Increase in periventricular white matter hyperintensities parallels decline in mental processing speed in a non-demented elderly population

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 77; no. 2; pp. 149 - 153
• Main Authors: van den Heuvel, D M J, ten Dam, V H, de Craen, A J M, Admiraal-Behloul, F, Olofsen, H, Bollen, E L E M, Jolles, J, Murray, H M, Blauw, G J, Westendorp, R G J, van Buchem, M A
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.02.2006; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: Aged; Aged, 80 and over; aging; Biological and medical sciences; Cerebral Infarction - diagnosis; Cerebral Infarction - drug therapy; Cerebral Infarction - pathology; Cerebral Ventricles - pathology; Cerebrospinal fluid; Clinical significance; cognition; Cognition Disorders - diagnosis; Cognition Disorders - psychology; Cognitive ability; deep white matter hyperintensities; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Dementia, Vascular - diagnosis; Dementia, Vascular - drug therapy; Dementia, Vascular - pathology; Disease Progression; Double-Blind Method; DWMH; DWMH, deep white matter hyperintensities; Executive function; Female; FLAIR; FLAIR, fluid attenuated inversion recovery; fluid attenuated inversion recovery; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Image Processing, Computer-Assisted; LDCT; LDCT, Letter Digit Coding Test; Letter Digit Coding Test; Longitudinal Studies; Magnetic Resonance Imaging; Male; Medical sciences; MRI; MRI, magnetic resonance imaging; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Neurology; Neuropsychological Tests; Older people; periventricular white matter hyperintensities; Pravastatin - adverse effects; Pravastatin - therapeutic use; Prospective Studies; PROspective Study of Pravastatin in the Elderly at Risk; PROSPER; PROSPER, PROspective Study of Pravastatin in the Elderly at Risk; PVWMH; PVWMH, periventricular white matter hyperintensities; Reaction Time - physiology; Statistics as Topic; white matter hyperintensities; WMH; WMH, white matter hyperintensities; Human; Speed; Nervous system diseases; Elderly; White matter; Hyperintensity
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp.2005.070193

Objective: To investigate the influence of deep white matter hyperintensities (DWMH) and periventricular white matter hyperintensities (PVWMH) on progression of cognitive decline in non-demented elderly people. Methods: All data come from the nested MRI sub-study of the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER). We performed a 3 year follow up study on 554 subjects of the PROSPER study using both repeated magnetic resonance imaging and cognitive testing. Cognitive decline and its dependency on WMH severity was assessed using linear regression models adjusted for sex, age, education, treatment group, and test version when applicable. Results: We found that the volume of PVWMH at baseline was longitudinally associated with reduced mental processing speed (p = 0.0075). In addition, we found that the progression in PVWMH volume paralleled the decline in mental processing speed (p = 0.024). In contrast, neither presence nor progression of DWMH was associated with change in performance on any of the cognitive tests. Conclusion: PVWMH should not be considered benign but probably underlie impairment in cognitive processing speed.