title: Effect of white matter lesions on manual dexterity in healthy middle-aged persons.
abstract: OBJECTIVE
  We hypothesized that integrated motor-visual functions measured by manipulative manual dexterity are affected by white matter lesion (WML) burden as measured on cranial MRI across relevant brain regions in subjects at risk of preclinical occult vascular disease.
  
  
  METHODS
  A real-time cross-sectional study of healthy subjects aged 29 to 74 years with a family history of early-onset coronary artery disease (n = 714; mean age, 51 ± 11 years; mean education, 14 ± 3 years; 42% male; 38% black) were identified from probands with coronary artery disease diagnosed before age 60 years. WMLs on 3-tesla brain MRI and Grooved Pegboard scores were measured.
  
  
  RESULTS
  WMLs were observed at all ages. Mean pegboard scores were 108 ± 18, similar to normal populations. In unadjusted analysis, WMLs and pegboard scores were significantly correlated by region (total WMLs, r = 0.34, p = 0.0001; frontal [r = 0.34, p < 0.0001], insula [r = 0.31, p < 0.0001], parietal [r = 0.31, p < 0.0001], and temporal [r = 0.17, p < 0.0001]). In multivariate analysis predicting (log) pegboard score adjusted for age, sex, race, education, regional or total volumes, and familial non-independence, total WML volume (p = 5.79E - 05) and regional WML volumes (p < 0.01) retained statistical significance in all but the youngest age quartile (29-43 years).
  
