title: Metabolic syndrome, brain magnetic resonance imaging, and cognition.
abstract: OBJECTIVE
  We explored cognitive impairment in metabolic syndrome in relation to brain magnetic resonance imaging (MRI) findings.
  
  
  METHODS
  We studied 819 participants free of clinical stroke and dementia of the population-based Austrian Stroke Prevention Study who had undergone brain MRI, neuropsychological testing, and a risk factor assessment relevant to National Cholesterol Education Program Adult Treatment Panel III criteria-defined metabolic syndrome. High-sensitivity C-reactive protein (hs-CRP) was also determined.
  
  
  RESULTS
  Of 819 subjects, 232 (28.3%) had metabolic syndrome. They performed worse than those without metabolic syndrome on cognitive tests assessing memory and executive functioning after adjustment for possible confounders. Stratification by sex demonstrated that metabolic syndrome was related to cognitive dysfunction in men but not in women. Only in men was an increasing number of metabolic syndrome components associated with worse cognitive performance. MRI showed no significant differences in focal ischemic lesions and brain volume between subjects with and without metabolic syndrome, and MRI abnormalities failed to explain impaired cognition. Cognitive performance was most affected in male subjects with metabolic syndrome who also had high hs-CRP levels.
  
  
  CONCLUSIONS
  Metabolic syndrome exerts detrimental effects on memory and executive functioning in community-dwelling subjects who have not had a clinical stroke or do not have dementia. Men are more affected than women, particularly if they have high inflammatory markers. MRI-detected brain abnormalities do not play a crucial role in these relationships.
authors.affiliation: Division of Special Neurology, Department of Neurology, Medical University of Graz, Graz, Austria.
authors.forename: Margherita
authors.initials: M
authors.lastname: Cavalieri
authors.forename: Stefan
authors.initials: S
authors.lastname: Ropele
authors.forename: Katja
authors.initials: K
authors.lastname: Petrovic
authors.forename: Aga
authors.initials: A
authors.lastname: Pluta-Fuerst
authors.forename: Nina
authors.initials: N
authors.lastname: Homayoon
authors.forename: Christian
authors.initials: C
authors.lastname: Enzinger
authors.forename: Anja
authors.initials: A
authors.lastname: Grazer
authors.forename: Petra
authors.initials: P
authors.lastname: Katschnig
authors.forename: Petra
authors.initials: P
authors.lastname: Schwingenschuh
authors.forename: Andrea
authors.initials: A
authors.lastname: Berghold
authors.forename: Reinhold
authors.initials: R
authors.lastname: Schmidt
mesh_terms: D000368:Aged; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D003071:Cognition / Q000502:physiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D024821:Metabolic Syndrome / Q000473:pathology*; D008875:Middle Aged; D011446:Prospective Studies