White matter hyperintensities are related to physical disability and poor motor function

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 76; no. 3; pp. 362 - 367
• Main Authors: Sachdev, P S, Wen, W, Christensen, H, Jorm, A F
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.03.2005; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: Automation; Biological and medical sciences; Brain - pathology; Brain Diseases - complications; Brain Diseases - pathology; Brain research; California Verbal Learning Test; cerebrospinal fluid; Cognition Disorders - etiology; cognitive function; Cross-Sectional Studies; CSF; CVLT; deep white matter region; degrees of freedom; Disabled Persons; DWMH; echo time; Female; field of view; FLAIR; fluid attenuated inversion recovery; FOV; grip strength; Health Status; Humans; ICC; ICV; intraclass correlation; intracranial volume; Magnetic Resonance Imaging; Male; Medical sciences; Memory Disorders - etiology; Mental depression; Mental Processes; Middle Aged; Mini Mental State Examination; MMSE; Motor Skills Disorders - etiology; motor speed; MRI; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Neurology; periventricular region; Physical Component Summary of the 12 Item Short Form Health Survey; physical health; Pneumology; PVH; Questionnaires; repetition time; SDMT; SF-12; Symbol Digits Modalities Test; Tumors of the respiratory system and mediastinum; white matter hyperintensities; white matter hyperintensity; WMH; United Kingdom > UK; Australia; Canberra Australian Capital Territory Australia; Disability; Nervous system diseases; White matter; Hyperintensity
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp.2004.042945

Objective: To determine the impact of white matter hyperintensities (WMHs) on physical health and cognitive function in 60–64 year old individuals residing in the community. Methods: A subsample of 478 persons aged 60–64 from a larger community sample underwent brain magnetic resonance imaging (MRI) scans. WMHs on T2 weighted FLAIR (fluid attenuated inversion recovery) MRI scans were assessed using an automated procedure. Subjects were assessed for global cognitive function, episodic memory, working memory (digit span), information processing speed (Symbol Digit Modalities Test; SDMT), fine motor dexterity (Purdue Pegboard), and grip strength, and completed the Physical Component Summary of the Short Form Health Survey (SF-12). Regression analyses were used to examine the effect of WMHs on physical and cognitive function. Results: Deep and periventricular WMHs were present in all subjects, with women having slightly more lesions than men. WMHs were significantly associated with poorer reported physical health on the SF-12 scale, after adjusting for depression, cognitive function, and brain atrophy. WMHs were also related to lower scores on the Purdue Pegboard test, grip strength, choice reaction time, and SDMT, but not on tests of episodic memory, working memory, general intellectual function, and global cognitive function. On regression analyses, the Purdue Pegboard test and grip strength were related to physical disability. Conclusion: WMHs are common, albeit mild, in middle adult life. They are associated with physical disability, possibly through reduced speed, fine motor coordination, and muscular strength. They are also related to slowed information processing speed but not other cognitive functions.