Mild cognitive impairment, poor episodic memory, and late-life depression are associated with cerebral cortical thinning and increased white matter hyperintensities.

Motonobu Fujishima,Masahiro Nakatsuka,Hiroshi Matsuda,Norihide Maikusa,Kei Nakamura,Kenichi Meguro

doi:10.3389/fnagi.2014.00306

Abstract

In various independent studies to date, cerebral cortical thickness and white matter hyperintensity (WMH) volume have been associated with episodic memory, depression, and mild cognitive impairment (MCI). The aim of this study was to uncover variations in cortical thickness and WMH volume in association with episodic memory, depressive state, and the presence of MCI simultaneously in a single study population. The participants were 186 individuals with MCI (clinical dementia rating [CDR] of 0.5) and 136 healthy elderly controls (HCs; CDR of 0) drawn from two community-based cohort studies in northern Japan. We computed cerebral cortical thickness and WMH volume by using MR scans and statistically analyzed differences in these indices between HCs and MCI participants. We also assessed the associations of these indices with memory performance and depressive state in participants with MCI. Compared with HCs, MCI participants exhibited thinner cortices in the temporal and inferior parietal lobes and greater WMH volumes in the corona radiata and semioval center. In MCI participants, poor episodic memory was associated with thinner cortices in the left entorhinal region and increased WMH volume in the posterior periventricular regions. Compared with non-depressed MCI participants, depressed MCI participants showed reduced cortical thickness in the anterior medial temporal lobe and gyrus adjacent to the amygdala bilaterally, as well as greater WMH volume as a percentage of the total intracranial volume (WMHr). A higher WMHr was associated with cortical thinning in the frontal, temporal, and parietal regions in MCI participants. These results demonstrate that episodic memory and depression are associated with both cortical thickness and WMH volume in MCI participants. Additional longitudinal studies are needed to clarify the dynamic associations and interactions among these indices.

Highlights

Mild cognitive impairment (MCI) is a heterogeneous clinical condition that may precede Alzheimer disease (AD) as well as vascular and other dementias (Meyer et al, 2002)
These findings indicate that both the cerebral cortex and white matter are altered in MCI patients as changes occur in episodic memory and depressive state
We found no significant differences in cortical thickness between MCI participants and healthy elderly controls (HCs) or between depressed and nondepressed MCI participants, unlike previous reports that have frequently reported hippocampal volume loss (Ballmaier et al, 2008; Steffens et al, 2011; den Heijer et al, 2011)

Summary

Introduction

Mild cognitive impairment (MCI) is a heterogeneous clinical condition that may precede Alzheimer disease (AD) as well as vascular and other dementias (Meyer et al, 2002). With regard to features of the brain observed with structural MRI, compared with healthy elderly controls (HCs), MCI patients tend to show decreased cortical thickness in the temporal lobe, reduced hippocampal volume (Liu et al, 2011), and increased white matter hyperintensity (WMH) volume in the cerebrum (Smith et al, 2011; Iorio et al, 2013; Yates et al, 2014). An association between decreased cerebral cortical thickness and increased WMH volume has been reported (Seo et al, 2012). In the context of associations between depressive symptoms and structural changes in the brain, reductions in amygdalar volume, hippocampal volume, or both have been reported in elderly patients with depression (Egger et al, 2008; Burke et al, 2011). Associations between WMHs and affective disorders in elderly populations have been elucidated. Herrmann et al (2008) reviewed the literature and reported that WMHs are

Objectives

Methods

Results

Discussion

Conclusion