Biesbroek J Matthijs, Lam Bonnie Y K, Zhao Lei, Tang Yumi, Wang Zhaolu, Abrigo Jill, Chu Winnie W C, Wong Adrian, Shi Lin, Kuijf Hugo J, Biessels Geert Jan, Mok Vincent C T
Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, SAR, China; Therese Pei Fong Chow Research Centre for Prevention of Dementia, Gerald Choa Neuroscience Centre, Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China.
J Neurol Sci. 2020 Jul 15;414:116835. doi: 10.1016/j.jns.2020.116835. Epub 2020 Apr 13.
White matter hyperintensities (WMH) are associated with cognitive impairment. The impact of WMH on cognitive domains (e.g. processing speed, executive functioning) depends on location. We determined whether the relevance of WMH location also applies to global cognitive functioning by testing if WMH in strategic white matter tracts are associated with global cognitive functioning independent of total WMH burden.
We included 830 community-dwelling individuals. WMH volume within two a priori specified strategic white matter tracts (forceps minor and anterior thalamic radiation) were entered in a linear regression model with the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) as outcome variables and corrected for total WMH volume and other MRI markers for vascular injury and neurodegenerations (i.e. brain parenchymal fraction, and the presence of lacunes and microbleeds).
WMH in the forceps minor and left anterior thalamic radiation inversely correlated with MoCA, and WMH in the forceps minor inversely correlated with MMSE, independent of total WMH volume and other MRI markers.
The impact of WMH on global cognitive functioning depends on location. Whether this reflects accumulated impairment in isolated cognitive domains or disruption of a network that is crucially involved in global cognitive performance remains to be determined.
白质高信号（WMH）与认知障碍相关。WMH对认知领域（如处理速度、执行功能）的影响取决于其位置。我们通过测试策略性白质束中的WMH是否与整体认知功能相关（独立于总的WMH负担）来确定WMH位置的相关性是否也适用于整体认知功能。
我们纳入了830名社区居住个体。将两个预先指定的策略性白质束（小钳和丘脑前辐射）内的WMH体积纳入线性回归模型，以蒙特利尔认知评估（MoCA）和简易精神状态检查表（MMSE）作为结果变量，并对总的WMH体积以及血管损伤和神经退行性变的其他MRI标记物（即脑实质分数、腔隙和微出血的存在情况）进行校正。
小钳和左侧丘脑前辐射中的WMH与MoCA呈负相关，小钳中的WMH与MMSE呈负相关，独立于总的WMH体积和其他MRI标记物。
WMH对整体认知功能的影响取决于位置。这是否反映了孤立认知领域中累积的损伤或对整体认知表现至关重要的网络的破坏仍有待确定。
