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White matter hyperintensities mediate the association between frailty and cognitive impairment in moyamoya disease

Juan Du1, Changhua Qu2, Ziwei Xu1

  • 1Department of Neurology, Huadong Hospital Affiliated to Fudan University, Shanghai, China.

Clinical Neurology and Neurosurgery
|April 12, 2024
PubMed
Abstract

Insights

Frailty is linked to cognitive decline in moyamoya disease (MMD). White matter hyperintensities (WMHs) partially explain this connection, highlighting their role in MMD-related cognitive impairment.

Area of Science:

  • Neurology
  • Neuroscience
  • Geriatrics

Background:

  • Cognitive impairment and frailty are significant concerns in moyamoya disease (MMD).
  • The underlying mechanisms linking frailty and cognitive dysfunction in MMD are not well understood.
  • White matter hyperintensities (WMHs) are implicated in cerebrovascular diseases and may play a role in cognitive decline.

Purpose of the Study:

  • To investigate the association between frailty and cognitive function in patients with moyamoya disease.
  • To determine if white matter hyperintensities (WMHs) mediate the relationship between frailty and cognitive impairment in MMD.

Main Methods:

  • 85 MMD patients were assessed for frailty (Clinical Frailty Scale) and cognitive function.
  • Regional deep WMH (DWMH) and periventricular WMH (PWMH) volumes were quantified.
  • Multivariate logistic regression and mediation analyses were employed to examine associations and mediation effects.

Main Results:

  • Frailty was significantly associated with impaired learning, memory, processing speed, executive functions, and semantic memory.
  • Frailty independently predicted memory and executive function deficits, even after accounting for WMHs.
  • WMHs, including DWMH and PWMH, partially mediated the relationship between frailty and cognitive impairments in memory and executive functions.

Conclusions:

  • Frailty is a significant risk factor for cognitive impairment in MMD.
  • White matter hyperintensities partially mediate the link between frailty and cognitive decline in MMD patients.
Keywords:
Cognitive functionFrailtyMoyamoya diseaseWMHs

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