Neurological signs in relation to white matter hyperintensity volumes in memory clinic patients.
OBJECTIVE
To determine the frequency of neurological signs in a memory clinic population and to explore their associations with white matter hyperintensity (WMH).


METHODS
We included patients with Alzheimer disease (AD; n = 210), vascular dementia (VaD; n = 34), mild cognitive impairment (MCI; n = 86) and subjective complaints (n = 153). The presence of extrapyramidal and unilateral signs was assessed from medical charts. On MRI, WMH volumes were extracted automatically.


RESULTS
Extrapyramidal signs were found in 10% and unilateral signs in 12% of the patients. Age- and sex-adjusted extrapyramidal signs occurred more often in VaD compared to patients with subjective complaints. Unilateral signs were more prevalent in all groups compared to patients with subjective complaints. Two-way analysis of variance (ANOVA) with WMH as the dependent variable showed a main effect of diagnosis (p < 0.001), but not of extrapyramidal signs (p = 0.62). In contrast, 2-way ANOVA showed main effects of diagnosis (p < 0.001) and unilateral signs (p = 0.001). Furthermore, there was an interaction between these factors (p = 0.04); if unilateral signs were present, patients with subjective complaints and VaD showed more WMH, whereas there was no relation in AD and MCI.


CONCLUSIONS
Extrapyramidal and unilateral signs are common in memory clinic patients, but are only modestly related to WMH.
Staekenborg
S S
SS
Department of Neurology and Alzheimer Center, Vrije Universiteit Medical Center, Amsterdam, The Netherlands. s.staekenborg @ vumc.nl
de Waal
H
H
Admiraal-Behloul
F
F
Barkhof
F
F
Reiber
J H C
JH
Scheltens
P
P
Pijnenburg
Y A L
YA
Vrenken
H
H
van der Flier
W M
WM
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000175:diagnosis; D000704:Analysis of Variance; D001480:Basal Ganglia Diseases / Q000150:complications / Q000175:diagnosis; D001921:Brain / Q000473:pathology*; D003072:Cognition Disorders / Q000150:complications / Q000175:diagnosis; D015140:Dementia, Vascular / Q000150:complications / Q000175:diagnosis; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008499:Medical Records; D008569:Memory Disorders / Q000150:complications* / Q000175:diagnosis*; D008875:Middle Aged; D009422:Nervous System Diseases / Q000150:complications* / Q000175:diagnosis*