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Clinical and neuropsychological features associated with structural imaging patterns in patients with mild cognitive

Roberta Rossi1, Cristina Geroldi, Lorena Bresciani

  • 1Laboratory of Epidemiology, Neuroimaging and Telemedicine, IRCCS San Giovanni di Dio FBF, Brescia, Italy.

Dementia and Geriatric Cognitive Disorders
|January 16, 2007
PubMed
Abstract

Insights

Patients with mild cognitive impairment (MCI) and medial temporal atrophy (MTA) or white matter hyperintensities (WMH) show distinct clinical and cognitive profiles. Those with both MTA and WMH have the highest risk of progressing to dementia.

Area of Science:

  • Neuroscience
  • Gerontology
  • Radiology

Background:

  • Mild cognitive impairment (MCI) represents a transitional stage between normal aging and dementia.
  • Identifying MCI subtypes is crucial for understanding disease progression and developing targeted interventions.
  • Medial temporal atrophy (MTA) and white matter hyperintensities (WMH) are common neuroimaging markers in aging and cognitive decline.

Purpose of the Study:

  • To characterize the clinical and neuropsychological features of MCI patients based on the presence or absence of MTA and WMH.
  • To compare these MCI subgroups with normal aging individuals.
  • To determine if the rate of progression to dementia differs across MCI subgroups.

Main Methods:

  • Ninety-five MCI patients were categorized into four groups: MTA- WMH-, MTA- WMH+, MTA+ WMH-, and MTA+ WMH+.
  • Thirty healthy controls were included for comparison.
  • Magnetic resonance imaging (MRI) was used to visually rate MTA and WMH.
  • An extensive clinical and neuropsychological assessment was performed, with a subset undergoing follow-up evaluations.

Main Results:

  • MCI patients without MTA or WMH exhibited better cognitive function and lower comorbidity.
  • MCI patients with WMH only showed deficits in executive function.
  • MCI patients with MTA only had memory impairments and higher vascular/physical comorbidity.
  • MCI patients with both MTA and WMH displayed widespread cognitive deficits, significant physical diseases, and severe vascular comorbidity.
  • Progression to dementia was observed in 25% of MTA+ WMH- and 32% of MTA+ WMH+ groups, but not in the other groups.

Conclusions:

  • Structural neuroimaging markers like MTA and WMH can delineate distinct MCI patient subgroups.
  • These subgroups possess unique clinical, neuropsychological, and progression profiles.
  • Neuroimaging-based stratification aids in predicting dementia conversion risk in MCI.

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