White matter changes in empirically derived incident MCI subtypes in the Mayo Clinic Study of Aging

Mary M Machulda1, Emily S Lundt2, Carly T Mester2

  • 1Division of Neurocognitive Disorders Department of Psychiatry and Psychology Mayo Clinic Rochester Minnesota USA.

Abstract

Insights

White matter changes, including white matter hyperintensities (WMH) and altered fractional anisotropy (FA), are associated with different subtypes of mild cognitive impairment (MCI). These changes likely contribute to cognitive symptoms in individuals with MCI.

Area of Science:

  • Neuroimaging
  • Neurology
  • Cognitive Science

Background:

  • White matter hyperintensities (WMH) and fractional anisotropy (FA) are key indicators of brain health.
  • Mild cognitive impairment (MCI) is a heterogeneous condition with distinct subtypes.

Purpose of the Study:

  • To investigate white matter hyperintensities (WMH) and fractional anisotropy (FA) in empirically derived incident mild cognitive impairment (MCI) subtypes.
  • To understand the relationship between specific MCI subtypes and white matter integrity.

Main Methods:

  • Evaluated 188 participants with incident MCI from the Mayo Clinic Study of Aging (MCSA).
  • Classified MCI participants into four subtypes: subtle cognitive impairment, amnestic, dysnomic, and dysexecutive.
  • Utilized linear regression for WMH volume analysis and diffusion tensor imaging for FA examination in a subset of 63 participants.

Main Results:

  • Amnestic and dysexecutive MCI subtypes exhibited distinct patterns of increased WMH compared to cognitively unimpaired individuals.
  • The dysexecutive subtype showed higher WMH volumes than the subtle cognitive impairment subtype.
  • Widespread white matter degeneration was observed in association and commissural fibers across amnestic, dysnomic, and dysexecutive subtypes, with corpus callosum FA significantly correlating with global cognition.

Conclusions:

  • White matter integrity, assessed by WMH and FA, plays a crucial role in the cognitive manifestations of incident MCI.
  • Specific patterns of white matter changes are associated with different MCI subtypes, suggesting distinct underlying pathologies.