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Published on: April 23, 2021
Cognitive impairments associated with medial temporal atrophy and white matter hyperintensities: an MRI study in
Eduard J Overdorp1, Roy P C Kessels2, Jurgen A Claassen3
1Department of Psychiatry, Gelre Medical Centre Zutphen, Netherlands ; Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Nijmegen, Netherlands.
Abstract:
In this retrospective study, we investigated the independent effects of white matter hyperintensities (WMH) and hippocampal atrophy on cognitive functions in a broad sample of patients seen in a memory clinic. To ensure generalizability, these associations were examined irrespective of diagnosis and with minimal exclusion criteria. Next to these independent effects, interactions between WMH and hippocampal atrophy were examined. Between January 2006 and September 2011 a total of 500 patients visited the memory clinic, 397 of whom were included. Magnetic resonance images of 397 patients were visually analyzed for WMH, medial temporal atrophy (MTA), and global atrophy. We evaluated the association of WMH and MTA with the following cognitive domains: global cognition, episodic memory, working memory, executive function and psychomotor speed. Main effects and interaction effects were examined by means of correlation and regression analyses. In the regression analyses, we controlled for potential confounding effects of global atrophy. The correlational results revealed that WMH were associated with global cognition, executive function and psychomotor speed, whereas a trend was found for episodic memory. MTA was associated with all these four cognitive domains; an additional trend was observed for working memory. Hierarchical regression analyses revealed main independent effects of MTA for episodic memory, executive function, psychomotor speed and global cognition; WMH were only associated with global cognition. The interaction between MTA and WMH was significant for episodic memory only. This study demonstrates that predominantly MTA is an independent predictor not only for memory function, with which is it classically associated, but also for global cognition and executive function. Taken together, MTA may be an important correlate of cognitive deficits found in people attending the memory clinic.
Insights
Medial temporal atrophy (MTA) significantly impacts memory, executive function, and global cognition. White matter hyperintensities (WMH) also affect global cognition, with interactions primarily seen in episodic memory.
Area of Science:
- Neurology
- Neuroimaging
- Cognitive Science
Background:
- White matter hyperintensities (WMH) and hippocampal atrophy are common in memory clinic patients.
- Their independent and interactive effects on cognition require further investigation for broad applicability.
Purpose of the Study:
- To investigate the independent and interactive effects of WMH and medial temporal atrophy (MTA) on various cognitive domains.
- To examine these associations in a general memory clinic population, irrespective of diagnosis.
Main Methods:
- Retrospective analysis of 397 memory clinic patients' MRI scans.
- Visual assessment of WMH, MTA, and global atrophy.
- Correlation and regression analyses to evaluate cognitive domain associations, controlling for global atrophy.
Main Results:
- MTA independently predicted episodic memory, executive function, psychomotor speed, and global cognition.
- WMH independently predicted global cognition.
- A significant interaction between MTA and WMH was found for episodic memory.
Conclusions:
- MTA is a key independent predictor of cognitive deficits, extending beyond memory to global cognition and executive function.
- WMH also contribute to cognitive decline, particularly in global cognition.
- The interplay between MTA and WMH is significant for episodic memory, highlighting their combined role in cognitive impairment.
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