Subclinical Cognitive and Neuropsychiatric Correlates and Hippocampal Volume Features of Brain White Matter Hyperintensity in Healthy People

White matter hyperintensities (WMH) are associated with brain aging and behavioral symptoms as a possible consequence of disrupted white matter pathways. In this study, we investigated, in a cohort of asymptomatic subjects aged 50 to 80, the relationship between WMH, hippocampal atrophy, and subtle, preclinical cognitive and neuropsychiatric phenomenology. Thirty healthy subjects with WMH (WMH+) and thirty individuals without (WMH−) underwent comprehensive neuropsychological and neuropsychiatric evaluations and 3 Tesla Magnetic Resonance Imaging scan. The presence, degree of severity, and distribution of WMH were evaluated with a semi-automated algorithm. Volumetric analysis of hippocampal structure was performed through voxel-based morphometry. A multivariable logistic regression analysis indicated that phenomenology of subclinical apathy and anxiety was associated with the presence of WMH. ROI-based analyses showed a volume reduction in the right hippocampus of WMH+. In healthy individuals, WMH are associated with significant preclinical neuropsychiatric phenomenology, as well as hippocampal atrophy, which are considered as risk factors to develop cognitive impairment and dementia.

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Abstract TMP56: Differential Effect of Left versus Right White Matter Hyperintensity Burden on Functional Decline: The Northern Manhattan Study

Stroke ◽

10.1161/str.48.suppl_1.tmp56 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Mandip S Dhamoon ◽

Ying-Kuen Cheung ◽

Ahmet M Bagci ◽

Dalila Varela ◽

Noam Alperin ◽

...

Keyword(s):

White Matter ◽

Large Population ◽

Functional Decline ◽

Frontal Lobes ◽

White Matter Hyperintensity ◽

Periventricular White Matter ◽

Parietal Lobes ◽

Brain White Matter ◽

The Right

Background: We previously showed that overall brain white matter hyperintensity volume (WMHV) was associated with accelerated long-term functional decline. Asymmetry of brain dysfunction may disrupt brain network efficiency. We hypothesized that greater left-right WMHV asymmetry was associated with functional trajectories. Methods: In the Northern Manhattan MRI study, participants had brain MRI with axial T1, T2, and fluid attenuated inversion recovery sequences, with baseline interview and examination. Volumetric WMHV distribution across 14 brain regions (brainstem, cerebellum, and bilateral frontal, occipital, temporal, and parietal lobes, and bilateral anterior and posterior periventricular white matter) was determined separately by combining bimodal image intensity distribution and atlas based methods.. Participants had annual functional assessments with the Barthel index (BI, range 0-100) over a mean of 7.3 years. Generalized estimating equations models estimated associations of regional WMHV and regional left-right asymmetry with baseline BI and change over time, adjusted for baseline medical risk factors, sociodemographics, and cognition, and stroke and myocardial infarction during follow-up. Results: Among 1195 participants, mean age was 71 (SD 9) years, 39% were male, 67% had hypertension and 19% diabetes. Greater WMHV asymmetry in the frontal lobes (-3.53 BI points per unit greater WMHV on the right compared to left, 95% CI -0.18, -6.88) and whole brain (-7.23 BI points, 95% CI 0.07, -14.54) was associated with lower overall function. Greater WMHV asymmetry in the frontal lobes (-0.74 additional BI points per year per unit greater WMHV on the right compared to left, 95% CI 0.05, -1.54) and parietal lobes (1.11 additional BI points per year, 95% CI 0.30, 1.93) was independently associated with accelerated functional decline. Periventricular WMHV asymmetry was not associated with function. Conclusions: In this large population-based study with long-term repeated measures of function, greater regional WMHV asymmetry was associated with lower function and functional decline, especially with greater WMHV on the right. In addition to global WMHV, WHMV asymmetry may be an important predictor of long-term functional decline.

