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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions

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Periventricular White Matter Hyperintensities and Functional Decline.

Mandip S Dhamoon¹, Ying-Kuen Cheung², Ahmet Bagci³

¹Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York.

Journal of the American Geriatrics Society

|November 21, 2017

Summary

This summary is machine-generated.

White matter hyperintensity volume (WMHV) in the periventricular region is linked to faster functional decline. This finding highlights specific brain areas affected by WMHV, impacting long-term health outcomes.

Keywords:

MRI disability white matter disease

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Area of Science:

Neuroimaging
Neurology
Gerontology

Background:

Previous research established a link between global white matter hyperintensity volume (WMHV) and accelerated long-term functional decline.
The current study aimed to identify specific brain regions where WMHV is most predictive of functional decline.

Purpose of the Study:

To determine if regional WMHV is a stronger predictor of functional decline than global WMHV.
To investigate the association between WMHV in 14 distinct brain regions and longitudinal functional decline.

Main Methods:

A prospective, population-based study involving 1,195 individuals (mean age 71) free of stroke at baseline.
Brain MRI was used to quantify volumetric WMHV distribution across 14 brain regions.
Least absolute shrinkage and selection operator (LASSO) regression identified key regional WMHV predictors, and generalized estimating equations modeled associations with functional decline (Barthel Index) over a mean of 7.3 years.

Main Results:

LASSO regression identified right anterior periventricular white matter (PVWM) as the only significant regional WMHV predictor.
Each standard deviation increase in right anterior PVWM WMHV was associated with accelerated functional decline of 0.87 Barthel Index points per year, even after adjusting for covariates, stroke, and myocardial infarction.

Conclusions:

Periventricular WMHV, specifically in the right anterior region, is a significant predictor of accelerated functional decline in a large, population-based cohort.
These findings emphasize the importance of regional WMHV assessment for predicting long-term functional trajectories and potential interventions.