Impact of regional white matter hyperintensity patterns on cognitive trajectories in NACC

IF 11.1 1区医学 Q1 CLINICAL NEUROLOGY

Alzheimer's & Dementia Pub Date : 2025-10-17 DOI:10.1002/alz.70764

Lindsay J. Rotblatt, Lauren Edwards, Fareshte Erani, Caitlin M. Terao, Katherine J. Bangen, Kelsey R. Thomas

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Abstract

INTRODUCTION

White matter hyperintensities (WMHs) are a biomarker of small vessel cerebrovascular changes that can emerge early in Alzheimer's disease. While global WMHs correlate with cognitive decline, the impact of regional WMHs remains understudied. We examined associations of regional WMH distributions with longitudinal cognition.

METHODS

National Alzheimer's Coordinating Center cohort participants (n = 1047; cognitively normal, mild cognitive impairment, dementia) completed neuropsychological and neuroimaging assessments. Hierarchical cluster analysis identified baseline regional WMH patterns, and linear mixed-effects models assessed 2 year change in cognitive domain by cluster.

RESULTS

Five WMH clusters emerged. Compared to those with low WMH burden, participants in the mild occipital and high parieto-occipital clusters had faster memory decline; mild fronto-parietal and high parieto-occipital clusters showed faster executive decline; and mild and high fronto-parietal and high parieto-occipital clusters had faster language decline.

DISCUSSION

Regional WMH distributions showed distinct trajectories. Posterior WMHs were most associated with memory decline, while even mild WMHs accelerated decline in some domains.

Highlights

Hierarchical cluster analysis identified five white matter hyperintensity (WMH) patterns.
Posterior WMHs were most related to memory decline.
Mild frontal and elevated posterior patterns were associated with executive function decline.
Multiple WMH patterns were associated with language decline.

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区域白质高强度模式对NACC认知轨迹的影响

白质高强度（WMHs）是小血管脑血管变化的生物标志物，可在阿尔茨海默病早期出现。虽然全球性的wmh与认知能力下降相关，但区域性wmh的影响仍未得到充分研究。我们研究了区域WMH分布与纵向认知的关系。方法国家阿尔茨海默病协调中心队列参与者（n = 1047，认知正常，轻度认知障碍，痴呆）完成神经心理学和神经影像学评估。分层聚类分析确定了基线区域WMH模式，线性混合效应模型通过聚类评估了认知领域2年的变化。结果出现5个WMH集群。与低WMH负荷组相比，轻度枕叶组和高顶枕叶组的记忆衰退速度更快；轻度额顶叶簇和高额顶叶-枕叶簇表现出更快的执行能力下降；轻度和高额顶叶和高顶枕叶簇有更快的语言衰退。区域WMH分布表现出明显的轨迹。后侧脑卒中与记忆衰退最相关，而即使是轻度脑卒中也会加速某些脑域的衰退。分层聚类分析确定了五种白质高强度（WMH）模式。后侧WMHs与记忆衰退最相关。轻度额叶型和抬高的后叶型与执行功能下降有关。多种WMH模式与语言能力下降有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Alzheimer's & Dementia 医学-临床神经学

CiteScore

14.50

自引率

5.00%

发文量

299

审稿时长

3 months

期刊介绍： Alzheimer's & Dementia is a peer-reviewed journal that aims to bridge knowledge gaps in dementia research by covering the entire spectrum, from basic science to clinical trials to social and behavioral investigations. It provides a platform for rapid communication of new findings and ideas, optimal translation of research into practical applications, increasing knowledge across diverse disciplines for early detection, diagnosis, and intervention, and identifying promising new research directions. In July 2008, Alzheimer's & Dementia was accepted for indexing by MEDLINE, recognizing its scientific merit and contribution to Alzheimer's research.