White Matter Changes on CT and MRI: An Overview of Visual Rating Scales

Scheltens, Philip; Erkinjunti, T.; Leys, Didier; Wahlund, Lars Olof; Inzitari, Domenico; Ser, Teodoro del; Pasquier, Florence; Barkhof, Frederik; Mäntylä, Riitta; Bowler, John V.; Wallin, Anders; Ghika, Joseph; Fazekas, Franz; Pantoni, Leonardo

doi:10.1159/000007921

Cited by 250 publications

(188 citation statements)

References 56 publications

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“…In order to identify subjects with incipient primary degenerative dementia, usuallyAD, a tentative diagnosis of primary degenerative MCI was made at the occurrence of symptoms of MCI, no more Neuropsychology of MCI with Alzheimer-typical CSF 583 than one vascular risk factor without complications and no or insignificant findings on brain imaging.All subjects underwent brain MRI scans, which were evaluated by experienced neuroradiologists. For primary degenerative MCI only insignificant (5mild) white matter changes on a 4-grade scale (Scheltens et al, 1998) and0or few lacunes (,3) or absence of cerebrovascular changes were allowed. Subjects with vascular disease (arterial hypertension, cardiac insufficiency, angina pectoris, cardiac rhythm disturbance, cardiac infarction, TIA, stroke, hyperlipidemia, diabetes mellitus, or peripheral vessel disease) and significant (5moderate or severe) white matter changes0several lacunes and0or signs of infarctions according to visually assessed brain imaging were considered MCI of vascular aetiology.…”

Section: Subjects and Diagnostic Proceduresmentioning

confidence: 99%

Episodic memory and speed/attention deficits are associated with Alzheimer-typical CSF abnormalities in MCI

Nordlund

Rolstad

Klang

et al. 2008

J Int Neuropsychol Soc

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Mild cognitive impairment (MCI) is regarded as the prodromal stage of dementia disorders, such as Alzheimer's disease (AD).Objective: To compare the neuropsychological profiles of MCI subjects with normal concentrations of total tau (T-t) and Ab42 in CSF (MCI-norm) to MCI subjects with deviating concentrations of the biomarkers (MCI-dev). MCI-norm (N 5 73) and MCI-dev (N 5 73) subjects were compared to normal controls (N 5 50) on tests of speed0attention, memory, visuospatial function, language and executive function.Results: MCI-norm performed overall better than MCI-dev, specifically on tests of speed and attention and episodic memory. When MCI-dev subjects were subclassified into those with only high T-tau (MCI-tau), only low Ab42 (MCI-Ab) and both high T-tau and low Ab42 (MCI-tauAb), MCI-tauAb tended to perform slightly worse. MCI-tau and MCI-Ab performed quite similarly.Conclusions: Considering the neuropsychological differences, many MCI-norm probably had more benign forms of MCI, or early non-AD forms of neurodegenerative disorders. Although most MCI-dev performed clearly worse than MCI-norm on the neuropsychological battery, some did not show any deficits when compared to age norms. A combination of CSF analyses and neuropsychology could be a step toward a more exact diagnosis of MCI as prodromal AD. (JINS, 2008, 14, 582-590.)

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Section: Subjects and Diagnostic Proceduresmentioning

confidence: 99%

Episodic memory and speed/attention deficits are associated with Alzheimer-typical CSF abnormalities in MCI

Nordlund

Rolstad

Klang

et al. 2008

J Int Neuropsychol Soc

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“…22 Improved methods to quantify WML subtypes have become available and have been validated and studied in large population samples. 23 For example, based on a strict WML scoring protocol, periventricular WML (pWML) were associated with lower psychomotor speed and general cognitive function in 1077 individuals from the Rotterdam scan study, aged 60 years and older, 24 while subcortical WML (sWML) were related with depressed mood. 25 In addition, pWML were associated with a three-fold greater reduction in general cognitive functioning (Mini-Mental State Examination) after a mean follow-up duration of 7.3 years.…”

