Psychiatry Investig.
2024 Aug;21(8):850-859. 10.30773/pi.2024.0082.
The Different Associations of White Matter Hyperintensities With Severity of Dementia and Cognitive Impairment According to the Distance From the Lateral Ventricular Surface in Patients With Alzheimer’s Disease
- Affiliations
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- 1Department of Psychiatry, Jeju National University School of Medicine, Jeju National University Hospital, Jeju Special Self-Governing Province, Jeju, Republic of Korea
- 2Department of Psychiatry, Jeju Medical Center, Jeju Special Self-Governing Province, Jeju, Republic of Korea
- 3Laboratory for Imaging Science and Technology, Department of Electrical and Computer Engineering, Seoul National University, Seoul, Republic of Korea
- 4Department of Radiology, Jeju National University, Jeju Special Self-Governing Province, Jeju, Republic of Korea
- 5Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
- 6Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea
- 7Jeju Dementia Center, Jeju Special Self-Governing Province, Jeju, Republic of Korea
- KMID: 2558394
- DOI: http://doi.org/10.30773/pi.2024.0082
Abstract
Objective
White matter hyperintensities (WMH) are common among the elderly. Although WMH play a key role in lowering the threshold for the clinical expression of dementia in Alzheimer’s disease (AD)-related pathology, the clinical significance of their location is not fully understood. This study aimed to investigate the association between WMH and cognitive function according to the location of WMH in AD.
Methods
Subjects underwent clinical evaluations including volumetric brain magnetic resonance imaging study and neuropsychological tests using the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease Assessment Packet. WMH were calculated using automated quantification method. According to the distance from the lateral ventricular surface, WMH within 3 mm, WMH within 3–13 mm, and WMH over 13 mm were classified as juxtaventricular WMH (JVWMH), periventricular WMH (PVWMH), and deep WMH (DWMH), respectively.
Results
Total WMH volume was associated with poor performance in categorical verbal fluency test (β=-0.197, p=0.035). JVWMH volume was associated with poor performances on categorical verbal fluency test (β=-0.201, p=0.032) and forward digit span test (β= -0.250, p=0.012). PVWMH volume was associated with poor performances on categorical verbal fluency test (β=-0.185, p=0.042) and word list memory test (β=-0.165, p=0.042), whereas DWMH volume showed no association with cognitive tests. PVWMH volume were also related to Clinical Dementia Rating Scale Sum of Boxes score (β=0.180, p=0.026).
Conclusion
WMH appear to exhibit different associations with the severity of dementia and cognitive impairment according to the distance from ventricle surface in AD.
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