Open AccessAssociation of the Irregular 3-Dimensional Shape of White Matter Hyperintensities with Cognitive Function
Author(s) -
Ji Won Han,
Hyunna Lee,
Subin Lee,
Hae Jin Kim,
Grace Eun Kim,
Jong Bin Bae,
Seung Wan Suh,
Jae Hyoung Kim,
Ki Woong Kim
Publication year - 2021
Publication title -
european neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.573
H-Index - 77
eISSN - 1421-9913
pISSN - 0014-3022
DOI - 10.1159/000515836
Subject(s) - dementia , hyperintensity , leukoaraiosis , cardiology , cognition , medicine , psychology , audiology , psychiatry , magnetic resonance imaging , disease , radiology
The irregular shapes of white matter hyperintensities (WMHs) are associated with poor cognitive function, diabetes, or lacunes. However, the association between the WMH shape and dementia remains understudied. We investigated the association between the calculated shape index of WMH and the diagnosis of dementia and cognitive function. Methods: The inverse sphericity index (ISI WMH ) and volume of WMHs (VOL WMH ) were compared among 82 participants with normal cognition, 82 with Alzheimer’s dementia (AD), and 82 with subcortical vascular dementia (SVD). We examined the associations of ISI WMH and VOL WMH with the modified Hachinski Ischemic Score (mHIS), diagnosis of AD and SVD, and cognitive test scores, using linear, multinomial, or hierarchical linear regression models. Results: The mHIS was associated with both ISI WMH (β = 0.326, p < 0.001) and VOL WMH (β = 0.299, p < 0.001). Both ISI WMH and VOL WMH were associated with the SVD diagnosis (odds ratio [OR] = 2.685, p = 0.002, ISI WMH ; OR = 2.597, p = 0.005, VOL WMH ), but not with AD. The SVD diagnosis was better explained when the multinomial regression model included both ISI WMH and VOL WMH instead of VOL WMH alone (χ 2 = 20.768, df = 2, p < 0.001). The Trail Making Test-D (TMT-D) scores of the SVD patients were associated with both ISI WMH (β = 0.308) and VOL WMH (β = 0.293). Conclusion: An irregular WMH shape may be associated with the high cerebrovascular component of cognitive impairment and the diagnosis and low cognitive flexibility of SVD, which may improve the prediction of SVD diagnosis when used in combination with WMH volume.