title: Spatial distribution of cerebral white matter lesions predicts progression to mild cognitive impairment and dementia.
abstract: BACKGROUND
  White matter lesions (WML) increase the risk of dementia. The relevance of WML location is less clear. We sought to determine whether a particular WML profile, based on the density and location of lesions, could be associated with an increased risk of mild cognitive impairment (MCI) or dementia over the following 7 years.
  
  
  METHODS
  In 426 healthy subjects from a cohort of community-dwelling people aged 65 years and over (ESPRIT Project), standardized cognitive and neurological evaluations were repeated after 2, 4 and 7 years. Patterns of WML were computed with a supervised data mining approach (decision trees) using the regional WML volumes (frontal, parietal, temporal, and occipital regions) and the total WML volume estimated at baseline. Cox proportional hazard models were then constructed to study the association between WML patterns and risk of MCI/dementia.
  
  
  RESULTS
  Total WML volume and percentage of WML in the temporal region proved to be the best predictors of progression to MCI and dementia. Specifically, severe total WML load with a high proportion of lesions in the temporal region was significantly associated with the risk of developing MCI or dementia.
  
  
  CONCLUSIONS
  Above a certain threshold of damage, a pattern of WML clustering in the temporal region identifies individuals at increased risk of MCI or dementia. As this WML pattern is observed before the onset of clinical symptoms, it may facilitate the detection of patients at risk of MCI/dementia.
authors: Inserm, U1061, La Colombière Hospital, Montpellier, France.
authors: Marion
authors: M
authors: Mortamais
authors: Christelle
authors: C
authors: Reynes
authors: Adam M
authors: AM
authors: Brickman
authors: Frank A
authors: FA
authors: Provenzano
authors: Jordan
authors: J
authors: Muraskin
authors: Florence
authors: F
authors: Portet
authors: Claudine
authors: C
authors: Berr
authors: Jacques
authors: J
authors: Touchon
authors: Alain
authors: A
authors: Bonafé
authors: Emmanuelle
authors: E
authors: le Bars
authors: Jerome J
authors: JJ
authors: Maller
authors: Chantal
authors: C
authors: Meslin
authors: Robert
authors: R
authors: Sabatier
authors: Karen
authors: K
authors: Ritchie
authors: Sylvaine
authors: S
authors: Artero
mesh_terms: D000368:Aged; D001921:Brain / Q000473:pathology*; D060825:Cognitive Dysfunction / Q000473:pathology*; D057225:Data Mining; D003663:Decision Trees; D003704:Dementia / Q000473:pathology*; D016002:Discriminant Analysis; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012306:Risk; D062206:Spatial Analysis; D013223:Statistics as Topic