TY - JOUR
T1 - How Do Different Forms of Vascular Brain Injury Relate to Cognition in a Memory Clinic Population
T2 - The TRACE-VCI Study
AU - Boomsma, Jooske M F
AU - Exalto, Lieza G
AU - Barkhof, Frederik
AU - Berg, Esther van den
AU - Bresser, Jeroen de
AU - Heinen, Rutger
AU - Leeuwis, Anna E
AU - Prins, Niels D
AU - Scheltens, Philip
AU - Weinstein, Henry C
AU - van der Flier, Wiesje M
AU - Biessels, Geert Jan
N1 - Publisher Copyright:
© 2019 - IOS Press and the authors. All rights reserved.
PY - 2019/3/18
Y1 - 2019/3/18
N2 - Memory clinic patients frequently present with different forms of vascular brain injury due to different etiologies, often co-occurring with Alzheimer's disease (AD) pathology. Objective: We studied how cognition was affected by different forms of vascular brain injury, possibly in interplay with AD pathology. Methods: We included 860 memory clinic patients with vascular brain injury on magnetic resonance imaging (MRI), receiving a standardized evaluation including cerebrospinal fluid (CSF) biomarker analyses (n=541). The cognitive profile of patients with different forms of vascular brain injury on MRI (moderate/severe white matter hyperintensities (WMH) (n=398), microbleeds (n=368), lacunar (n=188) and non-lacunar (n=96) infarct(s), macrobleeds (n=16)) was assessed by: 1) comparison of all these different forms of vascular brain injury with a reference group (patients with only mild WMH (n=205) without other forms of vascular brain injury), using linear regression analyses also stratified for CSF biomarker AD profile and 2) multivariate linear regression analysis. Results: The cognitive profile was remarkably similar across groups. Compared to the reference group effect sizes on all domains were <0.2 with narrow 95% confidence intervals, except for non-lacunar infarcts on information processing speed (age, sex, and education adjusted mean difference from reference group (β: - 0.26, p=0.05). Results were similar in the presence (n=300) or absence (n=241) of biomarker co-occurring AD pathology. In multivariate linear regression analysis, higher WMH burden was related to a slightly worse performance on attention and executive functioning (β: - 0.08, p=0.02) and working memory (β: - 0.08, p=0.04). Conclusion: Although different forms of vascular brain injury have different etiologies and different patterns of cerebral damage, they show a largely similar cognitive profile in memory clinic patients regardless of co-occurring AD pathology.
AB - Memory clinic patients frequently present with different forms of vascular brain injury due to different etiologies, often co-occurring with Alzheimer's disease (AD) pathology. Objective: We studied how cognition was affected by different forms of vascular brain injury, possibly in interplay with AD pathology. Methods: We included 860 memory clinic patients with vascular brain injury on magnetic resonance imaging (MRI), receiving a standardized evaluation including cerebrospinal fluid (CSF) biomarker analyses (n=541). The cognitive profile of patients with different forms of vascular brain injury on MRI (moderate/severe white matter hyperintensities (WMH) (n=398), microbleeds (n=368), lacunar (n=188) and non-lacunar (n=96) infarct(s), macrobleeds (n=16)) was assessed by: 1) comparison of all these different forms of vascular brain injury with a reference group (patients with only mild WMH (n=205) without other forms of vascular brain injury), using linear regression analyses also stratified for CSF biomarker AD profile and 2) multivariate linear regression analysis. Results: The cognitive profile was remarkably similar across groups. Compared to the reference group effect sizes on all domains were <0.2 with narrow 95% confidence intervals, except for non-lacunar infarcts on information processing speed (age, sex, and education adjusted mean difference from reference group (β: - 0.26, p=0.05). Results were similar in the presence (n=300) or absence (n=241) of biomarker co-occurring AD pathology. In multivariate linear regression analysis, higher WMH burden was related to a slightly worse performance on attention and executive functioning (β: - 0.08, p=0.02) and working memory (β: - 0.08, p=0.04). Conclusion: Although different forms of vascular brain injury have different etiologies and different patterns of cerebral damage, they show a largely similar cognitive profile in memory clinic patients regardless of co-occurring AD pathology.
KW - cerebral small vessel disease
KW - cerebrovascular disorders
KW - cognitive disorders
KW - neuropsychological test
U2 - 10.3233/JAD-180696
DO - 10.3233/JAD-180696
M3 - Article
C2 - 30909212
SN - 1387-2877
VL - 68
SP - 1273
EP - 1286
JO - Journal of Alzheimer's Disease
JF - Journal of Alzheimer's Disease
IS - 3
ER -