Longitudinal changes in white matter disease and cognition in the first year of the Alzheimer disease neuroimaging initiative.

Published

Journal Article

To evaluate relationships between magnetic resonance imaging (MRI)-based measures of white matter hyperintensities (WMHs), measured at baseline and longitudinally, and 1-year cognitive decline using a large convenience sample in a clinical trial design with a relatively mild profile of cardiovascular risk factors.Convenience sample in a clinical trial design.A total of 804 participants in the Alzheimer Disease Neuroimaging Initiative who received MRI scans, cognitive testing, and clinical evaluations at baseline, 6-month follow-up, and 12-month follow-up visits. For each scan, WMHs were detected automatically on coregistered sets of T1, proton density, and T2 MRI images using a validated method. Mixed-effects regression models evaluated relationships between risk factors for WMHs, WMH volume, and change in outcome measures including Mini-Mental State Examination (MMSE), Alzheimer Disease Assessment Scale-Cognitive Subscale (ADAS-Cog), and Clinical Dementia Rating Scale sum of boxes scores. Covariates in these models included race, sex, years of education, age, apolipoprotein E genotype, baseline clinical diagnosis (cognitively normal, mild cognitive impairment, or Alzheimer disease), cardiovascular risk score, and MRI-based hippocampal and brain volumes.Higher baseline WMH volume was associated with greater subsequent 1-year increase in ADAS-Cog and decrease in MMSE scores. Greater WMH volume at follow-up was associated with greater ADAS-Cog and lower MMSE scores at follow-up. Higher baseline age and cardiovascular risk score and more impaired baseline clinical diagnosis were associated with higher baseline WMH volume.White matter hyperintensity volume predicts 1-year cognitive decline in a relatively healthy convenience sample that was similar to clinical trial samples, and therefore should be considered as a covariate of interest at baseline and longitudinally in future AD treatment trials.

Full Text

Duke Authors

Cited Authors

  • Carmichael, O; Schwarz, C; Drucker, D; Fletcher, E; Harvey, D; Beckett, L; Jack, CR; Weiner, M; DeCarli, C; Alzheimer's Disease Neuroimaging Initiative,

Published Date

  • November 2010

Published In

Volume / Issue

  • 67 / 11

Start / End Page

  • 1370 - 1378

PubMed ID

  • 21060014

Pubmed Central ID

  • 21060014

Electronic International Standard Serial Number (EISSN)

  • 1538-3687

International Standard Serial Number (ISSN)

  • 0003-9942

Digital Object Identifier (DOI)

  • 10.1001/archneurol.2010.284

Language

  • eng