title: Executive dysfunction correlates with caudate nucleus atrophy in patients with white matter changes on MRI: a subset of LADIS.
abstract: White matter changes (WMC) are common magnetic resonance imaging (MRI) findings, particularly in the elderly. Recent studies such as the Leukoaraiosis and Disability Study (LADIS) have found that WMC relate to adverse outcomes including cognitive impairment, depression, disability, unsteadiness and falls in cross-sectional and follow-up studies. Frontostriatal (or frontosubcortical) brain circuits may serve many of these functions, with the caudate nuclei playing a role in convergence of cognitive functions. This study aimed to determine whether reduced caudate volume relates to cognitive functions (executive functions, memory functions and speed of processing) and WMC. We determined caudate nuclei volumes, through manual tracing, on a subgroup of the LADIS study (n=66) from four centres with baseline and 3-year follow-up MRI scans. Regression analysis was used to assess relationships between caudate volume, cognitive function and WMC. Severity of WMC did not relate to caudate volume. Smaller caudate volumes were significantly associated with poorer executive functioning at baseline and at 3 years, but were not associated with scores of memory or speed of processing. Thus, in patients with WMC, a surrogate of small vessel disease, caudate atrophy relates to the dysexecutive syndrome, supporting the role of caudate as an important part of the frontostriatal circuit.
authors.affiliation: Research Centre for the Neurosciences of Ageing, Academic Unit of Psychiatry and Addiction Medicine, Australian National University Medical School, Canberra Hospital, Canberra, ACT, Australia. mmacfarlane1@gmail.com
authors.forename: Matthew Duncan
authors.initials: MD
authors.lastname: Macfarlane
authors.forename: Jeffrey Chee Leong
authors.initials: JC
authors.lastname: Looi
authors.forename: Mark
authors.initials: M
authors.lastname: Walterfang
authors.forename: Gabriela
authors.initials: G
authors.lastname: Spulber
authors.forename: Dennis
authors.initials: D
authors.lastname: Velakoulis
authors.forename: Milita
authors.initials: M
authors.lastname: Crisby
authors.forename: Eva
authors.initials: E
authors.lastname: Orndahl
authors.forename: Timo
authors.initials: T
authors.lastname: Erkinjuntti
authors.forename: Ellen
authors.initials: E
authors.lastname: Garde
authors.forename: Gunhild
authors.initials: G
authors.lastname: Waldemar
authors.forename: Anders
authors.initials: A
authors.lastname: Wallin
authors.forename: Lars-Olof
authors.initials: LO
authors.lastname: Wahlund
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy / Q000473:pathology / Q000523:psychology; D002421:Caudate Nucleus / Q000473:pathology*; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D049292:Leukoaraiosis / Q000473:pathology* / Q000523:psychology; D008279:Magnetic Resonance Imaging; D008297:Male; D011939:Mental Recall / Q000502:physiology; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D009483:Neuropsychological Tests; D009929:Organ Size
keywords: Caudate nucleus; Cerebrovascular disease; Executive functioning; MRI