Cognitive performance in patients with Mild Cognitive Impairment and Alzheimer's disease with white matter hyperintensities: An exploratory analysis

Holz, Maila Rossato; Kochhann, Renata; Ferreira, Patrícia; Tarrasconi, Marina; Chaves, Márcia Lorena Fagundes; Fonseca, Róchele Paz

doi:10.1590/1980-57642016dn11-040013

Cited by 5 publications

(4 citation statements)

References 51 publications

(64 reference statements)

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“…Associations between WMH and cognitive performance have been widely reported in cognitively normal individuals, 29,30 as well as in individuals with MCI or AD. [31][32][33][34] Our results support the hypothesis that, in older individuals, larger baseline WMH burden is associated with worse cognitive and functional performance as well as accelerated decline in cognition and functional status. We did not find an association between the rate of change in WMH and cognitive and functional trajectory, confirming previous findings 35 and contrasting with others, 36 emphasizing the need to identify new biomarkers sensitive to early and subtle change in WM microstructure.…”

Section: Discussionsupporting

confidence: 83%

Cerebral white matter free water

et al. 2019

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ObjectiveTo determine whether free water (FW) content, initially developed to correct metrics derived from diffusion tensor imaging and recently found to be strongly associated with vascular risk factors, may constitute a sensitive biomarker of white matter (WM) microstructural differences associated with cognitive performance but remains unknown.MethodsFive hundred thirty-six cognitively diverse individuals, aged 77 ± 8 years, received yearly comprehensive clinical evaluations and a baseline MRI examination of whom 224 underwent follow-up MRI. WM microstructural measures, including FW, fractional anisotropy, and mean diffusivity corrected for FW and WM hyperintensity burden were computed within WM voxels of each individual. Baseline and change in MRI metrics were then used as independent variables to explain baseline and change in episodic memory (EM), executive function (EF), and Clinical Dementia Rating (CDR) scores using linear, logistic, and Cox proportional-hazards regressions.ResultsHigher baseline FW and WM hyperintensity were associated with lower baseline EM and EF, higher baseline CDR, accelerated EF and EM decline, and higher probability to transition to a more severe CDR stage (p values <0.01). Annual change in FW was also found to be associated with concomitant change in cognitive and functional performance (p values <0.01).ConclusionsThis study finds cross-sectional and longitudinal associations between FW content and trajectory of cognitive and functional performance in a large sample of cognitively diverse individuals. It supports the need to investigate the pathophysiologic process that manifests increased FW, potentially leading to more severe WM territory injury and promoting cognitive and functional decline.

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Section: Discussionsupporting

confidence: 83%

Cerebral white matter free water

et al. 2019

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“…Our findings showed that PM deficits were associated with both periventricular and deep WMHs in all the participants, while the relationship was not significant when inspecting only the SIVD or AD groups. This finding is partially consistent with the results of Holz et al ( 2017 ), in which a trend of correlation was only found between PM and WMHs in a group of people with MCI and mild AD ( p = 0.052). Therefore, the impact of WMHs on PM may be threshold-sensitive.…”

Section: Discussionsupporting

confidence: 92%

Prospective Memory and Regional Functional Connectivity in Subcortical Ischemic Vascular Disease

Zhuang

Lin

et al. 2021

Front. Aging Neurosci.

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Objectives: Patients with subcortical ischemic vascular disease (SIVD) often have prominent frontal dysfunction. However, it remains unclear how SIVD affects prospective memory (PM), which strongly relies on the frontoparietal network. The present study aimed to investigate PM performance in patients with early stage SIVD as compared to those with Alzheimer's disease (AD) and to older adults with normal cognition, and to explore the neural correlates of PM deficits.Method: Patients with very-mild to mild dementia due to SIVD or AD and normal controls (NC) aged above 60 years were recruited. Seventy-three participants (20 SIVD, 22 AD, and 31 NC) underwent structural magnetic resonance imaging (MRI), cognitive screening tests, and a computerized PM test. Sixty-five of these participants (19 SIVD, 20 AD, and 26 NC) also received resting-state functional MRI.Results: The group with SIVD had significantly fewer PM hits than the control group on both time-based and non-focal event-based PM tasks. Among patients in the very early stage, only those with SIVD but not AD performed significantly worse than the controls. Correlational analyses showed that non-focal event-based PM in SIVD was positively correlated with regional homogeneity in bilateral superior and middle frontal gyri, while time-based PM was not significantly associated with regional homogeneity in any of the regions of interest within the dorsal frontoparietal regions.Conclusions: The findings of this study highlight the vulnerability of non-focal event-based PM to the disruption of regional functional connectivity in bilateral superior and middle frontal gyri in patients with SIVD.

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“…Additionally, older adults completed a comprehensive neuropsychological assessment battery which evaluated executive functions, attention, language, praxis, and memory. Further information on this assessment battery is available in an article published by Holz et al 52 Only subjects whose cognitive evaluations excluded the presence of cognitive impairment (i.e. z-scores greater than -1.5 on every cognitive domain) were included in the final sample.…”

Section: Methodsmentioning

confidence: 99%

Age-related differences in conversational discourse abilities A comparative study

Pereira

Gonçalves

Goulart

et al. 2019

Dement. neuropsychol.

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ABSTRACT. Conversational discourse (CD) is among the most complex tasks in everyday life and relies on multiple cognitive domains (communicative and executive abilities). Alterations in discourse comprehension and production are often present in pathological aging. However, there is still a need to identify changes in healthy aging. Objective: This study aimed to compare young and older adults for the frequency of impaired communicative behaviors on a CD task. Performance was scored according to the Complementary Procedure of Conversational Discourse Analysis (CPCDA), developed based on the CD task from the Montreal Communication Evaluation Battery. Methods: A total of 95 participants (54 young-adults and 41 older adults) were evaluated. The frequency of communicative behaviors was compared between groups using MANCOVA and Chi-square tests. Results: Young adults showed fewer impairments in expression, pragmatics, cohesion, coherence, comprehension and emotional prosody. Older adults showed higher levels of verbal initiative and had fewer word finding difficulties. Communicative behaviors associated with planning and self-monitoring (e.g. repetition of information and syllabic false starts) appear to be common in the speech of healthy individuals in general. Conclusion: Studies which evaluate both discursive and cognitive skills are required to identify age-related changes. This would allow for the development of screening tools for CD assessment and preventive programs.

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Cognitive performance in patients with Mild Cognitive Impairment and Alzheimer's disease with white matter hyperintensities: An exploratory analysis

Cited by 5 publications

References 51 publications

Cerebral white matter free water

Cerebral white matter free water

Prospective Memory and Regional Functional Connectivity in Subcortical Ischemic Vascular Disease

Age-related differences in conversational discourse abilities A comparative study

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