Section: Introductionmentioning

confidence: 99%

Ambulatory blood pressure, asymptomatic cerebrovascular damage and cognitive function in essential hypertension

et al. 2005

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Prolonged exposure to elevated blood pressure (BP) can lead to both structural (white matter lesions (WML) or infarctions) and functional changes in the brain. We studied in previously diagnosed essential hypertensive individuals if diurnal BP variation and ambulatory BP (ABP) profile (daytime, night time and 24-h BP averages) were related to evidence of WML, the presence of 'silent' infarcts, and cognitive performance. A group of 86 patients (mean age 57.4710 years, range 40-80) were first screened for hypertension-related organ damage and underwent 24-h ABP monitoring, magnetic resonance imaging (MRI) of the brain, and a comprehensive neurocognitive assessment. Age and ABP profile were related to more periventricular, but not subcortical, WML and to presence of lacunar infarctions on MRI. After correction for demographical group differences, no association was found between night time dipping of BP on the one hand and both WML load and cognitive parameters (verbal memory, sensorimotor speed, cognitive flexibility) on the other. The presence of lacunar infarctions, however, predicted lower performance on verbal memory. Furthermore, daytime and 24-h pulse pressure averages were associated with pWML, whereas systolic BP and mean arterial pressure (MAP) for daytime, night-time and 24-h periods were higher in patients with lacunar infarctions. Notwithstanding the large variability of WML in this sample, the evidence of a connection between diurnal BP variation and early target organ damage in the brain was not convincing. However, the ABP profile may be predictive of cerebral lesion type.

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“…The slice thickness was 5-or 6 mm with an interslice gap of 1 or 1.2 mm. The evaluation of the MRI images was performed by a single reader using an established rating scale (Scheltens et al 1998;de Leeuw et al 2001). The detailed account of the reading protocol is publicized elsewhere (Launer et al 2000).…”

Section: Mri Scansmentioning

confidence: 99%

Structural brain changes and all-cause mortality in the elderly population—the mediating role of inflammation

Hanning

Roesler

Peters

et al. 2016

AGE

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While MRI brain changes have been related to mortality during ageing, the role of inflammation in this relationship remains poorly understood. Hence, this study aimed to investigate the impact of MRI changes on all-cause mortality and the mediating role of cytokines. All-cause mortality was evaluated in 268 community dwelling elderly (age 65-83 years) in the MEMO study (Memory and Morbidity in Augsburg elderly). MRI markers of brain atrophy and cerebral small vessel disease (SVD), C-reactive protein (CRP) and a panel of cytokines in serum were assessed. Cox proportional hazard models were used to estimate the association of MRI changes with survival over 9 years. Regression models were used to assess the hypothesis that inflammation is mediating the relationship between MRI-brain changes and mortality. In total, 77 (29 %) deaths occurred during a mean follow up of 9 years. After adjusting for confounders, the degree of global cortical atrophy and the level of the cytokines CRP, TNF-α and IL-8 were of higher significance in study participants who had died at follow-up in comparison to survivors. In Cox proportional hazard models, higher degrees of global cortical atrophy (HR 1.56, p = 0.003) and regional atrophy of the temporal lobe (HR 1.38, p = 0.011) were associated with a significantly increased risk of mortality. Mediation analyses revealed a partial mediation by IL-6 and IL-8 of the effects of global cortical atrophy on mortality. Global cortical brain atrophy is a significant indicator of survival in the elderly. Our study supports a possible role for inflammation in the atrophy pathogenesis. If replicated in other samples, IL-6 and IL-8 level assessment may improve risk prognosis for mortality.

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White Matter Changes on CT and MRI: An Overview of Visual Rating Scales

Cited by 250 publications

References 56 publications

Episodic memory and speed/attention deficits are associated with Alzheimer-typical CSF abnormalities in MCI

Episodic memory and speed/attention deficits are associated with Alzheimer-typical CSF abnormalities in MCI

Ambulatory blood pressure, asymptomatic cerebrovascular damage and cognitive function in essential hypertension

Structural brain changes and all-cause mortality in the elderly population—the mediating role of inflammation

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