Cognitive performance in patients with Mild Cognitive Impairment and Alzheimer's disease with white matter hyperintensities: An exploratory analysis.

Maila Rossato Holz,Renata Kochhann,Patrícia Ferreira,Rochele Paz Fonseca,Marina Tarrasconi,Márcia Lorena Fagundes Chaves

doi:10.1590/1980-57642016dn11-040013

Abstract

ABSTRACT.Background:White matter hyperintensities (WMH) are commonly associated with vascular dementia and poor executive functioning. Notwithstanding, recent findings have associated WMH with Alzheimer's disease as well as other cognitive functions, but there is no consensus.Objective:This study aimed to verify the relationship between WMH and cognitive performance in Mild Cognitive Impairment (MCI) and Alzheimer's disease (AD) patients. The study also sought to identify cognitive and demographic/cultural factors that might explain variability of WMH.Methods:The sample was composed of 40 participants (18 MCI and 22 AD patients) aged ≥ 65 years. Spearman's correlation was performed among cognitive performance (memory, language, visuospatial ability, and executive function) and WMH evaluated by the Fazekas and ARWMC scales. Two stepwise linear regressions were carried out, one with cognitive and the other with demographic/cultural variables as predictors.Results:Only naming showed significant correlation with ARWMC. Fazekas score exhibited significant correlation with all cognitive domains evaluated. Fazekas score was better predicted by episodic visual memory and age.Conclusion:This study found that the most relevant cognitive profile in MCI and AD patients with WMH was related to episodic memory. And, without taking clinical aspects into consideration, age was the best predictor of WMH.

Highlights

Alzheimer’s disease (AD) is traditionally characterized by amyloid-beta extracellular amyloid-positive neuritic plaques and intracellular tau-positive neurofibrillary tangles
White matter hyperintensities (WMH) are commonly associated with vascular neurodegenerative diseases, which are a consequence of vascular risk factors and lead to vascular cognitive impairment.[2]
The aim of this study was to determine whether there is a relationship between the amount of vascular components and cognitive performance in amnestic Mild Cognitive Impairment (MCI) patients and patients with dementia due to AD

Summary

Introduction

Alzheimer’s disease (AD) is traditionally characterized by amyloid-beta extracellular amyloid-positive neuritic plaques and intracellular tau-positive neurofibrillary tangles. White matter hyperintensities (WMH) are commonly associated with vascular dementia and poor executive functioning. Notwithstanding, recent findings have associated WMH with Alzheimer’s disease as well as other cognitive functions, but there is no consensus. Objective: This study aimed to verify the relationship between WMH and cognitive performance in Mild Cognitive Impairment (MCI) and Alzheimer’s disease (AD) patients. Spearman’s correlation was performed among cognitive performance (memory, language, visuospatial ability, and executive function) and WMH evaluated by the Fazekas and ARWMC scales. Fazekas score exhibited significant correlation with all cognitive domains evaluated. Fazekas score was better predicted by episodic visual memory and age. Conclusion: This study found that the most relevant cognitive profile in MCI and AD patients with WMH was related to episodic memory.

Objectives

Methods

Results

Conclusion