title: White matter hyperintensities in mild cognitive impairment: clinical impact of location and interaction with lacunes and medial temporal atrophy.
abstract: This study was to evaluate the influence on cognition and activities of daily living (ADL) by white matter hyperintensities (WMHs) based on the severity and location, as well as the interactions among WMHs, lacunes, and medial temporal atrophy (MTA). In 150 patients with amnestic mild cognitive impairment, WMHs were quantified with the use of a semiautomated volumetric method. Lacune counting and MTA assessment were performed by visual rating. The severer WMHs were, the more executive functions decreased. The influence on executive functions such as verbal fluency test and Stroop color reading test were greater in periventricular (PV) WMHs than deep WMHs, as well as bigger in anterior, middle, and posterior areas in order. The instrumental (I) ADL was strongly associated with the anterior (P = .028) and middle area (P = .014) of PVWMHs only. WMHs had synergistic interactions with lacunes in Controlled Oral Word Association Task-semantic (ß = -1.12; R(2) = .24; P = .039), Stroop color (ß = -2.07; R(2) = .15; P = .049), and IADL (ß = .23; R(2) = .20; P = .009). Anterior PVWMHs demonstrated the most powerful impact on frontal executive dysfunction and poor performance of IADL. WMHs had synergistic effects with the number of lacunes on them. Therefore, it is desirable to consider WMHs and lacunes simultaneously as potential imaging biomarkers for predicting cognition and IADL in aMCI.
authors.affiliation: Department of Neurology, Konyang University Hospital, College of Medicine, Konyang University, Daejeon, Republic of Korea.
authors.forename: Bora
authors.initials: B
authors.lastname: Yoon
authors.affiliation: Department of Neurology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Republic of Korea.
authors.forename: Yong S
authors.initials: YS
authors.lastname: Shim
authors.affiliation: Department of Social and Preventive Medicine, School of Medicine, Sungkyunkwan University, Suwon, Republic of Korea.
authors.forename: Hae-Kwan
authors.initials: HK
authors.lastname: Cheong
authors.affiliation: Department of Neurology, Yongin Hyoja Geriatric Hospital, Yongin, Republic of Korea.
authors.forename: Yun-Jeong
authors.initials: YJ
authors.lastname: Hong
authors.affiliation: Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Kwang-Soo
authors.initials: KS
authors.lastname: Lee
authors.affiliation: Department of Neurology, Gachon University Gil Medical Center, Incheon, Republic of Korea.
authors.forename: Kee Hyung
authors.initials: KH
authors.lastname: Park
authors.affiliation: Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Kook Jin
authors.initials: KJ
authors.lastname: Ahn
authors.affiliation: Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Dai Jin
authors.initials: DJ
authors.lastname: Kim
authors.affiliation: Department of Neurology, Konyang University Hospital, College of Medicine, Konyang University, Daejeon, Republic of Korea.
authors.forename: Yong-Duk
authors.initials: YD
authors.lastname: Kim
authors.affiliation: Department of Neurology, Inha University School of Medicine, Incheon, Republic of Korea.
authors.forename: Seong Hye
authors.initials: SH
authors.lastname: Choi
authors.affiliation: Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address: neuroman@catholic.ac.kr.
authors.forename: Dong-Won
authors.initials: DW
authors.lastname: Yang
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy; D001921:Brain / Q000473:pathology*; D003071:Cognition; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000473:pathology / Q000523:psychology; D056344:Executive Function; D005260:Female; D006801:Humans; D056784:Leukoencephalopathies / Q000175:diagnosis* / Q000473:pathology / Q000523:psychology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D056910:Republic of Korea; D012720:Severity of Illness Index; D057190:Stroop Test
keywords: White matter hyperintensities; activities of daily living; executive function; lacunar infarct; magnetic resonance imaging; mild cognitive impairment; subcortical ischemic vascular disease