title: Cognitive decline in metabolic syndrome is linked to microstructural white matter abnormalities.
abstract: Subjects with metabolic syndrome (MetS) often show worse cognitive performance compared with the healthy population. We investigated whether microstructural white matter abnormalities are associated with cognitive performance in adults with MetS using diffusion tensor MR imaging. A total of 32 subjects with MetS (age 64.8 ± 7.8, 56.25 % female) and 23 age-, gender-, and education-matched healthy controls completed a battery of neuropsychological tests and diffusion tensor imaging (DTI) at 3-T MRI. Brain global and regional volumes, white matter fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (LD) were calculated. The least-square models adjusted for age, sex, HbA1c, hypertension, body mass index, hyperlipidemia, and white matter hyperintensities were used to evaluate the relationship between cognitive function and DTI. The MetS group had worse performance in verbal fluency (VF) and learning and memory function (total VF: T score (p = 0.01), VF: animals T score (p = 0.0001), Hopkins Verbal Learning Test (HVLT): Total recall T score (p = 0.0001), and HVLT: delayed recall T score (p = 0.002), as compared with controls. In the MetS group, abnormalities in diffusivity measures were associated with worse cognitive performance [VF: animals T score and left post-central gyrus-LD (p = 0.0007, radj0.4), R angular gyrus-RD (p = 0.0008, radj0.3), L supra-marginal gyrus-RD (p = 0.009, radj0.2) after adjusting for age, sex, HbA1c, 24 h mean BP, presence of hyperlipidemia, and global white matter hyperintensities]. Microstructural white matter abnormalities in the MetS group might be the underlying mechanisms of worse verbal learning and memory performance.
authors.affiliation: Department of Neurology, Beth Israel Deaconess Medical Center, 185 Pilgrim Road, Palmer 127, Boston, MA, 02215, USA.
authors.forename: Freddy J
authors.initials: FJ
authors.lastname: Alfaro
authors.affiliation: Department of Neurology, Beth Israel Deaconess Medical Center, 185 Pilgrim Road, Palmer 127, Boston, MA, 02215, USA.
authors.forename: Vasileios-Arsenios
authors.initials: VA
authors.lastname: Lioutas
authors.affiliation: Department of Neurology, Beth Israel Deaconess Medical Center, 185 Pilgrim Road, Palmer 127, Boston, MA, 02215, USA.
authors.forename: Daniela A
authors.initials: DA
authors.lastname: Pimentel
authors.affiliation: Department of Neurology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
authors.forename: Chen-Chih
authors.initials: CC
authors.lastname: Chung
authors.affiliation: Department of Neurology, Beth Israel Deaconess Medical Center, 185 Pilgrim Road, Palmer 127, Boston, MA, 02215, USA.
authors.forename: Francisco
authors.initials: F
authors.lastname: Bedoya
authors.affiliation: Department of Physical Medicine and Rehabilitation, Hallym University College of Medicine, Chooncheon, Korea.|Hallym Institute of Translational Genomics and Bioinformatics, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: Woo-Kyoung
authors.initials: WK
authors.lastname: Yoo
authors.affiliation: Department of Neurology, Beth Israel Deaconess Medical Center, 185 Pilgrim Road, Palmer 127, Boston, MA, 02215, USA. vnovak@bidmc.harvard.edu.
authors.forename: Vera
authors.initials: V
authors.lastname: Novak
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016880:Anisotropy; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007091:Image Processing, Computer-Assisted; D056784:Leukoencephalopathies / Q000150:complications* / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D008659:Metabolic Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D011795:Surveys and Questionnaires
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Cognitive decline; Diffusion tensor imaging; Metabolic syndrome; Microstructural white matter