White matter lesions and brain gray matter volume in cognitively normal elders

Abstract

Objectives Cerebral white matter lesions (WMLs) reflect small vessel disease, are common in elderly individuals and are associated with cognitive impairment. We sought to determine the relationships between WMLs, age, gray matter (GM) volume, and cognition in the Cardiovascular Health Study (CHS). Methods From the CHS we selected 740 cognitively normal controls with a 1.5 T MRI scan of the brain and a detailed diagnostic evaluation. WML severity was determined using a standardized visual rating system. GM volumes were analyzed using voxel-based morphometry implemented in the Statistical Parametric Mapping software. Results WMLs were inversely correlated with GM volume, with the greatest volume loss in the frontal cortex. Age related atrophy was observed in the hippocampus and posterior cingulate cortex. Regression analyses revealed links among age, APOE*4 allele, hypertension, WMLs, GM volume, and digit symbol substitution test scores. Conclusions Both advancing age and hypertension predict higher WML load, which is itself associated with GM atrophy. Longitudinal data are needed to confirm the temporal sequence of events leading to a decline in cognitive function.

Advances in Vascular Cognitive Impairment

“…These data suggest that brain atrophy is part of the SVD pathological spectrum and is not a coincidental finding, a conclusion supported by the Cardiovascular Health Study. 13 Similar findings were recently reported by the SMART-MR Study (Second Manifestations of Arterial Disease-Magnetic Resonance).…”

Disconnections of Cortico-Subcortical Pathways Related to Cognitive Impairment in Patients with Leukoaraiosis: A Preliminary Diffusion Tensor Imaging Study

“…A higher vulnerability of frontal white matter to vascular disease plays a crucial role in deficits of executive function and attention due to frontal-subcortical disconnection [18]. A prior brain structural study also showed that the WMLs were inversely correlated with the volume of grey matter, with the greatest volume loss in the frontal cortex [19]. Furthermore, a close relationship between FA and executive function in the frontal was also performed and FA may provide an early valuable index to detect age-related cognitive decline [20].…”

Evaluation of Common Structural Brain Changes in Aging and Alzheimer Disease with the Use of an MRI-Based Brain Atrophy and Lesion Index: A Comparison Between T1WI and T2WI at 1.5T and 3T

“…Each of these changes can individually be related to an increased, albeit small, dementia risk; however, when combined, they produce additive effects on function. 11,24,25 It has also been suggested that many changes are interrelated, for example, more severe white matter damage and vascular lesions are associated with more severe gray matter and hippocampal atrophy, [26][27][28] producing a combined effect on cognition, though the relationships typically are nonlinear. 29,30 By combining these changes, their overall effect can be understood more comprehensively.…”