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Faculty Opinions recommendation of Regional white matter hyperintensity volume, not hippocampal atrophy, predicts incident Alzheimer disease in the community.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717965007.793466165 ◽

2012 ◽

Author(s):

Jean-François Dartigues ◽

Alexandra Foubert

Keyword(s):

White Matter ◽

Alzheimer Disease ◽

White Matter Hyperintensity ◽

Hippocampal Atrophy

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QOL-09. WHOLE-BRAIN WHITE MATTER NETWORK CONNECTIVITY IS DISRUPTED BY PEDIATRIC BRAIN TUMOR TREATMENT

Neuro-Oncology ◽

10.1093/neuonc/noaa222.673 ◽

2020 ◽

Vol 22 (Supplement_3) ◽

pp. iii432-iii432

Author(s):

Adeoye Oyefiade ◽

Kiran Beera ◽

Iska Moxon-Emre ◽

Jovanka Skocic ◽

Ute Bartels ◽

...

Keyword(s):

White Matter ◽

Pediatric Brain Tumor ◽

Pediatric Brain Tumors ◽

Magnetic Resonance Images ◽

Long Term Effects ◽

Brain White Matter ◽

The Right ◽

Pediatric Brain ◽

Betweeness Centrality

Abstract INTRODUCTION Treatments for pediatric brain tumors (PBT) are neurotoxic and lead to long-term deficits that are driven by the perturbation of underlying white matter (WM). It is unclear if and how treatment may impair WM connectivity across the entire brain. METHODS Magnetic resonance images from 41 PBT survivors (mean age: 13.19 years, 53% M) and 41 typically developing (TD) children (mean age: 13.32 years, 51% M) were analyzed. Image reconstruction, segmentation, and node parcellation were completed in FreeSurfer. DTI maps and probabilistic streamline generation were completed in MRtrix3. Connectivity matrices were based on the number of streamlines connecting two nodes and the mean DTI (FA) index across streamlines. We used graph theoretical analyses to define structural differences between groups, and random forest (RF) analyses to identify hubs that reliably classify PBT and TD children. RESULTS For survivors treated with radiation, betweeness centrality was greater in the left insular (p < 0.000) but smaller in the right pallidum (p < 0.05). For survivors treated without radiation (surgery-only), betweeness centrality was smaller in the right interparietal sulcus (p < 0.05). RF analyses showed that differences in WM connectivity from the right pallidum to other parts of the brain reliably classified PBT survivors from TD children (classification accuracy = 77%). CONCLUSIONS The left insular, right pallidum, and right inter-parietal sulcus are structurally perturbed hubs in PBT survivors. WM connectivity from the right pallidum is vulnerable to the long-term effects of treatment for PBT.

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[P2-420]: A COMPARISON OF BRAIN WHITE MATTER HYPERINTENSITY BURDEN ASSESSED IN VIVO AND EX VIVO

Alzheimer s & Dementia ◽

10.1016/j.jalz.2017.06.1076 ◽

2017 ◽

Vol 13 (7S_Part_16) ◽

pp. P794-P795

Author(s):

Arman P. Kulkarni ◽

Arnold M. Evia ◽

Julie A. Schneider ◽

David A. Bennett ◽

Konstantinos Arfanakis

Keyword(s):

White Matter ◽

Ex Vivo ◽

White Matter Hyperintensity ◽

Brain White Matter

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P4-184: Elevated arterial stiffness and deep-brain white matter hyperintensity in patients with mild cognitive impairment

Alzheimer s & Dementia ◽

10.1016/j.jalz.2012.05.1888 ◽

2012 ◽

Vol 8 (4S_Part_19) ◽

pp. P700-P701

Author(s):

Benjamin Tseng ◽

Muhammad Ayaz ◽

Estee Brunk ◽

Kyle Armstrong ◽

Kristin Martin-Cook ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

White Matter ◽

Arterial Stiffness ◽

White Matter Hyperintensity ◽

Brain White Matter ◽

Deep Brain

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P2-062: Are cerebrospinal fluid levels of neurogranin associated with hippocampal atrophy and brain white matter volume decrease?

