Al-Janabi Omar M, Bauer Christopher E, Goldstein Larry B, Murphy Richard R, Bahrani Ahmed A, Smith Charles D, Wilcock Donna M, Gold Brian T, Jicha Gregory A
Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY 40536, USA.
Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, KY 40508, USA.
Brain Sci. 2019 Jul 19;9(7):170. doi: 10.3390/brainsci9070170.
Subcortical white matter hyperintensities (WMHs) in the aging population frequently represent vascular injury that may lead to cognitive impairment. WMH progression is well described, but the factors underlying WMH regression remain poorly understood. A sample of 351 participants from the Alzheimer's Disease Neuroimaging Initiative 2 (ADNI2) was explored who had WMH volumetric quantification, structural brain measures, and cognitive measures (memory and executive function) at baseline and after approximately 2 years. Selected participants were categorized into three groups based on WMH change over time, including those that demonstrated regression ( = 96; 25.5%), stability ( = 72; 19.1%), and progression ( = 209; 55.4%). There were no significant differences in age, education, sex, or cognitive status between groups. Analysis of variance demonstrated significant differences in atrophy between the progression and both regression ( = 0.004) and stable groups ( = 0.012). Memory assessments improved over time in the regression and stable groups but declined in the progression group ( = 0.003; = 0.018). WMH regression is associated with decreased brain atrophy and improvement in memory performance over two years compared to those with WMH progression, in whom memory and brain atrophy worsened. These data suggest that WMHs are dynamic and associated with changes in atrophy and cognition.
老年人群的皮质下白质高信号（WMHs）通常代表可能导致认知障碍的血管损伤。WMHs进展已有充分描述，但WMHs消退的潜在因素仍知之甚少。对来自阿尔茨海默病神经影像学倡议2（ADNI2）的351名参与者进行了研究，这些参与者在基线时以及大约2年后进行了WMH体积量化、脑结构测量和认知测量（记忆和执行功能）。根据WMH随时间的变化，将选定的参与者分为三组，包括出现消退的参与者（n = 96；25.5%）、稳定的参与者（n = 72；19.1%）和进展的参与者（n = 209；55.4%）。各组之间在年龄、教育程度、性别或认知状态方面没有显著差异。方差分析表明，进展组与消退组（p = 0.004）和稳定组（p = 0.012）之间在萎缩方面存在显著差异。在消退组和稳定组中，记忆评估随时间改善，但在进展组中下降（p = 0.003；p = 0.018）。与WMHs进展且记忆和脑萎缩恶化的参与者相比，WMHs消退与两年内脑萎缩减少和记忆表现改善相关。这些数据表明，WMHs是动态的，与萎缩和认知的变化相关。
