Brain White Matter Hyperintensity Changes Associated with Vascular Cognitive Impairment and Dementia, Alzheimer's Dementia and Normal Aging

Abstract

Aim: The aim of this study was to analyze the relationship between the distribution and grading of white matter hyperintensity (WMH) obtained by brain magnetic resonance imaging and cognitive impairment associated with vascular cognitive impairment and dementia (VCID), Alzheimer's dementia (AD) and normal aging in individuals aged 65 years and older. Material and Methods: Retrospective analysis was performed on a total of 372 patients, who met the criteria for AD, VCID and normal aging. The basic clinical criteria of DSM-V and NIA-AA were considered for AD. The DSM-V and NINDS-AIREN diagnostic criteria were used for VCID and probable vascular dementia (VaD). WMHs were graded according to the Fazekas criteria. Results: Normal aging was detected in 58.3% (n=217) of the patients, AD in 24.7% (n=92) and VCID in 16.9% (n=63). The relationship between WMH and dementia was significant. (p<0.001). Periventricular hyperintensity was detected as 76.2% (n=70) in AD, 95.2% (n=60) in VCID, 40.6% (n=88) in normal aging, and deep white matter hyperintensity was detected as 63.0% (n=58) in AD, 74.5% (n=47) in VCID, 44.2% (n=96) in normal aging. In the VCID group, 52.4% (n=33) had basal ganglia lesions and 60.3% (n=38) had classical infarct areas. No relationship was found between the presence of cortical lesion and cognition. Conclusion: This study is important in terms of showing that it would be better to focus on markers of brain damage and dementia, such as WMH rather than focusing on clinical diagnoses with mixed-type pathologies such as Alzheimer's disease or vascular cognitive impairment.