title: Subclinical cerebrovascular disease inversely associates with learning ability: The NOMAS.
abstract: OBJECTIVE
  Memory has been examined in subjects with imaging markers of cerebrovascular disease, but learning has been less well studied. We examined the relationship among subclinical cerebrovascular disease, cerebral volumes, and verbal learning in an ethnically and racially diverse community sample.
  
  
  METHODS
  A clinically stroke-free subset of Northern Manhattan Study participants underwent cognitive testing and brain MRI with quantification of white matter hyperintensity volume (WMHV) and total cerebral volume (TCV) using semiautomated segmentation. We used generalized linear regression and mixed models to examine the association between imaging findings and verbal learning.
  
  
  RESULTS
  There were 1,272 participants (61% women, mean age 70 ± 9 years). Participants with greater WMHV and smaller TCV remembered fewer total words on a list-learning task (β = -0.83 per SD change in WMHV, 95% confidence interval [CI] = -1.22 to -0.45, p < 0.0001; and β = 0.48 per SD change in TCV, 95% CI = 0.05 to 0.90, p = 0.03, respectively). Subclinical brain infarction (SBI) was not associated with total words learned (β = -0.04, 95% CI = -1.08 to 1.00, p = 0.94). Those with greater WMHV had increased odds of a flatter learning slope. After excluding participants with SBI, the association between total words learned and WMHV remained significant. All measurements were adjusted for age, education, race/ethnicity, medical insurance status, and the presence of SBI.
  
