title: Brain atrophy and cognition: interaction with cerebrovascular pathology?
abstract: We examined the interaction of brain atrophy and white matter lesions (WML) with cognitive functioning in 605 patients (mean age, 58±10; 76% men) with atherosclerotic disease from the Second Manifestations of ARTerial disease-MR substudy (SMART-MR study). Automated brain segmentation was used to quantify volumes of brain tissue, cerebrospinal fluid, and WML on MRI. Total brain, ventricular, and cortical gray matter volume were divided by intracranial volume (ICV). Neuropsychological tests assessing executive functioning and memory performance were performed and composite scores were calculated. We observed that smaller total brain volume, larger ventricular volume, and smaller cortical gray matter volume (all as % of ICV) were associated with worse executive performance and that this association became stronger with presence of brain infarcts or severe WML volume (P-values for interaction <0.05). No interaction between measures of brain volume and cerebrovascular pathology on memory performance was observed. Our findings suggest that patients with cerebrovascular pathology on MRI may be more vulnerable to impairment in executive functioning related to global as well as focal brain atrophy.
authors.affiliation: Department of Geriatric Medicine, VU University Medical Center, The Netherlands.
authors.forename: Majon
authors.initials: M
authors.lastname: Muller
authors.forename: Auke P A
authors.initials: AP
authors.lastname: Appelman
authors.forename: Yolanda
authors.initials: Y
authors.lastname: van der Graaf
authors.forename: Koen L
authors.initials: KL
authors.lastname: Vincken
authors.forename: Willem P Th M
authors.initials: WP
authors.lastname: Mali
authors.forename: Mirjam I
authors.initials: MI
authors.lastname: Geerlings
mesh_terms: D000368:Aged; D001284:Atrophy / Q000473:pathology; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D020520:Brain Infarction / Q000473:pathology / Q000503:physiopathology; D002561:Cerebrovascular Disorders / Q000473:pathology* / Q000503:physiopathology; D003072:Cognition Disorders / Q000473:pathology* / Q000503:physiopathology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000473:pathology / Q000503:physiopathology; D008875:Middle Aged; D009483:Neuropsychological Tests; D009929:Organ Size; D011446:Prospective Studies