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Brain atrophy accelerates cognitive decline in cerebral small vessel disease: the LADIS study

H Jokinen1, J Lipsanen, R Schmidt

  • 1Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland. hanna.jokinen@helsinki.fi

Neurology
|May 18, 2012
PubMed
Abstract

Insights

Brain atrophy and white matter lesions independently predict cognitive decline in small vessel disease. Atrophy measures potentiate the negative effects of lesions on cognition over time.

Area of Science:

  • Neurology
  • Neuroimaging
  • Cognitive Science

Background:

  • Small vessel disease (SVD) is a common cause of cognitive impairment.
  • Understanding the specific contributions of different brain changes in SVD is crucial for predicting cognitive decline.

Purpose of the Study:

  • To investigate the independent and combined effects of medial temporal lobe atrophy (MTA), cortical atrophy, subcortical atrophy, and white matter lesion (WML) volume on longitudinal cognitive performance.

Main Methods:

  • 477 subjects with age-related WML underwent MRI and annual neuropsychological testing over 3 years.
  • Linear mixed models were used to analyze baseline MRI predictors of cognitive decline, controlling for confounders.

Main Results:

  • MTA and subcortical atrophy predicted faster decline in global cognition, psychomotor speed, executive functions, and memory.
  • Cortical atrophy independently predicted psychomotor speed decline. WML volume remained associated with cognitive decline.
  • Synergistic interactions were observed between WML and atrophy measures, and between lacunar infarcts and atrophy measures, on cognitive decline.

Conclusions:

  • Brain atrophy and WML are independent predictors of cognitive decline in SVD.
  • MTA, subcortical, and cortical atrophy appear to amplify the impact of WML and lacunes on cognitive decline.

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