Neuropsychologic Correlates of Brain White Matter Lesions Depicted on MR Images: 1921 Aberdeen Birth Cohort

Leaper, S. A.; Murray, Alison; Lemmon, Helen; Staff, Roger T.; Deary, Ian J.; Crawford, John R.; Whalley, Lawrence J.

doi:10.1148/radiol.2211010086

Cited by 75 publications

(57 citation statements)

References 32 publications

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“…Since cognitive effort normally triggers an increase in cerebral blood supply in response to increasing metabolic demands, any reduction in vascular reactivity is likely to induce a decline in mental efficiency. The greatly increased incidence of white matter lesions in adults with hypertension [52,53] could also underlie the decline in mental efficiency, since the presence of white matter lesions is associated with slower performance on psychomotor tasks like the DSST [54,55]. Whether those declines reflect neural changes secondary to demyelination [56] or to the haemodynamic abnormalities associated with white matter lesions [57] remains to be determined.…”

Section: Discussionmentioning

confidence: 99%

Cognitive efficiency declines over time in adults with Type 1 diabetes: effects of micro- and macrovascular complications

2003

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Aims/hypothesis. Mild cognitive dysfunction is not uncommon in adults with Type 1 diabetes, but its pathogenesis remains unclear. Previous cross-sectional studies had suggested that microangiopathy might affect brain integrity and lead to 'central neuropathy.' To assess the relationship between changes in cognitive performance and the incidence of new micro-and macrovascular complications, 103 young and middle-aged adults (mean age: 40 yrs) with childhood-onset Type 1 diabetes were followed over a 7-year period, and were compared to 57 demographically-similar adults without diabetes. Methods. All subjects completed a comprehensive battery of neurocognitive tests on two occasions. Diabetic subjects also received repeated medical assessments to diagnose the onset of clinically significant complications.Results. Relative to control subjects, diabetic adults showed significant declines on measures of psychomotor efficiency; no between-group differences were evident on learning, memory, or problem-solving tasks. The development of proliferative retinopathy and autonomic neuropathy during the follow-up period predicted decline in psychomotor speed (p<0.01), as did incident macrovascular complications (p<0.05), systolic blood pressure at follow-up (p<0.01), and duration of diabetes (p<0.01). Conclusion/interpretation. This study shows that cognitive efficiency may decline over time in diabetic adults, and that this neurocognitive change may be linked, at least in part, to the occurrence of complications like proliferative retinopathy and elevated blood pressure. Therapeutic interventions that reduce the risk of vascular complications may have a similarly beneficial effect on the brain and reduce the risk of neurocognitive dysfunction in diabetic patients. [Diabetologia (2003)

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Section: Discussionmentioning

confidence: 99%

Cognitive efficiency declines over time in adults with Type 1 diabetes: effects of micro- and macrovascular complications

2003

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“…The present article examines the association between brain white matter abnormalities (WML and PVL) and cognitive change measured across most of the human life span (age 11 to age 78 years). It is based on the same cohort sample as the report by Leaper et al (2001): (a) It adds a few new participants; (b) it analyzes a different combination of psychometric tests; (c) it presents entirely new analyses; and (d) it introduces the effect of medical conditions, especially hypertension. Both PVL and deep WML are rated separately.…”

Section: Prior Mental Abilitymentioning

confidence: 99%

Cerebral white matter abnormalities and lifetime cognitive change: A 67-year follow-up of the Scottish Mental Survey of 1932.

