White matter hyperintensities and medial temporal lobe atrophy in clinical subtypes of mild cognitive impairment: the DESCRIPA study

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 80; no. 10; pp. 1069 - 1074
• Main Authors: van de Pol, L A, Verhey, F, Frisoni, G B, Tsolaki, M, Papapostolou, P, Nobili, F, Wahlund, L-O, Minthon, L, Frölich, L, Hampel, H, Soininen, H, Knol, D L, Barkhof, F, Scheltens, P, Visser, P J
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.10.2009; BMJ Publishing Group; BMJ Publishing Group LTD
• Subjects: Age; Age Factors; Aged; Alzheimer's disease; Amnesia - etiology; Amnesia - pathology; Atrophy - etiology; Atrophy - pathology; Atrophy - psychology; Biological and medical sciences; Brain research; Case-Control Studies; Clinical Medicine; Cognition Disorders - etiology; Cognition Disorders - pathology; Cognition Disorders - psychology; Cognitive ability; Cohort Studies; Dementia; Educational Status; Europe; Female; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Hypertension; Klinisk medicin; Male; Medical and Health Sciences; Medical sciences; Medicin och hälsovetenskap; Memory; Nervous system (semeiology, syndromes); Neurologi; Neurology; Neuropsychological Tests; Risk factors; Sex Factors; Studies; Temporal Lobe - pathology; Europe; Atrophy; Temporal lobe; Nervous system diseases; Cognitive disorder; mild cognitive impairment; Subtype; White matter; Hyperintensity; COGNITION; MRI; white matter hyperintensities; medial temporal lobe atrophy; subtypes
• ISSN: 0022-3050; 1468-330X; 1468-330X
• DOI: 10.1136/jnnp.2008.158881

Background:Clinical subtypes of mild cognitive impairment (MCI) may represent different underlying aetiologies.Methods:This European, multicentre, memory clinic based study (DESCRIPA) of non-demented subjects investigated whether MCI subtypes have different brain correlates on MRI and whether the relation between subtypes and brain pathology is modified by age. Using visual rating scales, medial temporal lobe atrophy (MTA) (0–4) and white matter hyperintensities (WMH) (0–30) were assessed.Results:Severity of MTA differed between MCI subtypes (p<0.001), increasing from a mean of 0.8 (SD 0.7) in subjective complaints (n = 77) to 1.3 (0.8) in non-amnestic MCI (n = 93), and from 1.4 (0.9) in single domain amnestic MCI (n = 70) to 1.7 (0.9) in multiple domain amnestic MCI (n = 89). The association between MCI subtype and MTA was modified by age and mainly present in subjects >70 years of age. Severity of WMH did not differ between MCI subtypes (p = 0.21). However, the combination of MTA and WMH differed between MCI subtypes (p = 0.02)Conclusion:We conclude that MCI subtypes may have different brain substrates, especially in older subjects. Isolated MTA was mainly associated with amnestic MCI subtypes, suggesting AD as the underlying cause. In non-amnestic MCI, the relatively higher prevalence of MTA in combination with WMH may suggest a different pathophysiological origin.