Cerebral small-vessel disease and decline in information processing speed, executive function and memory

Prins, Niels D.; Dijk, Ewoud J. van; Heijer, Tom den; Vermeer, Sarah E.; Jolles, J.; Koudstaal, Peter J.; Hofman, Albert; Breteler, Monique M.B.

doi:10.1093/brain/awh553

Cited by 666 publications

(518 citation statements)

References 40 publications

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“…Mania/BD was the second most impaired exposure group on three of five measures (reasoning, numeric memory and prospective memory), and sensitivity analyses showed that impairment in this group was higher still when exposure information sources were strictly equivalent with the other groups. Reaction time impairment was most prevalent in the MS group, which is in line with previous research showing particular problems with processing speed in MS and other white matter disorders 28, 29, 30. Although the increased prevalence (compared with the unexposed group) of cognitive impairment in major depression was relatively small, lifetime prevalence of major depression is approximately ten times that of BD and schizophrenia and fifty times that of MS and PD, which meant that the population attributable prevalence of cognitive impairment was highest overall for this group.…”

Section: Discussionsupporting

confidence: 91%

The ‘cognitive footprint’ of psychiatric and neurological conditions: cross‐sectional study in the UK Biobank cohort

Cullen

Smith

Deary

et al. 2017

Acta Psychiatr Scand

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ObjectiveWe aimed to quantify the prevalence of cognitive impairment in adults with a history of mood disorder, schizophrenia, multiple sclerosis or Parkinson's disease, within a large general population cohort.MethodCross‐sectional study using UK Biobank data (n = 502 642). Psychiatric and neurological exposure status was ascertained via self‐reported diagnoses, hospital records and questionnaires. Impairment on reasoning, reaction time and memory tests was defined with reference to a single unexposed comparison group. Results were standardised for age and gender. Sensitivity analyses examined the influence of comorbidity, education, information sources and missing data.ResultsRelative to the unexposed group, cognitive impairment was least common in major depression (standardised prevalence ratios across tests = 1.00 [95% CI 0.98, 1.02] to 1.49 [95% CI 1.24, 1.79]) and most common in schizophrenia (1.89 [95% CI 1.47, 2.42] to 3.92 [95% CI 2.34, 6.57]). Prevalence in mania/bipolar was similar to that in multiple sclerosis and Parkinson's disease. Estimated population attributable prevalence of cognitive impairment was higher for major depression (256 per 100 000 [95% CI 130, 381]) than for all other disorders.ConclusionAlthough the relative prevalence of cognitive impairment was lowest in major depression, the population attributable prevalence was highest overall for this group.

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Section: Discussionsupporting

confidence: 91%

The ‘cognitive footprint’ of psychiatric and neurological conditions: cross‐sectional study in the UK Biobank cohort

Cullen

Smith

Deary

et al. 2017

Acta Psychiatr Scand

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“…Our findings suggest that the relationship is fairly specific; hippocampus remained in the model predicting MEM, but cortical gray matter, WMSH, and lacunae did not. This lack of a significant contribution from WMSH and lacunae is similar to findings reported by Prins et al (2005), who found that none of their markers of small vessel disease were related to decline in memory.The relationships between executive functioning and brain structure appear more complex. We found that decreases in cortical gray matter and increases in WMSH were both associated with decline in EXEC.…”

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confidence: 89%

Longitudinal MRI and cognitive change in healthy elderly.

