Cognitive Deficits Are Associated with Frontal and Temporal Lobe White Matter Lesions in Middle-Aged Adults Living in the Community

David Bunce,Nicolas Cherbuin,Kaarin J Anstey,Perminder S Sachdev,Richard Burns,Wei Wen,Helen Christensen,Paul L Gribble

doi:10.1371/journal.pone.0013567

Abstract

BackgroundThe association between brain white matter lesions and cognitive impairment in old age is well established. However, little is known about this association in midlife. As this information will inform policy for early preventative healthcare initiatives, we investigated non-periventricular frontal, temporal, parietal and occipital lobe white matter hyperintensities (WMH) in relation to cognitive function in 428 (232 women) community-dwelling adults aged 44 to 48 years.ResultsFrontal white matter lesions were significantly associated with greater intraindividual RT variability in women, while temporal WMH were associated with face recognition deficits in men. Parietal and occipital lobe lesions were unrelated to cognitive performance. These findings did not differ when education and a range of health variables, including vascular risk factors, were taken into account.ConclusionGender differences in WMH-cognition associations are discussed, and we conclude that small vessel disease is present in midlife and has functional consequences which are generally not recognized. Preventative strategies should, therefore, begin early in life.

Highlights

There is substantial evidence that subcortical white matter lesions are associated with cognitive deficits [for reviews see 1–3]
In the light of the associations that we report with the cognitive variables below, it is important to note that a relatively small percentage of white matter hyperintensities (WMH) were recorded across the various brain regions, and that percentages were largely similar for men and women
Apart from that expected for total white matter volume, the associations between gender and WMH were all statistically unreliable

Summary

Introduction

There is substantial evidence that subcortical white matter lesions are associated with cognitive deficits [for reviews see 1–3]. Is such work theoretically important, but practically, it may provide valuable information concerning when screening and assessment for age-related neuropathology should begin, and thereby facilitate early intervention. We focused on healthy, community-dwelling adults aged between 44 and 48 years. Our objective was to assess whether associations between white matter lesions and cognitive deficits typically reported in the over 60 s, were evident in this comparatively younger age group. Little is known about this association in midlife As this information will inform policy for early preventative healthcare initiatives, we investigated non-periventricular frontal, temporal, parietal and occipital lobe white matter hyperintensities (WMH) in relation to cognitive function in 428 (232 women) community-dwelling adults aged 44 to 48 years

Objectives

Results

Conclusion