  
  CONCLUSIONS
  White matter hyperintensities, a marker of cerebral small vessel disease, may have an impact on learning slope. This suggests that verbal learning performance can be incorporated into neuropsychological measures for vascular cognitive impairment and that cerebrovascular disease discovered on imaging affects the ability to learn new information.
authors.affiliation: From the Evelyn F. McKnight Brain Institute (H.G., C. Dong, T.R., R.L.S., C.B.W.), Departments of Neurology (H.G., C. Dong, T.R., R.L.S., C.B.W.) and Public Health Sciences (R.L.S., C.B.W.), Leonard M. Miller School of Medicine, and the Neuroscience Program (C.B.W.), University of Miami, FL; Department of Neurology (M.Y.), Hokuriku National Hospital, Japan; Department of Neurology, College of Physicians and Surgeons (M.S.V.E., Y.S.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; and Department of Neurology and Center for Neuroscience (C. DeCarli), University of California at Davis, Sacramento.
authors.forename: Hilary
authors.initials: H
authors.lastname: Glazer
authors.affiliation: From the Evelyn F. McKnight Brain Institute (H.G., C. Dong, T.R., R.L.S., C.B.W.), Departments of Neurology (H.G., C. Dong, T.R., R.L.S., C.B.W.) and Public Health Sciences (R.L.S., C.B.W.), Leonard M. Miller School of Medicine, and the Neuroscience Program (C.B.W.), University of Miami, FL; Department of Neurology (M.Y.), Hokuriku National Hospital, Japan; Department of Neurology, College of Physicians and Surgeons (M.S.V.E., Y.S.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; and Department of Neurology and Center for Neuroscience (C. DeCarli), University of California at Davis, Sacramento.
authors.forename: Chuanhui
authors.initials: C
authors.lastname: Dong
authors.affiliation: From the Evelyn F. McKnight Brain Institute (H.G., C. Dong, T.R., R.L.S., C.B.W.), Departments of Neurology (H.G., C. Dong, T.R., R.L.S., C.B.W.) and Public Health Sciences (R.L.S., C.B.W.), Leonard M. Miller School of Medicine, and the Neuroscience Program (C.B.W.), University of Miami, FL; Department of Neurology (M.Y.), Hokuriku National Hospital, Japan; Department of Neurology, College of Physicians and Surgeons (M.S.V.E., Y.S.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; and Department of Neurology and Center for Neuroscience (C. DeCarli), University of California at Davis, Sacramento.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Yoshita
authors.affiliation: From the Evelyn F. McKnight Brain Institute (H.G., C. Dong, T.R., R.L.S., C.B.W.), Departments of Neurology (H.G., C. Dong, T.R., R.L.S., C.B.W.) and Public Health Sciences (R.L.S., C.B.W.), Leonard M. Miller School of Medicine, and the Neuroscience Program (C.B.W.), University of Miami, FL; Department of Neurology (M.Y.), Hokuriku National Hospital, Japan; Department of Neurology, College of Physicians and Surgeons (M.S.V.E., Y.S.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; and Department of Neurology and Center for Neuroscience (C. DeCarli), University of California at Davis, Sacramento.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Rundek
authors.affiliation: From the Evelyn F. McKnight Brain Institute (H.G., C. Dong, T.R., R.L.S., C.B.W.), Departments of Neurology (H.G., C. Dong, T.R., R.L.S., C.B.W.) and Public Health Sciences (R.L.S., C.B.W.), Leonard M. Miller School of Medicine, and the Neuroscience Program (C.B.W.), University of Miami, FL; Department of Neurology (M.Y.), Hokuriku National Hospital, Japan; Department of Neurology, College of Physicians and Surgeons (M.S.V.E., Y.S.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; and Department of Neurology and Center for Neuroscience (C. DeCarli), University of California at Davis, Sacramento.
authors.forename: Mitchell S V
authors.initials: MS
authors.lastname: Elkind
authors.affiliation: From the Evelyn F. McKnight Brain Institute (H.G., C. Dong, T.R., R.L.S., C.B.W.), Departments of Neurology (H.G., C. Dong, T.R., R.L.S., C.B.W.) and Public Health Sciences (R.L.S., C.B.W.), Leonard M. Miller School of Medicine, and the Neuroscience Program (C.B.W.), University of Miami, FL; Department of Neurology (M.Y.), Hokuriku National Hospital, Japan; Department of Neurology, College of Physicians and Surgeons (M.S.V.E., Y.S.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; and Department of Neurology and Center for Neuroscience (C. DeCarli), University of California at Davis, Sacramento.
authors.forename: Ralph L
authors.initials: RL
authors.lastname: Sacco
authors.affiliation: From the Evelyn F. McKnight Brain Institute (H.G., C. Dong, T.R., R.L.S., C.B.W.), Departments of Neurology (H.G., C. Dong, T.R., R.L.S., C.B.W.) and Public Health Sciences (R.L.S., C.B.W.), Leonard M. Miller School of Medicine, and the Neuroscience Program (C.B.W.), University of Miami, FL; Department of Neurology (M.Y.), Hokuriku National Hospital, Japan; Department of Neurology, College of Physicians and Surgeons (M.S.V.E., Y.S.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; and Department of Neurology and Center for Neuroscience (C. DeCarli), University of California at Davis, Sacramento.
authors.forename: Charles
authors.initials: C
authors.lastname: DeCarli
authors.affiliation: From the Evelyn F. McKnight Brain Institute (H.G., C. Dong, T.R., R.L.S., C.B.W.), Departments of Neurology (H.G., C. Dong, T.R., R.L.S., C.B.W.) and Public Health Sciences (R.L.S., C.B.W.), Leonard M. Miller School of Medicine, and the Neuroscience Program (C.B.W.), University of Miami, FL; Department of Neurology (M.Y.), Hokuriku National Hospital, Japan; Department of Neurology, College of Physicians and Surgeons (M.S.V.E., Y.S.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; and Department of Neurology and Center for Neuroscience (C. DeCarli), University of California at Davis, Sacramento.
authors.forename: Yaakov
authors.initials: Y
authors.lastname: Stern
authors.affiliation: From the Evelyn F. McKnight Brain Institute (H.G., C. Dong, T.R., R.L.S., C.B.W.), Departments of Neurology (H.G., C. Dong, T.R., R.L.S., C.B.W.) and Public Health Sciences (R.L.S., C.B.W.), Leonard M. Miller School of Medicine, and the Neuroscience Program (C.B.W.), University of Miami, FL; Department of Neurology (M.Y.), Hokuriku National Hospital, Japan; Department of Neurology, College of Physicians and Surgeons (M.S.V.E., Y.S.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; and Department of Neurology and Center for Neuroscience (C. DeCarli), University of California at Davis, Sacramento. c.wright21@med.miami.edu.
authors.forename: Clinton B
authors.initials: CB
authors.lastname: Wright
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D054022:Cerebrum / Q000473:pathology* / Q000503:physiopathology; D003072:Cognition Disorders / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007858:Learning / Q000502:physiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009519:New York City; D066127:White Matter / Q000473:pathology* / Q000503:physiopathology