Magnetic Resonance Imaging White Matter Hyperintensities and Brain Volume in the Prediction of Mild Cognitive Impairment and Dementia

Smith, Eric E.; Egorova, Svetlana; Blacker, Deborah; Killiany, Ronald J.; Muzikansky, Alona; Dickerson, Bradford C.; Tanzi, Rudolph E.; Albert, Marilyn; Greenberg, Steven M.

doi:10.1001/archneurol.2007.23

Cited by 208 publications

(172 citation statements)

References 52 publications

Supporting

Mentioning

162

Contrasting

Order By: Relevance

“…24 Furthermore, in a recent longitudinal analysis found that increased white matter hyperintensities could be a predictor of progression from normal to MCI. 31 Association of silent cerebral infarctions with the development of MCI was also reported in another community-based longitudinal study. 32 By considering these findings together with our present data, asymptomatic cerebrovascular damages were thought to be one of possible mechanisms explainable for the relation between abnormal nocturnal BP profile and MCI in apparently healthy elderly persons.…”

Section: Discussionmentioning

confidence: 53%

Abnormal nocturnal blood pressure profile is associated with mild cognitive impairment in the elderly: the J-SHIPP study

et al. 2009

View full text Add to dashboard Cite

Mild cognitive impairment (MCI), a syndrome characteristic of the transition phase between normal cognitive function and dementia, has been shown to carry the risk of progression to dementia. Dysregulation of blood pressure (BP) is thought to be an indicator of cerebrovascular damage, including cognitive impairment. Here, we investigated the possible association of circadian BP variation with MCI in community-dwelling persons exhibiting no definitive dementia. Our study enrolled 144 persons (68 ± 7 years). Nocturnal BP profile was defined as dipper, with a 10-19% drop in nocturnal systolic BP; extreme dipper, X20% drop; non-dipper, 0-10% drop; and riser, any increase in nocturnal BP. MCI was assessed using the MCI screen, a cross-validated, staff-administered battery of tests. Subjects with MCI (n¼38) were significantly older (74±6, 67±6 years, Po0.001) and had higher frequency of apolipoprotein E e4 allele (36.8, 18.9%, P¼0.018). Although the ambulatory measured BP and the percent changes in nocturnal systolic BP (À10 ± 12% and À12 ± 8%, respectively; P¼0.291) did not differ between MCI subjects and normal controls, frequency of MCI was significantly higher in the extreme dippers (32.0%), non-dippers (30.0%) and risers (50.0%) than in dippers (13.2%, P¼0.018). Multiple logistic regression analysis identified a blunted nocturnal BP decline, non-dipping or increase in nocturnal BP and extreme drop in BP as potent determinants of MCI (odds ratio 3.062, P¼0.039), after adjustment for possible confounding factors, including apolipoprotein E e4 genotype. Abnormal nocturnal BP profile was found to be a strong indicator of MCI in otherwise apparently healthy community-dwelling elderly persons. Keywords: ambulatory blood pressure monitoring; mild cognitive impairment; nocturnal blood pressure INTRODUCTION Mild cognitive impairment (MCI) is a syndrome defined as cognitive decline greater than expected for an individual's age and education level that does not notably interfere with activities of daily life. 1 MCI is classified into four subtypes: amnestic MCI involving only memory impairment (single domain) or memory impairment along with deficits in another cognitive domain such as language function, visuospatial skills, or executive function (multiple domain) and non-amnestic MCI involving discrete cognitive impairments in single or multiple domains other than memory function. 2 MCI prevalence has been estimated to be between 6 and 10% based on community assessments, 3 a frequency about four times that of dementia. MCI also exhibits Alzheimer-type dementia-like neuropathology on autopsy, and at least half of those diagnosed with MCI, in particular amnestic MCI subtype, eventually progress into Alzheimer-type dementia (AD) with a smaller percentage progression to other forms of dementia,

show abstract

Section: Discussionmentioning

confidence: 53%

Abnormal nocturnal blood pressure profile is associated with mild cognitive impairment in the elderly: the J-SHIPP study

et al. 2009

View full text Add to dashboard Cite

show abstract

“…Although some evidence suggests that WMH may increase the risk of MCI, data come mainly from studies that included small or highly selected samples (i.e., clinic‐based persons), used semi‐quantitative ratings of WMH, and did not involve annual assessments of cognition 2, 8, 9. Furthermore, findings are inconsistent; whereas one study of 67 cognitively intact persons found that WMH were associated with the development of MCI, a considerably larger study did not, particularly when other MRI indices were included in the analyses 8, 9. The degree to which WMH contribute to progressive cognitive decline among older persons initially free of cognitive impairment also is poorly understood.…”

