Neuroimaging predictors of cognitive impairment in confluent white matter lesion: volumetric analyses of 99 brain regions.
BACKGROUND
Although confluent white matter lesion (WML) is associated with cognitive impairment, the mechanism explaining this association is controversial. We aimed to investigate comprehensively the MRI predictors of cognitive impairment in confluent WML.


METHODS
Among 45 lacunar stroke patients who had confluent WML, we evaluated the association of executive function [Mattis Dementia Rating Scale - Initiation/Perseveration subscale (MDRS I/P)] and global cognition [Mini-Mental State Examination (MMSE)] with the volume of WML, measures of lacunes and microbleeds, and the volumes of 99 other specific brain regions.


RESULTS
Regression analyses showed that WML volume predicted performance on the MDRS I/P (beta = -0.34, p = 0.016) independent of age. Volumes of cortical gray matter (cGM; beta = 0.41, p = 0.003), the lateral fronto-orbital gyrus (beta = 0.38, p = 0.01), superior frontal gyrus (beta = 0.29, p = 0.04), lateral ventricle (beta = -0.30, p = 0.04), and posterior limb of the internal capsule (beta = 0.43, p = 0.002) predicted MDRS I/P performance independent of WML volume. Volumes of cGM, and the lateral fronto-orbital gyrus predicted MMSE performance as well.


CONCLUSIONS
Atrophy along the frontosubcortical pathways and cGM predict cognition in confluent WML independent of WML volume.
Department of Medicine and Therapeutics, Chinese University of Hong Kong, Shatin, Hong Kong, SAR, China. vctmok@cuhk.edu.hk
Vincent C T
VC
Mok
Tianming
T
Liu
Wynnie W M
WW
Lam
Adrian
A
Wong
Xintao
X
Hu
Lei
L
Guo
Xiang Yan
XY
Chen
Wai Kwong
WK
Tang
Ka Sing
KS
Wong
Stephen
S
Wong
D000203:Activities of Daily Living; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data; D001284:Atrophy / Q000473:pathology; D001921:Brain / Q000033:anatomy & histology* / Q000473:pathology*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D015161:Dementia, Multi-Infarct / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires