardiovascular risk factors were performed (p > 0.05). Cognitive performance was not associated with microbleeds, but individuals with WMH performed slightly worse than those without WMH on the Symbol Digit Modalities Test (mean ± SD, 35 ± 7.8 vs. 39 ± 8.1, p < 0.05). Linear regression revealed no direct associations between arterial stiffness and the results of the cognitive tests. Conclusions: Arterial stiffness was not associated with the presence of cerebral microbleeds or cognitive function in cognitively healthy elderly. However, arterial stiffness was related to the presence of WMH, but the association was attenuated when multiple adjustments were made. There was a weak negative association between WMH and performance in one specific test of attention. Longitudinal follow-up studies are needed to further assess the associations.

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