Association of the Brain White Matter Hyperintensity with the Cognitive Performance in Middle-Aged Population.

IF 2.2 3区医学 Q3 CLINICAL NEUROLOGY

Cerebrovascular Diseases Pub Date : 2024-11-21 DOI:10.1159/000542710

Yousef Hannawi, Lisa R Yanek, Brian G Kral, Lewis C Becker, Dhananjay Vaidya, Paul A Nyquist

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引用次数: 0

Abstract

Introduction: White matter hyperintensity (WMH) is typically classified into periventricular- and deep-WMH (PVWMH and DWMH) based on its proximity to the ventricles. While WMH volume has been associated with the cognitive performance and decline in patients with cerebral small vessel disease (cSVD), the relative contributions of PVWMH and DWMH to the cognitive profile of these patients remain unclear. Therefore, we aimed to determine the differences in association of PVWMH and DWMH with a battery of cognitive tests in a group of middle-aged population at risk for cardiovascular disease.

Methods: Participants in the Genetic Study for Atherosclerosis Risk (GeneSTAR) who had a brain MRI, a cognitive battery, and were older than 50 years of age were studied. The relative association of PVWMH and DWMH with each of the cognitive measures was tested using multilevel linear regression models adjusting for age, intracranial volume, and cardiovascular risk factors. Adjustment for multiple comparisons was completed by using Benjamini-Hochberg procedure for the primary outcome and q-value of < 0.1 was considered significant. Maximal likelihood estimation analysis was used to explore whether age moderated the difference in association of PVWMH and DWMH with the cognitive tests.

Results: 435 participants (age 58.9±6.14 years, 58.38% women, and 39.54% black) were studied. We identified a greater association of PVWMH than DWMH with a worse performance on grooved peg board test (q-value=0.06) including the dominant (q-value=0.098) and non-dominant hand (q-value=0.098) performance as well as the delayed word recall test in its short form (q-value=0.098). Age did not moderate the differences in the association of PVWMH and DWMH with these cognitive tests.

Conclusions: Our findings indicate a greater effect of PVWMH than DWHM on manipulative manual dexterity and delayed word recall functions suggesting potential injury of the white matter tracts that are relevant to these function by PVWMH. These findings need to be confirmed in future large prospective studies.

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中年人大脑白质高密度与认知能力的关系

简介白质高密度（WMH）通常根据其是否靠近脑室分为脑室周围白质高密度（PVWMH）和深部白质高密度（DWMH）。虽然 WMH 体积与脑小血管疾病（cSVD）患者的认知能力和衰退有关，但 PVWMH 和 DWMH 对这些患者认知能力的相对贡献仍不清楚。因此，我们的目的是在一组有心血管疾病风险的中年人群中确定 PVWMH 和 DWMH 与一系列认知测试之间的关联差异：研究对象为动脉粥样硬化风险基因研究（GeneSTAR）中接受过脑核磁共振成像和认知测试的 50 岁以上的参与者。使用多层次线性回归模型检验了 PVWMH 和 DWMH 与各项认知指标的相对关系，并对年龄、颅内容积和心血管风险因素进行了调整。主要结果的多重比较调整采用本杰明-霍奇伯格程序（Benjamini-Hochberg procedure）完成，q 值小于 0.1 视为显著。最大似然估计分析用于探讨年龄是否调节了PVWMH和DWMH与认知测试之间的差异：共研究了 435 名参与者（年龄为 58.9±6.14 岁，58.38% 为女性，39.54% 为黑人）。我们发现，PVWMH 比 DWMH 与凹槽钉板测试（q-value=0.06）（包括惯用手（q-value=0.098）和非惯用手（q-value=0.098））以及短式延迟单词回忆测试（q-value=0.098）的成绩更差有关。年龄并不影响PVWMH和DWMH与这些认知测试的关联差异：我们的研究结果表明，PVWMH 比 DWHM 对手部操作灵活性和延迟单词记忆功能的影响更大，这表明 PVWMH 可能会损伤与这些功能相关的白质束。这些发现需要在未来的大型前瞻性研究中得到证实。

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来源期刊

Cerebrovascular Diseases 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

审稿时长

1 months

期刊介绍： A rapidly-growing field, stroke and cerebrovascular research is unique in that it involves a variety of specialties such as neurology, internal medicine, surgery, radiology, epidemiology, cardiology, hematology, psychology and rehabilitation. ''Cerebrovascular Diseases'' is an international forum which meets the growing need for sophisticated, up-to-date scientific information on clinical data, diagnostic testing, and therapeutic issues, dealing with all aspects of stroke and cerebrovascular diseases. It contains original contributions, reviews of selected topics and clinical investigative studies, recent meeting reports and work-in-progress as well as discussions on controversial issues. All aspects related to clinical advances are considered, while purely experimental work appears if directly relevant to clinical issues.