et al. 2007

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Cross-sectional studies of normal aging indicate an association between memory and hippocampal volume, and between executive functioning and subcortical-frontal circuits. Much less is known, however, about the relationship between longitudinal MRI changes and cognitive decline. The authors hypothesized that longitudinal change in memory would be best predicted by change in hippocampal volumes, whereas change in executive functioning would be best predicted by cortical atrophy and progression of MRI markers of cerebrovascular disease. For this study, 50 healthy elderly subjects underwent structural MRI and cognitive testing at baseline and again at follow-up, with a mean follow-up interval of 45 months. Volumetric MRI measures were hippocampus, cortical gray matter, white matter signal hyperintensity (WMSH), and lacunae. Neuropsychological measures were psychometrically robust composite scores of episodic memory (MEM) and executive functioning (EXEC). Hierarchical multiple regression indicated that a decrease in hippocampus was associated with a decline in MEM, whereas decreased cortical gray matter and increased WMSH were independently associated with a decline in EXEC. Results suggest that in normal aging, cognitive functioning declines as cortical gray matter and hippocampus decrease, and WMSH increases. The association between WMSH and EXEC further highlights the cognitive sequealae associated with cerebrovascular disease in normal elderly.Correspondence concerning this article should be addressed to Joel H. Kramer , 1997). There are also age-related increases in subcortical ischemic vascular disease that can independently contribute to cognitive decline and dementia (Román, Erkinjuntti, Wallin, Pantoni, & Chui, 2002). Population-based studies have reported "silent" (i.e., asymptomatic) lacunae in 11%-28% of clinically asymptomatic elderly (Longstreth et al., 1998;Price et al., 1997;Vermeer et al., 2003), whereas the prevalence of white matter signal hyperintensities on MRI has ranged from 30% to 100% across studies of healthy elderly samples (Breteler et al., 1994;Longstreth et al., 1998;Ylikoski et al., 2000). Diffusion tensor MRIs have shown a progressive reduction in fractional anisotropy and an increase in diffusivity with age (Charlton et al., 2006).Despite the co-occurrence of age-related cognitive decline and brain changes, associations between brain volume and cognitive ability in healthy subjects have been difficult to establish. Although several studies have reported that hippocampal atrophy is associated with poorer episodic memory performance in older subjects (De Leon et al., 1997;Golomb et al., 1996), an extensive review and meta-analysis by Van Petten (2004) noted considerable variability across studies. The common correlation between hippocampal volume and memory performance across 33 studies was statistically significant but quite low, leading to the conclusion that the evidence for a positive relationship between hippocampal volume and memory performance was weak. Divergent result...

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“…There is ample evidence to indicate that WMH is associated with reduced memory, processing speed, and executive function [6,25,28]. However, the sole presence of WMH cannot be considered as a factor of cognitive deterioration.…”

Section: Discussionmentioning

confidence: 99%

White matter hyperintensities in patients with multiple system atrophy

et al. 2009

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Recent studies have reported that the majority of patients with multiple system atrophy (MSA) had hypertensive heart disease. However, the effect of autonomic failure on the brain in MSA has not been studied. We consecutively enrolled 63 patients with MSA and selected 63 age-and sex-matched healthy subjects. We performed a comparative analysis of cerebrovascular lesions between the patients with MSA and the control subjects and analyzed predisposing factors for cerebrovascular lesions in the patients with MSA. There was no significant difference in lacune and territorial infarcts between the patients with MSA and the control subjects. The median grading score of white matter hyperintensity (WMH) was significantly higher in the patients with MSA (1.0, interquartile range 0.5-2.0) than the control subjects (0.0, interquartile range 0.0-1.0; P \ 0.01). In the patients with MSA, there was strong correlation between the grading score of WMH and supine systolic blood pressure (r = 0.529, P \ 0.001) after adjusting for age. Multiple linear regression analysis showed that age and supine systolic blood pressure was significantly and independently correlated with the grading score of WMH. The present study demonstrates that patients with MSA had more severe WMH and that supine systolic pressure is a major contributing factor for the severity of WMH, suggesting that patients with MSA have target-organ damage of the brain.

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Cerebral small-vessel disease and decline in information processing speed, executive function and memory

Cited by 666 publications

References 40 publications

The ‘cognitive footprint’ of psychiatric and neurological conditions: cross‐sectional study in the UK Biobank cohort

The ‘cognitive footprint’ of psychiatric and neurological conditions: cross‐sectional study in the UK Biobank cohort

Longitudinal MRI and cognitive change in healthy elderly.

White matter hyperintensities in patients with multiple system atrophy

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