Three types of white matter hyperintensities have different effects on depression and cognitive function in patients with CADASIL

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.

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White Matter Hyperintensities and Medication Adherence

Biological Research For Nursing ◽

10.1177/1099800408322216 ◽

2008 ◽

Vol 10 (2) ◽

pp. 121-127 ◽

Cited By ~ 2

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.

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

Alzheimer s & Dementia ◽

10.1016/j.jalz.2017.06.1622 ◽

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

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

Cerebrovascular Diseases Extra ◽

10.1159/000377710 ◽

2015 ◽

Vol 5 (2) ◽

pp. 41-51 ◽

Cited By ~ 21

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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MRI white matter hyperintensities,1H-MR spectroscopy and cognitive function in geriatric depression: a comparison of early- and late-onset cases

International Journal of Geriatric Psychiatry ◽

10.1002/gps.501 ◽

2001 ◽

Vol 16 (12) ◽

pp. 1129-1135 ◽

Cited By ~ 64

Author(s):

Tetsuhito Murata ◽

Hirohiko Kimura ◽

Masao Omori ◽

Hirotsugu Kado ◽

Hirotaka Kosaka ◽

...

Keyword(s):

Cognitive Function ◽

White Matter ◽

Mr Spectroscopy ◽

White Matter Hyperintensities ◽

Late Onset ◽

Geriatric Depression ◽

1H Mr Spectroscopy

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Cognitive Function and 3-Tesla Magnetic Resonance Imaging Tractography of White Matter Hyperintensities in Elderly Persons

Dementia and Geriatric Cognitive Disorders Extra ◽

10.1159/000439045 ◽

2015 ◽

Vol 5 (3) ◽

pp. 387-394 ◽

Cited By ~ 5

Author(s):

William Reginold ◽

Angela C. Luedke ◽

Angela Tam ◽

Justine Itorralba ◽

Juan Fernandez-Ruiz ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Cognitive Function ◽

White Matter ◽

Magnetic Resonance ◽

Fractional Anisotropy ◽

White Matter Hyperintensities ◽

Mean Diffusivity ◽

Elderly Persons ◽

Resonance Imaging ◽

Wechsler Memory Scale

Background/Aims: This study used 3-Tesla magnetic resonance imaging (MRI) tractography to determine if there was an association between tracts crossing white matter hyperintensities (WMH) and cognitive function in elderly persons. Methods: Brain T2-weighted fluid-attenuated inversion recovery (FLAIR) and diffusion tensor MRI scans were acquired in participants above the age of 60 years. Twenty-six persons had WMH identified on T2 FLAIR scans. They completed a battery of neuropsychological tests and were classified as normal controls (n = 15) or with Alzheimer's dementia (n = 11). Tractography was generated by the Fiber Assignment by Continuous Tracking method. All tracts that crossed WMH were segmented. The average fractional anisotropy and average mean diffusivity of these tracts were quantified. We studied the association between cognitive test scores with the average mean diffusivity and average fractional anisotropy of tracts while controlling for age, total WMH volume and diagnosis. Results: An increased mean diffusivity of tracts crossing WMH was associated with worse performance on the Wechsler Memory Scale-III Longest Span Forward (p = 0.02). There was no association between the fractional anisotropy of tracts and performance on cognitive testing. Conclusion: The mean diffusivity of tracts crossing WMH measured by tractography is a novel correlate of performance on the Wechsler Memory Scale-III Longest Span Forward in elderly persons.

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White matter hyperintensities do not impact cognitive function in patients with newly diagnosed Parkinson's disease

NeuroImage ◽

10.1016/j.neuroimage.2009.06.020 ◽

2009 ◽

Vol 47 (4) ◽

pp. 2083-2089 ◽

Cited By ~ 42

Author(s):

Turi O. Dalaker ◽

Jan P. Larsen ◽

Michael G. Dwyer ◽

Dag Aarsland ◽

Mona K. Beyer ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Function ◽

White Matter ◽

White Matter Hyperintensities ◽

Newly Diagnosed

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

Journal of Alzheimer s Disease ◽

10.3233/jad-210143 ◽

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.

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Coagulation factor VIII, white matter hyperintensities and cognitive function: Results from the Cardiovascular Health Study

PLoS ONE ◽

10.1371/journal.pone.0242062 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0242062

Author(s):

Jessica L. Rohmann ◽

W. T. Longstreth ◽

Mary Cushman ◽

Annette L. Fitzpatrick ◽

Susan R. Heckbert ◽

...

Keyword(s):

Cognitive Function ◽

White Matter ◽

White Matter Hyperintensities ◽

Cardiovascular Health ◽

Coagulation Factor ◽

Health Study ◽

Cardiovascular Health Study ◽

Digit Symbol Substitution Test ◽

Cross Sectional ◽

Over Time

Objective To investigate the relationship between high FVIII clotting activity (FVIII:C), MRI-defined white matter hyperintensities (WMH) and cognitive function over time. Methods Data from the population-based Cardiovascular Health Study (n = 5,888, aged ≥65) were used. FVIII:C was measured in blood samples taken at baseline. WMH burden was assessed on two cranial MRI scans taken roughly 5 years apart. Cognitive function was assessed annually using the Modified Mini-Mental State Examination (3MSE) and Digit Symbol Substitution Test (DSST). We used ordinal logistic regression models adjusted for demographic and cardiovascular factors in cross-sectional and longitudinal WMH analyses, and adjusted linear regression and linear mixed models in the analyses of cognitive function. Results After adjustment for confounding, higher levels of FVIII:C were not strongly associated with the burden of WMH on the initial MRI scan (OR>p75 = 1.20, 95% CI 0.99–1.45; N = 2,735) nor with WMH burden worsening over time (OR>p75 = 1.18, 95% CI 0.87–1.59; N = 1,527). High FVIII:C showed no strong association with cognitive scores cross-sectionally (3MSE>p75 β = -0.06, 95%CI -0.45 to 0.32, N = 4,005; DSST>p75 β = -0.69, 95%CI -1.52 to 0.13, N = 3,954) or over time (3MSE>p75 β = -0.07,95% CI -0.58 to 0.44, N = 2,764; DSST>p75 β = -0.22, 95% CI -0.97 to 0.53, N = 2,306) after confounding adjustment. Interpretation The results from this cohort study of older adult participants indicate no strong relationships between higher FVIII:C levels and WMH burden or cognitive function in cross-sectional and longitudinal analyses.

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