Increase in periventricular white matter hyperintensities parallels decline in mental processing speed in a non-demented elderly population.
OBJECTIVE
To investigate the influence of deep white matter hyperintensities (DWMH) and periventricular white matter hyperintensities (PVWMH) on progression of cognitive decline in non-demented elderly people.


METHODS
All data come from the nested MRI sub-study of the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER). We performed a 3 year follow up study on 554 subjects of the PROSPER study using both repeated magnetic resonance imaging and cognitive testing. Cognitive decline and its dependency on WMH severity was assessed using linear regression models adjusted for sex, age, education, treatment group, and test version when applicable.


RESULTS
We found that the volume of PVWMH at baseline was longitudinally associated with reduced mental processing speed (p = 0.0075). In addition, we found that the progression in PVWMH volume paralleled the decline in mental processing speed (p = 0.024). In contrast, neither presence nor progression of DWMH was associated with change in performance on any of the cognitive tests.


CONCLUSIONS
PVWMH should not be considered benign but probably underlie impairment in cognitive processing speed.
van den Heuvel
D M J
DM
Department of Radiology, Leiden University Medical Center, The Netherlands.
ten Dam
V H
VH
de Craen
A J M
AJ
Admiraal-Behloul
F
F
Olofsen
H
H
Bollen
E L E M
EL
Jolles
J
J
Murray
H M
HM
Blauw
G J
GJ
Westendorp
R G J
RG
van Buchem
M A
MA
D000368:Aged; D000369:Aged, 80 and over; D002544:Cerebral Infarction / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D002552:Cerebral Ventricles / Q000473:pathology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology; D015140:Dementia, Vascular / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D018450:Disease Progression; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D007091:Image Processing, Computer-Assisted; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D017035:Pravastatin / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D011930:Reaction Time / Q000502:physiology*; D013223:Statistics as Topic
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D017035:Pravastatin