Functional impact of white matter hyperintensities in cognitively normal elderly subjects.
نویسندگان
چکیده
OBJECTIVE To investigate the impact white matter hyperintensities (WMH) detected on magnetic resonance imaging have on motor dysfunction and cognitive impairment in elderly subjects without dementia. DESIGN Cross-sectional study. SETTING Population-based study on the incidence and prevalence of cognitive impairment in Olmsted County, Minnesota. PARTICIPANTS A total of 148 elderly subjects (65 men) without dementia ranging in age from 73 to 91 years. MAIN OUTCOME MEASURES We measured the percentage of the total white matter volume classified as WMH in a priori-defined brain regions (ie, frontal, temporal, parietal, occipital, periventricular, or subcortical). Motor impairment was evaluated qualitatively using the Unified Parkinson's Disease Rating Scale summary measures of motor skills and quantitatively using a digitized portable walkway system. Four cognitive domains were evaluated using z scores of memory, language, executive function, and visuospatial reasoning. RESULTS A higher WMH proportion in all regions except the occipital lobe was associated with lower executive function z score (P value <.01). A higher WMH proportion in all regions, but most strongly for the parietal lobe, correlated with higher Unified Parkinson's Disease Rating Scale gait, posture, and postural stability sum (P value <.01). A higher WMH proportion, whether periventricular, subcortical, or lobar, correlated with reduced velocity (P value <.001). CONCLUSIONS We conclude that executive function is the primary cognitive domain affected by WMH burden. The data suggest that WMH in the parietal lobe are chiefly responsible for reduced balance and postural support compared with the other 3 lobes and may alter integration of sensory information via parietal lobe dysfunction in the aging brain. Parietal white matter changes were not the predominant correlate with motor speed, lending evidence to a global involvement of neural networks in gait velocity.
منابع مشابه
The effect of white matter hyperintensities on statistical analysis of diffusion tensor imaging in cognitively healthy elderly and prodromal Alzheimer's disease
Diffusion tensor imaging (DTI) has been used to study microstructural white matter alterations in a variety of conditions including normal aging and Alzheimer's disease (AD). White matter hyperintensities (WMH) are common in cognitively healthy elderly as well as in AD and exhibit elevated mean diffusivity (MD) and reduced fractional anisotropy (FA). However, the effect of WMH on statistical an...
متن کاملReduced binding of Pittsburgh Compound-B in areas of white matter hyperintensities
The amyloid imaging agent, Pittsburgh Compound-B, binds with high affinity to β-amyloid (Aβ) in the brain, and it is well established that PiB also shows non-specific retention in white matter (WM). However, little is known about retention of PiB in areas of white matter hyperintensities (WMH), abnormalities commonly seen in older adults. Further, it is hypothesized that WMH are related to both...
متن کاملAge-related changes in normal-appearing brain tissue and white matter hyperintensities: more of the same or something else?
BACKGROUND AND PURPOSE Cerebral white matter (WM) hyperintensities are a frequent finding in elderly people, and lowering of cerebral magnetization transfer ratio (MTR) has been observed. The aim of this study was to assess the relationship between age-related WM hyperintensities and MTR changes in the brain. METHODS We performed MR imaging in a group of young subjects, a group of elderly ind...
متن کاملThe Spatial Associations of Cerebral Blood Flow and Spontaneous Brain Activities with White Matter Hyperintensities—An Exploratory Study Using Multimodal Magnetic Resonance Imaging
White matter hyperintensities (WMHs) have been reported to be correlated with functional brain changes, but the association of the specific WMHs distribution pattern with regional functional changes remains uncertain. The aim of this study is to explore the possible spatial correlation of WMH with changes in cerebral blood flow (CBF) and spontaneous brain activities in elderly using a novel app...
متن کاملNeuroanatomic localization of magnetic resonance imaging signal hyperintensities in geriatric depression.
BACKGROUND AND PURPOSE Increased frequency and severity of signal hyperintensities have been regularly reported in elderly depressed patients compared with normal subjects, however, greater neuroanatomic localization of lesions has been limited. METHODS T2-weighted MRI scans in elderly depressed patients (n = 35) and normal comparison subjects (n = 31) were assessed for signal hyperintensitie...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Archives of neurology
دوره 67 11 شماره
صفحات -
تاریخ انتشار 2010