Section: Introductionmentioning

confidence: 99%

White matter hyperintensities, incident mild cognitive impairment, and cognitive decline in old age

Boyle

Fleischman

et al. 2016

Ann Clin Transl Neurol

View full text Add to dashboard Cite

ObjectiveExamine the association of white matter hyperintensities (WMH) with risk of incident mild cognitive impairment (MCI) and rate of decline in multiple cognitive systems in community‐based older persons.MethodsParticipants (n = 354) were older persons initially free of cognitive impairment from two ongoing longitudinal epidemiologic studies of aging. All underwent brain magnetic resonance imaging (MRI) for quantification of WMH and gray matter volumes and detailed annual clinical evaluations including 17 cognitive tests. Proportional hazards models were used to examine the relationship between WMH and incident MCI, and mixed‐effects models were used to examine the relationship between WMH and decline in global cognition and five specific cognitive systems.ResultsDuring up to about 6 years of follow‐up (mean = 4.1), 106 (30% of 354) persons developed MCI. In a proportional hazards model adjusted for age, gender, and education, WMH volume was associated with a substantially increased risk of MCI (P < 0.001). Thus, a person with a high WMH volume (90th percentile) was about 2.7 times more likely to develop MCI compared to a person with a low volume (10th percentile). WMH volume also was associated with an increased rate of decline in global cognition (P < 0.001), perceptual speed, working memory, episodic memory, and semantic memory. Associations persisted after adjustment for total gray matter volume, vascular risk factors, and vascular diseases.Interpretation WMH contribute to the development of MCI and are associated with progressive decline in multiple cognitive systems in old age.

show abstract

“…8 Cognitive dysfunction has been studied extensively in persons with WMH lesions on MRI. 9,[11][12][13][14][15][16][17][18] Perceived cognitive dysfunction as measured by Cognitive Difficulties Scale was found to be worse with higher WMH burden and the annual rate of decline on the minimental status examination (MMSE) was 0.035 points per standard deviation increase in periventricular WMH. 19 In Importantly, among patients with a history of stroke and/or transient ischemic attack in the Perindopril Protection Against Recurrent Stroke Study (PROGRESS), the dementia risk during a median follow-up period of 3.9 years was found to be 7.7 times higher in patients with white matter disease than those without it at the time of study enrollment.…”

Section: Cognitive Functionmentioning

confidence: 96%

Small Vessel Disease of the Brain and Stroke: Association with Clinic and Ambulatory Blood Pressure

Gupta¹,

White²,

Ram³

2016

Hypertension Journal

View full text Add to dashboard Cite

Several potential vascular risk factors exist for the development and accumulation of small vessel disease of the brain and stroke in older people. In older people followed up for several years, we and others have reported that white matter hyperintensity lesions on magnetic resonance imaging nearly doubled in volume and were associated with alterations in neurologic function. In this article, we review blood pressure (BP) as a risk factor for the development and pathogenesis of small vessel disease and stroke in older persons. The research efforts have focused on ambulatory BP measurements, which have proven to be a stronger indicator than clinic pressures for the progression of small vessel disease in older people as well as the development of stroke. Based on relations among 24 hours systolic BP levels, the accrual of small vessel disease, and relations with cognitive function and mobility, we have designed the INFINITY trial, a novel interventional study that uses ambulatory BP to guide antihypertensive therapy addressed at improving functional decline.

show abstract

Magnetic Resonance Imaging White Matter Hyperintensities and Brain Volume in the Prediction of Mild Cognitive Impairment and Dementia

Cited by 208 publications

References 52 publications

Abnormal nocturnal blood pressure profile is associated with mild cognitive impairment in the elderly: the J-SHIPP study

Abnormal nocturnal blood pressure profile is associated with mild cognitive impairment in the elderly: the J-SHIPP study

White matter hyperintensities, incident mild cognitive impairment, and cognitive decline in old age

Small Vessel Disease of the Brain and Stroke: Association with Clinic and Ambulatory Blood Pressure

Contact Info

Product

Resources

About