White matter hyperintensities associated with progression of cerebral small vessel disease: a 7-year Chinese urban community study.

Yiwei Xia,Zonghui Liang,Xiaoniu Liang,Yi Wang,Yu Li,Yi Shen,Ding Ding,Xiaoxiao Wang,Bensheng Qiu,Yiqing Wang,Qianhua Zhao,Shuguang Chu,Qiang Dong,Xin Cheng,Jianjun Wu,Lumeng Yang,Hansheng Ding

doi:10.18632/aging.103154

Abstract

We aimed to explore the role of white matter hyperintensities (WMH) in progression of cerebral small vessel disease (CSVD) in an urban community in China over a period of 7 years, and to investigate associations between WMH volume (baseline and progression) and cognitive impairment. CSVD markers and neuropsychological tests at baseline and follow-up of 191 participants of the Shanghai Aging Study (SAS) were assessed. WMH volume were assessed by automatic segmentation based on U-net model. Lacunes, cerebral microbleeds (CMBs) and enlarged perivascular spaces (ePVS) were rated manually. Small vessel disease (SVD) score was rated as the total burden of CSVD markers. Global cognitive function and 5 main cognitive domains (memory, language, spatial construction, attention and executive function) were evaluated by neuropsychological tests. We performed multivariable linear regression and binominal logistic regression. Participants with higher baseline WMH volume developed more progression of WMH volume, increased risk of incident lacunes, incident CMBs, and ePVS progression. WMH (baseline and progression) were associated with decline of executive function. WMH were associated with progression of cerebral small vessel disease and decline of executive function in a Chinese urban community study over a period of 7 years.

Highlights

Brain imaging studies in the general population have demonstrated that markers of cerebral small vessel disease (CSVD), including white matter hyperintensities (WMH), lacunes, cerebral microbleeds (CMBs), and enlarged perivascular spaces, are highly prevalent in individuals over 60 years of age [1,2,3,4]
Our study demonstrated that baseline WMH were associated with incident lacunes in the general population in China, which helped to fill the gap of previous community studies
Model 1 WMH volume, per 1% increase Lacunes, per No increase CMBs, per No increase enlarged perivascular spaces (ePVS), per score increase

Summary

Introduction

Brain imaging studies in the general population have demonstrated that markers of cerebral small vessel disease (CSVD), including white matter hyperintensities (WMH), lacunes, cerebral microbleeds (CMBs), and enlarged perivascular spaces (ePVS), are highly prevalent in individuals over 60 years of age [1,2,3,4]. WMH is the most common marker among these CSVD markers, detected in approximately 90% of individuals older than 60 years of age in the general population [7]. Several longitudinal community studies indicated that high burden of WMH at baseline was associated with progression of WMH [8,9,10,11], incident CMBs [2, 12] and progression of ePVS [13]. The association between baseline WMH and incident lacunes remains uncertain, though one study validated this association in a hospital cohort [14]

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