Clinical and neuropsychological features associated with structural imaging patterns in patients with mild cognitive impairment.
OBJECTIVE
To describe the clinical and neuropsychological features of mild cognitive impairment (MCI) patients with medial temporal atrophy (MTA), white matter hyperintensities (WMH), both, and neither and to assess whether the rate of progression differs among groups.


METHODS
Ninety-five MCI patients were divided into 4 groups based on the presence of MTA and WMH: 29 were MTA- WMH-, 11 MTA- WMH+, 23 MTA+ WMH-, and 32 MTA+ WMH+. MCI patients were compared with 30 normal subjects. MTA and WMH were assessed with MR-based visual rating scales. Subjects underwent an extensive clinical and neuropsychological investigation. Fifty-six underwent follow-up evaluation.


RESULTS
MTA- WMH- had relatively good neuropsychological performance, little vascular and physical comorbidity. MTA- WMH+ performed poorly only on executive neuropsychological tests. MTA+ WMH- patients had poor neuropsychological performances (mainly on memory tests), high physical and vascular comorbidity. MTA+ WMH+ were impaired in neuropsychological performances, had a high number of physical diseases and severe vascular comorbidity. On follow-up, 25% of MTA+ WMH- and 32% of MTA+ WMH+ and none in MTA- WMH- and in MTA- WMH+ converted to dementia (p = 0.05, log rank test).


CONCLUSIONS
Structural neuroimaging can identify subgroups of MCI patients with specific clinical and neuropsychological features.
Rossi
Roberta
R
Laboratory of Epidemiology, Neuroimaging and Telemedicine, IRCCS San Giovanni di Dio FBF, Brescia, Italy.
Geroldi
Cristina
C
Bresciani
Lorena
L
Testa
Cristina
C
Binetti
Giuliano
G
Zanetti
Orazio
O
Frisoni
Giovanni B
GB
D000368:Aged; D000704:Analysis of Variance; D001284:Atrophy; D001931:Brain Mapping; D003072:Cognition Disorders / Q000145:classification / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012016:Reference Values; D012720:Severity of Illness Index; D013702:Temporal Lobe / Q000473:pathology* / Q000502:physiology / Q000503:physiopathology