Pattern of regional white matter hyperintensity volume in mild cognitive impairment subtypes and associations with decline in daily functioning

• Published in: Neurobiology of aging 2020-02, Vol.86, p.134-142
• Main Authors: Bangen, Katherine J., Thomas, Kelsey R., Weigand, Alexandra J., Sanchez, Danielle L., Delano-Wood, Lisa, Edmonds, Emily C., Carmichael, Owen T., Schwarz, Christopher G., Brickman, Adam M., Bondi, Mark W.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Cerebrovascular disease; Cognition; Cognitive Dysfunction - classification; Cognitive Dysfunction - diagnostic imaging; Cognitive Dysfunction - pathology; Cognitive Dysfunction - physiopathology; Daily functioning; Female; Forecasting; Humans; Magnetic Resonance Imaging - methods; Male; MCI subtypes; Mild cognitive impairment; Neuropsychological Tests; Neuropsychology; Risk; White Matter - diagnostic imaging; White Matter - pathology; White matter hyperintensity
• ISSN: 0197-4580; 1558-1497
• DOI: 10.1016/j.neurobiolaging.2019.10.016

White matter hyperintensities (WMHs), a marker of small-vessel cerebrovascular disease, increase risk for mild cognitive impairment (MCI). Less is known about whether regional WMHs distinguish MCI subtypes and predict decline in everyday functioning. About 618 Alzheimer's Disease Neuroimaging Initiative participants (301 cognitively normal [CN]; 232 amnestic MCI [aMCI]; 85 nonamnestic MCI [naMCI]) underwent neuropsychological testing, MRI, and assessment of everyday functioning. aMCI participants showed greater temporal (p = 0.002) and occipital WMHs (p = 0.030) relative to CN whereas naMCI participants had greater frontal (p = 0.045), temporal (p = 0.003), parietal (p = 0.018), and occipital (p < 0.001) WMH compared with CN. Relative to those with aMCI, individuals with naMCI showed greater occipital WMH (p = 0.013). Greater WMH in temporal (p = 0.001) and occipital regions (p = 0.006) was associated with faster decline in everyday functioning across the sample. Temporal lobe WMHs were disproportionately associated with accelerated functional decline among naMCI (p = 0.045). Regional WMH volumes vary across cognitive groups and predict functional decline. Cerebrovascular markers may help identify individuals at risk for decline and distinguish subtypes of cognitive impairment. •Mild cognitive impairment (MCI) subtypes are associated with greater baseline regional White matter hyperintensities (WMHs) compared with controls.•Nonamnestic MCIs show greater baseline occipital WMH relative to amnestic MCIs.•Posterior WMH volume predicts functional decline across the entire sample.•Temporal WMHs are disproportionately associated with decline among nonamnestic MCIs.•Cerebrovascular markers may help identify individuals at risk for functional decline.