Deary¹,

Leaper²,

Murray³

et al. 2003

Psychology and Aging

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Cerebral white matter abnormalities relate to cognitive functioning in elders. We examine whether this association is (a) independent of mental ability in youth and (b) related to general and/or specific mental abilities. We retested 83 participants of the Scottish Mental Survey of 1932 on a battery of mental tests. Their brains were scanned by magnetic resonance imaging. Three independent ratings (Fazekas) were made of periventricular, and subcortical and deep white matter abnormalities. Structural equation models showed that, irrespective of brain location, white matter abnormalities contributed about 14% of cognitive function variance in old age. Some of this effect might be due to hypertension. This contribution is independent of mental function in early life and is associated with general cognitive ability.People who retain their cognitive functions in old age tend to have higher quality of life and live longer (Korten et al., 1999; National Research Council, 2000). Therefore, it is important to discover the factors that contribute to individual differences in cognitive functioning among the elderly. Ideally, researchers should establish the extent to which putative determinants of differences in cognitive aging are independent of prior cognitive ability differences, but cognitive data from youth are rarely available for aging cohorts. We discovered a population-wide cohort of individuals who took a validated mental test under standardized conditions in 1932 at 11 years of age (Scottish Council for Research in Education, 1933;Deary, Whalley, Lemmon, Crawford, & Starr, 2000). A measure of early life cognitive ability was available, therefore, for many individuals who were in their late 70s at the time of this investigation.In the present study, we examined the contribution of brain white matter lesions (WML) to cognitive ability differences in old age. Brain white matter abnormalities are important in the study of psychology and aging: (a) They are common, even in people with no dementia or other neurocognitive disorders; (b) they appear to be associated with other factors related to cognitive aging (such as hypertension and other illnesses, e.g., diabetes, that have an impact on vascular function); and (c) they are related to cognitive functioning in old age. In this article, we enquire whether (a) any association between WML and cognitive ability in old age is independent of cognitive ability in youth; (b) WML relate to specific or general cognitive abilities; and (c) hypertension underlies both differences in WML and cognitive function in old age. Brain White Matter AbnormalitiesIn this section, the phenomenon of brain WML is described, and causes of WML are discussed. One possible cause of both WML and cognitive aging is hypertension, which we examine in the present study.White matter abnormalities are frequently observed on T2 weighted magnetic resonance imaging (T2W MRI) of the brain, particularly in adults over the age of 60. They are alternatively referred to as lesions or hyperintensities, which is...

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“…Childhood intelligence is the strongest predictor of late-life intelligence and accounts for about 40% of the variance in intelligence at age 78 . Magnetic resonance imaging (MRI)-detected white matter hyperintensities (WMH) (Young et al 2008) are associated with vascular risk factors (Murray et al 2005) and with reduced cognitive ability and dementia in older adults (Leaper et al 2001;Firbank et al 2007). We previously found that WMH contribute 14% of the variance in cognitive ability at age 78, that WMH are linked to hypertension , and it is now widely accepted that WMH are an imaging biomarker of vascular disease (Kearney-Schwartz et al 2009, Raz et al 2007, Fischer et al 2007).…”

Section: Introductionmentioning

confidence: 99%

“…Cross-sectional investigations into the relationship between hypertension, WMH and late-life cognition are limited by difficulty in controlling for prior cognitive ability (Leaper et al 2001, Wright et al 2008, Breteler et al 1994. While longitudinal population-based studies confirm the negative effect of WMH on cognitive ageing (Silbert et al 2008, Gouw et al 2008, it is unclear whether WMH in late midlife, are as detrimental to the lifelong cognitive trajectory as in the eighth decade.…”

Section: Introductionmentioning

confidence: 99%

Brain lesions, hypertension and cognitive ageing in the 1921 and 1936 Aberdeen birth cohorts

Murray

Staff

McNeil

et al. 2011

AGE

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The objectives of this study are to model the relative effects of positive (childhood intelligence) and negative (magnetic resonance imaging (MRI)-derived white matter hyperintensities (WMH)) predictors of late-life intelligence in two well-characterised normal cohorts aged 68 and 78 and to measure the influence of hypertension on WMH and lifelong cognitive change. The Scottish Mental Surveys of 1932 and 1947 tested the intelligence of almost all school children at age 11. One hundred and one participants born in 1921 and 233 participants born in 1936 had brain MRI, with measurement of WMH using Scheltens' scale, and tests of late-life fluid intelligence. Structural equation models of the effect of childhood intelligence and brain WMH on the general intelligence factor 'g' in late life in the two samples were constructed using AMOS 18. Similar models were constructed to test the effect of hypertension on WMH and lifelong cognitive change. Fluid intelligence scores were lower and WMH scores were higher in the older samples. Hypertensive participants in both samples had more WMH than normotensive participants. The positive influence of childhood intelligence on 'g' was greater in the younger sample. The negative effect of WMH on 'g' was linear and greater in the older sample due to greater WMH burden. The negative effect of hypertension on lifelong cognitive ageing was all mediated via MRIderived brain WMH. The positive relationship between AGE (2012)

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Neuropsychologic Correlates of Brain White Matter Lesions Depicted on MR Images: 1921 Aberdeen Birth Cohort

Abstract: Lower fluid-type ("prevailing") intelligence test scores were associated with increased severity of white matter lesion ratings but not crystallized-type ("premorbid") intelligence test scores. This indicates that MR imaging-depicted white matter lesions are of clinical importance.

Cited by 75 publications

References 32 publications

Cognitive efficiency declines over time in adults with Type 1 diabetes: effects of micro- and macrovascular complications

Cognitive efficiency declines over time in adults with Type 1 diabetes: effects of micro- and macrovascular complications

Cerebral white matter abnormalities and lifetime cognitive change: A 67-year follow-up of the Scottish Mental Survey of 1932.

Brain lesions, hypertension and cognitive ageing in the 1921 and 1936 Aberdeen birth cohorts

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