Periventricular white matter hyperintensities increase the likelihood of progression from amnestic mild cognitive impairment to dementia

E. C W Van Straaten, Danielle J Harvey, P. Scheltens, F. Barkhof, R. C. Petersen, L. J. Thal, C. R. Jack, Charles DeCarli

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

Background: White matter hyperintensities (WMH) have an effect on cognition and are increased in severity among individuals with amnestic mild cognitive impairment (aMCI). The influence of WMH on progression of aMCI to Alzheimer's disease (AD) is less clear. Methods: Data were drawn from a three-year prospective, double blind, placebo controlled clinical trial that examined the effect of donepezil or vitamin E on progression from aMCI to AD. WMH from multiple brain regions were scored on MR images obtained at entry into the trial from a subset of 152 study participants using a standardized visual rating scale. Cox proportional hazards models adjusting for age, education and treatment arm were used to investigate the role of WMH on time to progression. Results: 55 of the 152 (36.2%) aMCI subjects progressed to AD. Only periventricular hyperintensities (PVH) were related to an increased risk of AD within three years (HR = 1.59, 95% CI = 1.24 - 2.05, p-value < 0.001). Correcting for medial temporal lobe atrophy or the presence of lacunes did not change statistical significance. Conclusion: PVH are associated with an increased risk of progression from aMCI to AD. This suggests that PVH, an MRI finding thought to represent cerebrovascular damage, contributes to AD onset in vulnerable individuals independent of Alzheimer pathology.

Original languageEnglish (US)
Pages (from-to)1302-1308
Number of pages7
JournalJournal of Neurology
Volume255
Issue number9
DOIs
StatePublished - Sep 2008

Fingerprint

Dementia
Alzheimer Disease
Controlled Clinical Trials
Temporal Lobe
Vitamin E
Proportional Hazards Models
Cognition
Atrophy
Cognitive Dysfunction
White Matter
Placebos
Pathology
Education
Brain

Keywords

  • Alzheimer's disease
  • Cerebrovascular disease
  • MCI (mild cognitive impairment)
  • MRI

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Periventricular white matter hyperintensities increase the likelihood of progression from amnestic mild cognitive impairment to dementia. / Van Straaten, E. C W; Harvey, Danielle J; Scheltens, P.; Barkhof, F.; Petersen, R. C.; Thal, L. J.; Jack, C. R.; DeCarli, Charles.

In: Journal of Neurology, Vol. 255, No. 9, 09.2008, p. 1302-1308.

Research output: Contribution to journalArticle

Van Straaten, E. C W ; Harvey, Danielle J ; Scheltens, P. ; Barkhof, F. ; Petersen, R. C. ; Thal, L. J. ; Jack, C. R. ; DeCarli, Charles. / Periventricular white matter hyperintensities increase the likelihood of progression from amnestic mild cognitive impairment to dementia. In: Journal of Neurology. 2008 ; Vol. 255, No. 9. pp. 1302-1308.
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