title: Effects of medial temporal atrophy and white matter hyperintensities on the cognitive functions in patients with Alzheimer's disease.
abstract: OBJECTIVE
  We conducted this study to investigate the independent association of medial temporal atrophy (MTA) and white matter hyperintensities (WMH) with cognitive impairments of Alzheimer's disease (AD) patients and the interaction between MTA and WMH.
  
  
  METHODS
  From 13 centers, a total of 216 AD patients were consecutively recruited and their MTA and WMH were visually rated. We evaluated the association of MTA and WMH with the various cognitive domains, and the interaction between MTA and WMH.
  
  
  RESULTS
  MTA independently correlated with scores of the Mini-Mental State Examination (MMSE), Clinical Dementia Rating scale (CDR), delayed recalls of the Seoul Verbal Learning Test (SVLT), the Boston Naming Test (BNT), and Word Fluency. WMH independently correlated with MMSE, CDR, Digit Span, and Stroop word reading, but not with delayed recall. There were interactions of WMH and MTA on CDR (p = 0.004), SVLT (p = 0.023), BNT (p = 0.002) and the semantic Word Fluency (p = 0.007).
  
  
  CONCLUSIONS
  MTA and WMH independently affected cognitive deficits in AD patients, with somewhat different patterns where MTA was associated mostly with memory and language, while WMH were associated with attention and frontal executive functions. This study also showed interactions between MTA and WMH on some cognitive deficits and dementia severity, suggesting that they synergistically contribute to cognitive impairment in AD.
authors.affiliation: Department of Neurology, Bucheon St. Mary's Hospital, College of Medicine, Catholic University of Korea, Bucheon, Korea.
authors.forename: Yong S
authors.initials: YS
authors.lastname: Shim
authors.forename: Young Chul
authors.initials: YC
authors.lastname: Youn
authors.forename: Duk L
authors.initials: DL
authors.lastname: Na
authors.forename: Seong Yoon
authors.initials: SY
authors.lastname: Kim
authors.forename: Hae-Kwan
authors.initials: HK
authors.lastname: Cheong
authors.forename: So Young
authors.initials: SY
authors.lastname: Moon
authors.forename: Kyung Won
authors.initials: KW
authors.lastname: Park
authors.forename: Bon D
authors.initials: BD
authors.lastname: Ku
authors.forename: Jun-Young
authors.initials: JY
authors.lastname: Lee
authors.forename: Jee H
authors.initials: JH
authors.lastname: Jeong
authors.forename: Heeyoung
authors.initials: H
authors.lastname: Kang
authors.forename: Eun-Joo
authors.initials: EJ
authors.lastname: Kim
authors.forename: Jung-Sun
authors.initials: JS
authors.lastname: Lee
authors.forename: Seok Min
authors.initials: SM
authors.lastname: Go
authors.forename: Sook Hui
authors.initials: SH
authors.lastname: Kim
authors.forename: Kyung R
authors.initials: KR
authors.lastname: Cha
authors.forename: Sang Won
authors.initials: SW
authors.lastname: Seo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications*; D001284:Atrophy / Q000473:pathology; D003072:Cognition Disorders / Q000209:etiology* / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D011939:Mental Recall / Q000502:physiology; D008609:Mental Status Schedule; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D009483:Neuropsychological Tests; D013702:Temporal Lobe / Q000473:pathology*; D014706:Verbal Learning