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White matter volumes and periventricular white matter hyperintensities in aging and dementia
C D Smith1, D A Snowdon, H Wang
1Department of Neurology, University of Kentucky Medical Center, Lexington 40536, USA. csmith@mri.uky.edu
Objective:
To determine the relationship between MRI periventricular white matter hyperintensities, cerebral white matter volumes, neuropathologic findings, and cognitive status in aged individuals.
Background:
The significance of periventricular white matter hyperintensities seen on MR images in aged individuals remains controversial. The Nun Study is a longitudinal cohort aging study in which all 678 initially enrolled participants agreed to autopsy neuropathologic examination.
Methods:
We used MRI to measure white matter volumes of the cerebral hemispheres in 52 formaldehyde-fixed brains for correlation with white matter and neocortical pathology, postmortem MRI observations, and cognitive measures.
Results:
Reduced white matter volume is associated with dementia, but periventricular white matter hyperintensities were not related to white matter volume, stroke, or dementia.
Conclusions:
Our results do not support the hypothesis that periventricular hyperintensities seen on MR images have deleterious consequences in these aged individuals.
Insights
Periventricular white matter hyperintensities on MRI scans did not correlate with brain pathology or cognitive decline in aged individuals. Reduced white matter volume, however, was linked to dementia in this study.
Area of Science:
- Neurology
- Gerontology
- Neuroimaging
Background:
- Periventricular white matter hyperintensities (PWMH) on MRI in aging populations have unclear significance.
- The Nun Study provides a unique longitudinal cohort with autopsy data for 678 participants.
- This study investigates the link between brain imaging, pathology, and cognition in aging.
Purpose of the Study:
- To investigate the relationship between MRI-detected periventricular white matter hyperintensities, cerebral white matter volumes, and neuropathologic findings.
- To correlate these imaging markers with cognitive status in aged individuals.
Main Methods:
- Utilized MRI to measure cerebral white matter volumes in 52 fixed brains.
- Correlated MRI findings with postmortem neuropathologic examination of white matter and neocortex.
- Examined associations with cognitive measures from the Nun Study.
Main Results:
- Reduced cerebral white matter volume was associated with dementia.
- Periventricular white matter hyperintensities were not significantly related to white matter volume, stroke, or dementia.
- No direct link found between PWMH and adverse neuropathologic or cognitive outcomes.
Conclusions:
- The findings do not support the hypothesis that periventricular hyperintensities on MRI have detrimental effects in aged individuals.
- Reduced white matter volume, not PWMH, appears to be a more significant indicator of cognitive impairment in this cohort.
- Further research may clarify the role of white matter integrity in cognitive aging.