Alzheimer s & Dementia ◽

10.1016/j.jalz.2015.06.599 ◽

2015 ◽

Vol 11 (7S_Part_11) ◽

pp. P506-P507

Author(s):

Simone Lista ◽

Enrica Cavedo ◽

Henrik Zetterberg ◽

Bruno Dubois ◽

Stéphane Epelbaum ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

White Matter ◽

Hippocampal Atrophy ◽

White Matter Volume ◽

Cerebrospinal Fluid Levels ◽

Matter Volume ◽

Brain White Matter ◽

Fluid Levels ◽

Volume Decrease

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THUR 006 A case of GABA-B antibody mediated encephalopathy

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2018-abn.5 ◽

2018 ◽

Vol 89 (10) ◽

pp. A2.1-A2

Author(s):

Abdel-Mannan Omar ◽

Harikrishnan Seeedharan ◽

Abdel-Aziz Khaled

Keyword(s):

White Matter ◽

New Left ◽

Cognitive Status ◽

White Matter Hyperintensity ◽

Oral Steroid ◽

Emotional Lability ◽

Intravenous Methylprednisolone ◽

Underlying Malignancy ◽

Pet Ct ◽

The Right

A previously well 17 year old female presented with a self-limiting episode of derealisation and depersonalisation lasting 24 hours. Initial MRI demonstrated new left peri-trigonal white matter hyperintensity. Initial bloods were normal and serum was negative for white cell enzymes, VLCFA and broad autoimmune screen but positive for GABA-b antibodies (Ab).Six months later, an acute cognitive decline, intermittent upper limb tremor and emotional lability led to readmission. On examination she had an ACE-R of 88/100 and mildly slowed saccades. Repeat MRI was stable and EEG was diffusely slow, particularly the right temporal lobe. She had a mild CSF lymphocytosis (8 cells). An underlying malignancy was excluded with CT chest, abdomen, pelvis and PET CT. She was treated with PLEX and pulsed intravenous methylprednisolone, which led to an improvement of her symptoms and cognitive status. She was discharged on oral steroid taper. One month later she had a milder relapse and was retreated with PLEX and started on mycophenolate. She has now been in remission for 18 months.ConclusionsOur case highlights that neurologists should consider GABA-b Ab mediated encephalitis as a differential in patients presenting with derealisation and depersonalisation, in addition to previously described presentations of seizures and ataxia.

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Severity of white matter hyperintensities: Lesion patterns, cognition, and microstructural changes

Journal of Cerebral Blood Flow & Metabolism ◽

10.1177/0271678x19893600 ◽

2019 ◽

Vol 40 (12) ◽

pp. 2454-2463 ◽

Cited By ~ 2

Author(s):

Weiyi Zeng ◽

Yaojing Chen ◽

Zhibao Zhu ◽

Shudan Gao ◽

Jianan Xia ◽

...

Keyword(s):

White Matter ◽

Episodic Memory ◽

Specific Pattern ◽

White Matter Hyperintensity ◽

Common Finding ◽

Superior Cerebellar Peduncle ◽

Brain White Matter ◽

Brain Microstructure ◽

Cerebellar Peduncle ◽

Fazekas Scale

White matter hyperintensity (WMH) is a common finding in aging population and considered to be a contributor to cognitive decline. Our study aimed to characterize the spatial patterns of WMH in different severities and explore its impact on cognition and brain microstructure in non-demented elderly. Lesions were both qualitatively (Fazekas scale) and quantitatively assessed among 321 community-dwelled individuals with MRI scanning. Voxel- and atlas-based analyses of the whole-brain white matter microstructure were performed. The WMH of the same severities was found to occur uniformly with a specific pattern of lesions. The severity of WMH had a significant negative association with the performance of working and episodic memory, beginning to appear in Fazekas 3 and 4. The white matter tracts presented significant impairments in Fazekas 3, which showed brain-wide changes above Fazekas 4. Lower FA in the superior cerebellar peduncle and left posterior thalamic radiation was mainly associated with episodic memory, and the middle cerebellar peduncle was significantly associated with working memory. These results support that memory is the primary domain to be affected by WMH, and the effect may potentially be influenced by tract-specific WM abnormalities. Fazekas scale 3 might be the critical stage predicting a future decline in cognition.

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