Cognitive and balance impairments in people with incidental white matter hyperintensities

Abstract

Background White matter hyperintensities (WMHs) is the most frequent type of cerebral small vessel diseases and a common incidental finding in MRI films of the geriatric population. The objectives of this work were to study the existence of occult cognitive and balance impairments in subjects with accidentally discovered WMHs. Methods The study was conducted on 44 subjects with accidentally discovered WMHs and 24 non-WMHs subjects submitted to the advanced activity of daily living scale (AADLs), a neurocognitive battery assessing different cognitive domains, Berg balance test (BBT), computerized dynamic posturography (CDP), and brain MRI diffusion tensor tractography (DTT). Results WMHs subjects showed a significant decrease in AADLs as well as visual and vestibular ratios of CDP. Regarding the neurocognitive battery, there were significant decreases in MoCA as well as arithmetic test and block design of Wechsler adult intelligence scale-IV in WMHs compared to non-WMHs subjects’ groups (p value < 0.001). Concerning Wisconsin Card Sorting subtests, each preservative response, preservative errors, non-preservative errors and trials to complete the 1st category showed a highly significant increase in WMHs compared to non-WMHs subjects (p values < 0.001). DTT showed a substantial reduction in fractional anisotropy (FA) of each corticospinal tract, thalamocortical connectivity, and arcuate fasciculi. Conclusion Subjects with WMHs have lower cognitive performance and subtle balance impairment which greatly impair their ADLs.

Contrast agent‐free state‐of‐the‐art magnetic resonance imaging on cerebral small vessel disease – Part 2: Diffusion tensor imaging and functional magnetic resonance imaging

“…Besides cognitive decline, gait (lower extremities) abnormalities are also a clinical feature of cSVD and have been investigated using DTI. Recently, it was shown that cSVD patients with higher WMH burdens presented worse cognitive performance and balance issues affecting their daily lives 113 . One study reported that FA measured in the NAWM mediated the negative association between WMH and gait disturbances 114 .…”

“…Recently, it was shown that cSVD patients with higher WMH burdens presented worse cognitive performance and balance issues affecting their daily lives. 113 One study reported that FA measured in the NAWM mediated the negative association between WMH and gait disturbances. 114 Although in a 5-year longitudinal study baseline GM volume and DTI-derived cSVD markers did not correlate with gait impairment, 115 progressive changes in WM volume, MD, AxD, and FA (extracted from a skeleton of the significant WM tracts) were associated with such gait decline in another study.…”

Outcome of Magnetic Resonance Imaging (MRI) Technique on Vascular Cognitive Impairment (VCI): Meta-Analysis

“…The meta-analysis executed on five studies [26,28,33,41,43] showed no significant difference between control (n = 161) and VCI (n = 167). Heterogeneity: Tau 2 = 4.53; Chi 2 = 85.17, df = 4 (P < 0.00001); I 2 = 95%.…”

“…Higher MoCA score represents good cognitive function and a cut off of 26 following education is need for people with cognitive disorders. The MOCA score was recorded in sixteen studies [23,24,27,30,31,33,37,39,[40][41][42][43][44][45][46][47]. The metaanalysis showed a statistically significant difference between the two groups.…”