title: White matter hyperintensities and medial temporal lobe atrophy in clinical subtypes of mild cognitive impairment: the DESCRIPA study.
abstract: BACKGROUND
  Clinical subtypes of mild cognitive impairment (MCI) may represent different underlying aetiologies.
  
  
  METHODS
  This European, multicentre, memory clinic based study (DESCRIPA) of non-demented subjects investigated whether MCI subtypes have different brain correlates on MRI and whether the relation between subtypes and brain pathology is modified by age. Using visual rating scales, medial temporal lobe atrophy (MTA) (0-4) and white matter hyperintensities (WMH) (0-30) were assessed.
  
  
  RESULTS
  Severity of MTA differed between MCI subtypes (p<0.001), increasing from a mean of 0.8 (SD 0.7) in subjective complaints (n = 77) to 1.3 (0.8) in non-amnestic MCI (n = 93), and from 1.4 (0.9) in single domain amnestic MCI (n = 70) to 1.7 (0.9) in multiple domain amnestic MCI (n = 89). The association between MCI subtype and MTA was modified by age and mainly present in subjects >70 years of age. Severity of WMH did not differ between MCI subtypes (p = 0.21). However, the combination of MTA and WMH differed between MCI subtypes (p = 0.02)
  
  
  CONCLUSIONS
  We conclude that MCI subtypes may have different brain substrates, especially in older subjects. Isolated MTA was mainly associated with amnestic MCI subtypes, suggesting AD as the underlying cause. In non-amnestic MCI, the relatively higher prevalence of MTA in combination with WMH may suggest a different pathophysiological origin.
authors.affiliation: VUMC, Department of Neurology, Amsterdam, The Netherlands. L.vandepol@vumc.nl
authors.forename: L A
authors.initials: LA
authors.lastname: van de Pol
authors.forename: F
authors.initials: F
authors.lastname: Verhey
authors.forename: G B
authors.initials: GB
authors.lastname: Frisoni
authors.forename: M
authors.initials: M
authors.lastname: Tsolaki
authors.forename: P
authors.initials: P
authors.lastname: Papapostolou
authors.forename: F
authors.initials: F
authors.lastname: Nobili
authors.forename: L-O
authors.initials: LO
authors.lastname: Wahlund
authors.forename: L
authors.initials: L
authors.lastname: Minthon
authors.forename: L
authors.initials: L
authors.lastname: Frölich
authors.forename: H
authors.initials: H
authors.lastname: Hampel
authors.forename: H
authors.initials: H
authors.lastname: Soininen
authors.forename: D L
authors.initials: DL
authors.lastname: Knol
authors.forename: F
authors.initials: F
authors.lastname: Barkhof
authors.forename: P
authors.initials: P
authors.lastname: Scheltens
authors.forename: P J
authors.initials: PJ
authors.lastname: Visser
mesh_terms: D000367:Age Factors; D000368:Aged; D000647:Amnesia / Q000209:etiology* / Q000473:pathology*; D001284:Atrophy / Q000209:etiology / Q000473:pathology / Q000523:psychology; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000209:etiology / Q000473:pathology* / Q000523:psychology*; D015331:Cohort Studies; D004522:Educational Status; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D012737:Sex Factors; D013702:Temporal Lobe / Q000473:pathology*