  
  CONCLUSIONS
  Greater WML volumes in different brain regions are associated with higher pegboard scores (worse performance) independent of age, sex, race, education, and total or regional volumes. This suggests that small vessel cerebrovascular disease may be present in healthy individuals in a preclinical state with measurable impact on complex integrative functions in individuals with excess risk of clinical vascular disease.
authors: From the Departments of Neurology (P.A.N.), Anesthesiology and Critical Care Medicine (P.A.N.), and Neurosurgery (P.A.N.), and Department of Medicine, Division of General Internal Medicine (L.R.Y., L.C.B., K.C.-D., B.G.K., D.V., D.M.B.), GeneSTAR Research Program; Department of Biomedical Engineering (M.B., J.L.C., J.P.), Johns Hopkins School of Medicine; and Department of Medicine, Division of Cardiology (L.C.B., B.G.K.), and Department of Radiology, Divisions of Diagnostic Radiology and Neuroradiology (D.Y.), The Johns Hopkins Medical Institutions, Baltimore, MD. pnyquis1@jhmi.edu.
authors: Paul A
authors: PA
authors: Nyquist
authors: From the Departments of Neurology (P.A.N.), Anesthesiology and Critical Care Medicine (P.A.N.), and Neurosurgery (P.A.N.), and Department of Medicine, Division of General Internal Medicine (L.R.Y., L.C.B., K.C.-D., B.G.K., D.V., D.M.B.), GeneSTAR Research Program; Department of Biomedical Engineering (M.B., J.L.C., J.P.), Johns Hopkins School of Medicine; and Department of Medicine, Division of Cardiology (L.C.B., B.G.K.), and Department of Radiology, Divisions of Diagnostic Radiology and Neuroradiology (D.Y.), The Johns Hopkins Medical Institutions, Baltimore, MD.
authors: Lisa R
authors: LR
authors: Yanek
authors: From the Departments of Neurology (P.A.N.), Anesthesiology and Critical Care Medicine (P.A.N.), and Neurosurgery (P.A.N.), and Department of Medicine, Division of General Internal Medicine (L.R.Y., L.C.B., K.C.-D., B.G.K., D.V., D.M.B.), GeneSTAR Research Program; Department of Biomedical Engineering (M.B., J.L.C., J.P.), Johns Hopkins School of Medicine; and Department of Medicine, Division of Cardiology (L.C.B., B.G.K.), and Department of Radiology, Divisions of Diagnostic Radiology and Neuroradiology (D.Y.), The Johns Hopkins Medical Institutions, Baltimore, MD.
authors: Murat
authors: M
authors: Bilgel
authors: From the Departments of Neurology (P.A.N.), Anesthesiology and Critical Care Medicine (P.A.N.), and Neurosurgery (P.A.N.), and Department of Medicine, Division of General Internal Medicine (L.R.Y., L.C.B., K.C.-D., B.G.K., D.V., D.M.B.), GeneSTAR Research Program; Department of Biomedical Engineering (M.B., J.L.C., J.P.), Johns Hopkins School of Medicine; and Department of Medicine, Division of Cardiology (L.C.B., B.G.K.), and Department of Radiology, Divisions of Diagnostic Radiology and Neuroradiology (D.Y.), The Johns Hopkins Medical Institutions, Baltimore, MD.
authors: Jennifer L
authors: JL
authors: Cuzzocreo
authors: From the Departments of Neurology (P.A.N.), Anesthesiology and Critical Care Medicine (P.A.N.), and Neurosurgery (P.A.N.), and Department of Medicine, Division of General Internal Medicine (L.R.Y., L.C.B., K.C.-D., B.G.K., D.V., D.M.B.), GeneSTAR Research Program; Department of Biomedical Engineering (M.B., J.L.C., J.P.), Johns Hopkins School of Medicine; and Department of Medicine, Division of Cardiology (L.C.B., B.G.K.), and Department of Radiology, Divisions of Diagnostic Radiology and Neuroradiology (D.Y.), The Johns Hopkins Medical Institutions, Baltimore, MD.
authors: Lewis C
authors: LC
authors: Becker
authors: From the Departments of Neurology (P.A.N.), Anesthesiology and Critical Care Medicine (P.A.N.), and Neurosurgery (P.A.N.), and Department of Medicine, Division of General Internal Medicine (L.R.Y., L.C.B., K.C.-D., B.G.K., D.V., D.M.B.), GeneSTAR Research Program; Department of Biomedical Engineering (M.B., J.L.C., J.P.), Johns Hopkins School of Medicine; and Department of Medicine, Division of Cardiology (L.C.B., B.G.K.), and Department of Radiology, Divisions of Diagnostic Radiology and Neuroradiology (D.Y.), The Johns Hopkins Medical Institutions, Baltimore, MD.
authors: Karinne
authors: K
authors: Chevalier-Davis
authors: From the Departments of Neurology (P.A.N.), Anesthesiology and Critical Care Medicine (P.A.N.), and Neurosurgery (P.A.N.), and Department of Medicine, Division of General Internal Medicine (L.R.Y., L.C.B., K.C.-D., B.G.K., D.V., D.M.B.), GeneSTAR Research Program; Department of Biomedical Engineering (M.B., J.L.C., J.P.), Johns Hopkins School of Medicine; and Department of Medicine, Division of Cardiology (L.C.B., B.G.K.), and Department of Radiology, Divisions of Diagnostic Radiology and Neuroradiology (D.Y.), The Johns Hopkins Medical Institutions, Baltimore, MD.
authors: David
authors: D
authors: Yousem
authors: From the Departments of Neurology (P.A.N.), Anesthesiology and Critical Care Medicine (P.A.N.), and Neurosurgery (P.A.N.), and Department of Medicine, Division of General Internal Medicine (L.R.Y., L.C.B., K.C.-D., B.G.K., D.V., D.M.B.), GeneSTAR Research Program; Department of Biomedical Engineering (M.B., J.L.C., J.P.), Johns Hopkins School of Medicine; and Department of Medicine, Division of Cardiology (L.C.B., B.G.K.), and Department of Radiology, Divisions of Diagnostic Radiology and Neuroradiology (D.Y.), The Johns Hopkins Medical Institutions, Baltimore, MD.
authors: Jerry
authors: J
authors: Prince
authors: From the Departments of Neurology (P.A.N.), Anesthesiology and Critical Care Medicine (P.A.N.), and Neurosurgery (P.A.N.), and Department of Medicine, Division of General Internal Medicine (L.R.Y., L.C.B., K.C.-D., B.G.K., D.V., D.M.B.), GeneSTAR Research Program; Department of Biomedical Engineering (M.B., J.L.C., J.P.), Johns Hopkins School of Medicine; and Department of Medicine, Division of Cardiology (L.C.B., B.G.K.), and Department of Radiology, Divisions of Diagnostic Radiology and Neuroradiology (D.Y.), The Johns Hopkins Medical Institutions, Baltimore, MD.
authors: Brian G
authors: BG
authors: Kral
authors: From the Departments of Neurology (P.A.N.), Anesthesiology and Critical Care Medicine (P.A.N.), and Neurosurgery (P.A.N.), and Department of Medicine, Division of General Internal Medicine (L.R.Y., L.C.B., K.C.-D., B.G.K., D.V., D.M.B.), GeneSTAR Research Program; Department of Biomedical Engineering (M.B., J.L.C., J.P.), Johns Hopkins School of Medicine; and Department of Medicine, Division of Cardiology (L.C.B., B.G.K.), and Department of Radiology, Divisions of Diagnostic Radiology and Neuroradiology (D.Y.), The Johns Hopkins Medical Institutions, Baltimore, MD.
authors: Dhananjay
authors: D
authors: Vaidya
authors: From the Departments of Neurology (P.A.N.), Anesthesiology and Critical Care Medicine (P.A.N.), and Neurosurgery (P.A.N.), and Department of Medicine, Division of General Internal Medicine (L.R.Y., L.C.B., K.C.-D., B.G.K., D.V., D.M.B.), GeneSTAR Research Program; Department of Biomedical Engineering (M.B., J.L.C., J.P.), Johns Hopkins School of Medicine; and Department of Medicine, Division of Cardiology (L.C.B., B.G.K.), and Department of Radiology, Divisions of Diagnostic Radiology and Neuroradiology (D.Y.), The Johns Hopkins Medical Institutions, Baltimore, MD.
authors: Diane M
authors: DM
authors: Becker
mesh_terms: D000328:Adult; D000368:Aged; D002561:Cerebrovascular Disorders / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D003324:Coronary Artery Disease / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000209:etiology / Q000473:pathology / Q000503:physiopathology*; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D011597:Psychomotor Performance; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity