OBJECTIVE: A study was undertaken to determine whether diffusion-weighted imaging (DWI) abnormalities in normal-appearing brain tissue (NABT) and in white matter hyperintensities (WMH) predict longitudinal cognitive decline and disability in older individuals independently of the concomitant magnetic resonance imaging (MRI) findings. METHODS: A total of 340 LADIS (Leukoaraiosis and Disability Study) participants, aged 65 to 84 years, underwent brain MRI including DWI at baseline. Neuropsychological and functional assessments were carried out at study entry and repeated annually over a 3-year observational period. Linear mixed models and Cox regression survival analysis adjusted for demographics, WMH volume, lacunes, and brain atrophy were used to evaluate the independent effect of the DWI measures on change in cognitive performance and functional abilities. RESULTS: The mean global apparent diffusion coefficient (ADC) and the relative peak height and peak position of the ADC histogram in NABT predicted faster rate of decline in a composite score for speed and motor control. Higher mean ADC and lower peak height were also related to deterioration in executive functions and memory (specifically working memory), with peak height also being related to more rapid transition to disability and higher rate of mortality. Mean ADC in WMH had less pronounced effects on cognitive and functional outcomes. INTERPRETATION: DWI microstructural changes in NABT predict faster decline in psychomotor speed, executive functions, and working memory regardless of conventional MRI findings. Moreover, these changes are related to functional disability and higher mortality.
OBJECTIVE: A study was undertaken to determine whether diffusion-weighted imaging (DWI) abnormalities in normal-appearing brain tissue (NABT) and in white matter hyperintensities (WMH) predict longitudinal cognitive decline and disability in older individuals independently of the concomitant magnetic resonance imaging (MRI) findings. METHODS: A total of 340 LADIS (Leukoaraiosis and Disability Study) participants, aged 65 to 84 years, underwent brain MRI including DWI at baseline. Neuropsychological and functional assessments were carried out at study entry and repeated annually over a 3-year observational period. Linear mixed models and Cox regression survival analysis adjusted for demographics, WMH volume, lacunes, and brain atrophy were used to evaluate the independent effect of the DWI measures on change in cognitive performance and functional abilities. RESULTS: The mean global apparent diffusion coefficient (ADC) and the relative peak height and peak position of the ADC histogram in NABT predicted faster rate of decline in a composite score for speed and motor control. Higher mean ADC and lower peak height were also related to deterioration in executive functions and memory (specifically working memory), with peak height also being related to more rapid transition to disability and higher rate of mortality. Mean ADC in WMH had less pronounced effects on cognitive and functional outcomes. INTERPRETATION: DWI microstructural changes in NABT predict faster decline in psychomotor speed, executive functions, and working memory regardless of conventional MRI findings. Moreover, these changes are related to functional disability and higher mortality.
Authors: I W M van Uden; A M Tuladhar; H M van der Holst; E M C van Leijsen; A G W van Norden; K F de Laat; L C A Rutten-Jacobs; D G Norris; J A H R Claassen; E J van Dijk; R P C Kessels; F-E de Leeuw Journal: Hum Brain Mapp Date: 2015-10-15 Impact factor: 5.038
Authors: Gary A Rosenberg; Anders Wallin; Joanna M Wardlaw; Hugh S Markus; Joan Montaner; Leslie Wolfson; Costantino Iadecola; Berislav V Zlokovic; Anne Joutel; Martin Dichgans; Marco Duering; Reinhold Schmidt; Amos D Korczyn; Lea T Grinberg; Helena C Chui; Vladimir Hachinski Journal: J Cereb Blood Flow Metab Date: 2016-01 Impact factor: 6.200
Authors: J E F Moonen; J C Foster-Dingley; A A van den Berg-Huijsmans; W de Ruijter; A J M de Craen; J van der Grond; R C van der Mast Journal: AJNR Am J Neuroradiol Date: 2016-09-22 Impact factor: 3.825
Authors: Melinda C Power; Dan Su; Aozhou Wu; Robert I Reid; Clifford R Jack; David S Knopman; Joe Coresh; Juebin Huang; Kejal Kantarci; A Richey Sharrett; Rebecca G Gottesman; Mike E Griswold; Thomas H Mosley Journal: Neurobiol Aging Date: 2019-08-29 Impact factor: 4.673
Authors: Marco Duering; Sofia Finsterwalder; Ebru Baykara; Anil Man Tuladhar; Benno Gesierich; Marek J Konieczny; Rainer Malik; Nicolai Franzmeier; Michael Ewers; Eric Jouvent; Geert Jan Biessels; Reinhold Schmidt; Frank-Erik de Leeuw; Ofer Pasternak; Martin Dichgans Journal: Alzheimers Dement Date: 2018-02-16 Impact factor: 21.566