Increase in periventricular white matter hyperintensities parallels decline in mental processing speed in a non-demented elderly population

Abstract

Objective: To investigate the influence of deep white matter hyperintensities (DWMH) and periventricular white matter hyperintensities (PVWMH) on progression of cognitive decline in non-demented elderly people. Methods: All data come from the nested MRI sub-study of the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER). We performed a 3 year follow up study on 554 subjects of the PROSPER study using both repeated magnetic resonance imaging and cognitive testing. Cognitive decline and its dependency on WMH severity was assessed using linear regression models adjusted for sex, age, education, treatment group, and test version when applicable. Results: We found that the volume of PVWMH at baseline was longitudinally associated with reduced mental processing speed (p = 0.0075). In addition, we found that the progression in PVWMH volume paralleled the decline in mental processing speed (p = 0.024). In contrast, neither presence nor progression of DWMH was associated with change in performance on any of the cognitive tests. Conclusion: PVWMH should not be considered benign but probably underlie impairment in cognitive processing speed.

Impact of white matter hyperintensity volume progression on rate of cognitive and motor decline

“…Increased progression of subcortical WMH lesions was associated with increased rate of memory decline, independent of cerebral or hippocampal atrophy. This was examined but not seen in one previous study 16 that used a visual rather than auditory verbal memory task. Others 13 have reported a relationship between total WMH and memory decline that did not remain after adjusting for brain volume change, which was also associated with WMH progression.…”

“…The question as to whether there is likely to exist a differential effect of total WMH burden on age-related morbidity based on the location within the CNS of white matter change remains unanswered. Longitudinal studies looking at the progression of WMH have been reported [9][10][11][12][13][14][15][16][17][18][19] ; however, differences in methodologies of WMH measurement make comparisons difficult. A poor cor-relation in estimated WMH burden between differing visual rating scales 20 and increased reliability and sensitivity of WMH volumetric measurements 21 make studies using volumetric measures preferable to those that use visual rating scales.…”

“…A poor cor-relation in estimated WMH burden between differing visual rating scales 20 and increased reliability and sensitivity of WMH volumetric measurements 21 make studies using volumetric measures preferable to those that use visual rating scales. Only one previous study has investigated the differential effects of PV and subcortical WMH volume progression on changes in cognitive performance, 16 and to our knowledge none have examined such volumetric changes in relation to rates of motor skill decline over time. Such processes are crucial to our understanding of WMH effects on what may have been previously considered to be age-related changes in CNS processing.…”

Essen stroke risk score, cerebral cholinergic pathways and cognitive performances in patients with cerebral small vessel disease

“…In contrast, there was no significant effect of non periventricular WMLs on global cortical cholinergic activity [5]. What's more, Heuvel et al performed a 3-year follow-up including repeated MRI and cognitive tests in a large group of over 500 older subjects enrolled in a therapeutic trial, finding that the progression of periventricular WML volume was related to decline in mental processing speed [13]. Both support a regionally specific disruption of cholinergic projection fibers by WMLs.…”

Determining the Relationship between White Matter Volume and Processing Speed in Adolescence

“…Some studies have used DTI to assess how physical damages such as lesions affect the liquid diffusion, as well as WM maturation over periods such as adolescence [1]. It has been reported in some cases that damage to white matter tracts may underlie age-related cognitive decline [10,34] Nevertheless, many of these studies have used a sample of either elderly or adult participants in determining processing speed [26,34]; in the cases of children and adolescents included, the sample remained relatively small (N<100).…”