Association of serum cystatin C with white matter abnormalities in patients with amnestic mild cognitive impairment.

Kentaro Hirao,Takahiko Umahara,Hirofumi Sakurai,Haruo Hanyu,Hidekazu Kanetaka,Misa Okita,Soichiro Shimizu,Akito Tsugawa,Rieko Haime,Fumio Yamashita,Tomohiko Sato,Raita Fukasawa

doi:10.1111/ggi.13767

Abstract

AimWhite matter hyperintensities (WMH) on MRI have been reported to be a risk factor for the conversion from mild cognitive impairment (MCI) to Alzheimer's disease, although the reason remains unclear. In the present study, we hence investigated the associations between WMH volumes and cognitive function, blood levels of various molecules, and the presence of lifestyle‐associated diseases in patients with amnestic MCI.MethodsThe initial data of 38 patients with amnestic MCI and 10 normal control individuals were analyzed. The volumes of periventricular hyperintensities (PVH) and deep WMH (DWMH) were measured on T2 fluid‐attenuated inversion recovery using the imaging software, 3D Slicer; and the association between PVH/DWMH volumes and cognitive function, blood levels of molecules (such as cystatin C [CysC], 25‐hydroxyvitamin D and homocysteine) and the presence of lifestyle‐associated diseases (such as hypertension, hyperlipidemia and diabetes mellitus) were analyzed.ResultsIn the MCI group, the PVH volume : intracranial volume ratio significantly correlated with Trail Making Test‐A/B scores and CysC level by Pearson's analysis, and the PVH volume : intracranial volume ratio significantly correlated with only CysC levels, whereas the DWMH volume : intracranial volume ratio did not correlate with any items at all by linear multiple regression analysis.ConclusionsPVH volume was closely associated with frontal lobe dysfunction, particularly with attention and executive dysfunction. Serum CysC level was associated with PVH volume, which suggests that CysC might be a useful marker for determining treatment strategies for white matter abnormalities in amnestic MCI. Geriatr Gerontol Int 2019; 19: 1036–1040.

Highlights

White matter abnormalities have been recognized to be associated with aging, geriatric depression and dementia, such as Alzheimer disease (AD).[1,2] white matter hyperintensities (WMH) on magnetic resonance imaging (MRI) have been reported to be a risk factor for the conversion from mild cognitive impairment (MCI) to AD.[3–5] Even among healthy older people, a significant association between WMH and cognitive dysfunction has been reported, the reason is not clear.[6,7] it is crucial to establish aggressive treatment strategies for the prevention of geriatric syndrome, including dementia and geriatric depression caused by white matter abnormalities
We investigated the association between periventricular hyperintensities (PVH)/deep WMH (DWMH) volumes and cognitive function, depressive symptoms, blood levels of molecules and the presence of lifestyle-associated diseases using the data at the initial visit of patients with amnestic MCI
The PVH volume : intracranial volumes (ICV) ratio significantly correlated with Trail Making Test (TMT)-A/B and cystatin C (CysC) levels

Summary

Introduction

White matter abnormalities have been recognized to be associated with aging, geriatric depression and dementia, such as Alzheimer disease (AD).[1,2] white matter hyperintensities (WMH) on magnetic resonance imaging (MRI) have been reported to be a risk factor for the conversion from mild cognitive impairment (MCI) to AD.[3–5] Even among healthy older people, a significant association between WMH and cognitive dysfunction has been reported, the reason is not clear.[6,7] it is crucial to establish aggressive treatment strategies for the prevention of geriatric syndrome, including dementia and geriatric depression caused by white matter abnormalities. Several studies have shown the association between WMH and blood levels of molecules, such as cystatin C (CysC), 25-hydroxyvitamin D and homocysteine, and the presence of lifestyleassociated diseases, such as hypertension, hyperlipidemia and diabetes mellitus.[8–10]. Most of these studies have assessed WMH by visual rating, which is not very precise.[3–5]. We investigated the association between PVH/DWMH volumes and cognitive function, depressive symptoms, blood levels of molecules (such as CysC, 25-hydroxyvitamin D and homocysteine) and the presence of lifestyle-associated diseases (such as hypertension, hyperlipidemia and diabetes mellitus) using the data at the initial visit of patients with amnestic MCI

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