White matter lesion severity is associated with reduced cognitive performances in patients with normal CSF Abeta42 levels.
OBJECTIVE
To identify possible associations between white matter lesions (WML) and cognition in patients with memory complaints, stratified in groups with normal and low cerebrospinal fluid (CSF) Abeta42 values.


METHODS
215 consecutive patients with subjective memory complaints were retrospectively included. Patients were stratified into two groups with normal (n = 127) or low (n = 88) CSF Abeta42 levels (cut-off is 450 ng/l). Cognitive scores from the Mini-Mental State Examination (MMSE) and the Neurobehavioral Cognitive Status Examination (Cognistat) were used as continuous dependent variables in linear regression. WML load was used as a continuous independent variable and was scored with a visual rating scale. The regression model was corrected for possible confounding factors.


RESULTS
WML were significantly associated with MMSE and all Cognistat subscores except language (repetition and naming) and attention in patients with normal CSF Abeta42 levels. No significant associations were observed in patients with low CSF Abeta42.


CONCLUSIONS
WML were associated with affection of multiple cognitive domains, including delayed recall and executive functions, in patients with normal CSF Abeta42 levels. The lack of such associations for patients with low CSF Abeta42 (i.e. with evidence for amyloid deposition), suggests that amyloid pathology may obscure cognitive effects of WML.
Department of Neurology, Akershus University Hospital, Lørenskog, Norway. vidar.stenset@medisin.uio.no
V
V
Stenset
D
D
Hofoss
L
L
Johnsen
A
A
Skinningsrud
A E
AE
Berstad
A
A
Negaard
I
I
Reinvang
L
L
Gjerstad
T
T
Fladby
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000134:cerebrospinal fluid / Q000473:pathology / Q000503:physiopathology; D016229:Amyloid beta-Peptides / Q000032:analysis / Q000134:cerebrospinal fluid*; D053327:Apolipoprotein E4 / Q000235:genetics; D015415:Biomarkers / Q000032:analysis / Q000134:cerebrospinal fluid; D001921:Brain / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology; D003072:Cognition Disorders / Q000134:cerebrospinal fluid / Q000473:pathology* / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications; D020138:Hyperhomocysteinemia / Q000150:complications; D008279:Magnetic Resonance Imaging; D008297:Male; D008569:Memory Disorders / Q000134:cerebrospinal fluid / Q000473:pathology* / Q000503:physiopathology; D008875:Middle Aged; D036421:Nerve Fibers, Unmyelinated / Q000378:metabolism / Q000473:pathology*; D009483:Neuropsychological Tests; D010446:Peptide Fragments / Q000032:analysis / Q000134:cerebrospinal fluid*; D058225:Plaque, Amyloid / Q000378:metabolism / Q000473:pathology; D011237:Predictive Value of Tests; D011379:Prognosis; D013223:Statistics as Topic
D016229:Amyloid beta-Peptides; D053327:Apolipoprotein E4; D015415:Biomarkers; D010446:Peptide Fragments; C075222:amyloid beta-protein (1-42)