2
|
Passiak BS, Liu D, Kresge HA, Cambronero FE, Pechman KR, Osborn KE, Gifford KA, Hohman TJ, Schrag MS, Davis LT, Jefferson AL. Perivascular spaces contribute to cognition beyond other small vessel disease markers. Neurology 2019; 92:e1309-e1321. [PMID: 30814324 PMCID: PMC6511092 DOI: 10.1212/wnl.0000000000007124] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 11/13/2018] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE To cross-sectionally relate multiple small vessel disease (SVD) neuroimaging markers to cognition among older adults. METHODS Vanderbilt Memory & Aging Project participants free of clinical dementia and stroke (n = 327, age 73 ± 7 years, 59% male, 40% with mild cognitive impairment) completed neuropsychological assessment and 3T MRI to measure white matter hyperintensities (WMH), perivascular spaces (PVS), cerebral microbleeds (CMBs), and lacunes. Linear regressions related each SVD marker to neuropsychological performances and adjusted for age, sex, race/ethnicity, education, cognitive diagnosis, APOE ε4 presence, Framingham Stroke Risk Profile, and intracranial volume. RESULTS WMH related to the most neuropsychological measures, including the Boston Naming Test, Animal Naming, Coding, Number Sequencing, Executive Function Composite, and Hooper Visual Organization Test performances (p ≤ 0.01). PVS related to multiple information processing and executive function performances (p ≤ 0.02). Lacunes and CMBs related to fewer measures than expected. Combined models simultaneously testing multiple statistically significant SVD predictors suggested that WMH, PVS, and CMBs each independently related to information processing and executive function performances; however, compared to other SVD markers, PVS remained statistically significant in models related to information processing and executive functioning performances. CONCLUSIONS As expected, increased WMH corresponded to poorer performances across multiple cognitive domains. PVS, previously considered a benign neuroimaging feature in older adults, may have important clinical implications because PVS was related to information processing and executive function performances even in combined models. On the basis of models with multiple SVD predictors, WMH, PVS, and CMBs may each reflect a separate pathway of small vessel injury.
Collapse
Affiliation(s)
- Brittany S Passiak
- From the Vanderbilt Memory & Alzheimer's Center (B.S.P., D.L., H.A.K., F.E.C., K.R.P., K.E.O., K.A.G., T.J.H., M.S.S., A.L.J.), Department of Neurology (K.R.P., K.E.O., K.A.G., T.J.H., M.S.S., A.L.J.), Department of Biostatistics (D.L.), and Radiology & Radiological Sciences (L.T.D.), Vanderbilt University Medical Center; and Vanderbilt University School of Medicine (B.S.P.), Nashville, TN
| | - Dandan Liu
- From the Vanderbilt Memory & Alzheimer's Center (B.S.P., D.L., H.A.K., F.E.C., K.R.P., K.E.O., K.A.G., T.J.H., M.S.S., A.L.J.), Department of Neurology (K.R.P., K.E.O., K.A.G., T.J.H., M.S.S., A.L.J.), Department of Biostatistics (D.L.), and Radiology & Radiological Sciences (L.T.D.), Vanderbilt University Medical Center; and Vanderbilt University School of Medicine (B.S.P.), Nashville, TN
| | - Hailey A Kresge
- From the Vanderbilt Memory & Alzheimer's Center (B.S.P., D.L., H.A.K., F.E.C., K.R.P., K.E.O., K.A.G., T.J.H., M.S.S., A.L.J.), Department of Neurology (K.R.P., K.E.O., K.A.G., T.J.H., M.S.S., A.L.J.), Department of Biostatistics (D.L.), and Radiology & Radiological Sciences (L.T.D.), Vanderbilt University Medical Center; and Vanderbilt University School of Medicine (B.S.P.), Nashville, TN
| | - Francis E Cambronero
- From the Vanderbilt Memory & Alzheimer's Center (B.S.P., D.L., H.A.K., F.E.C., K.R.P., K.E.O., K.A.G., T.J.H., M.S.S., A.L.J.), Department of Neurology (K.R.P., K.E.O., K.A.G., T.J.H., M.S.S., A.L.J.), Department of Biostatistics (D.L.), and Radiology & Radiological Sciences (L.T.D.), Vanderbilt University Medical Center; and Vanderbilt University School of Medicine (B.S.P.), Nashville, TN
| | - Kimberly R Pechman
- From the Vanderbilt Memory & Alzheimer's Center (B.S.P., D.L., H.A.K., F.E.C., K.R.P., K.E.O., K.A.G., T.J.H., M.S.S., A.L.J.), Department of Neurology (K.R.P., K.E.O., K.A.G., T.J.H., M.S.S., A.L.J.), Department of Biostatistics (D.L.), and Radiology & Radiological Sciences (L.T.D.), Vanderbilt University Medical Center; and Vanderbilt University School of Medicine (B.S.P.), Nashville, TN
| | - Katie E Osborn
- From the Vanderbilt Memory & Alzheimer's Center (B.S.P., D.L., H.A.K., F.E.C., K.R.P., K.E.O., K.A.G., T.J.H., M.S.S., A.L.J.), Department of Neurology (K.R.P., K.E.O., K.A.G., T.J.H., M.S.S., A.L.J.), Department of Biostatistics (D.L.), and Radiology & Radiological Sciences (L.T.D.), Vanderbilt University Medical Center; and Vanderbilt University School of Medicine (B.S.P.), Nashville, TN
| | - Katherine A Gifford
- From the Vanderbilt Memory & Alzheimer's Center (B.S.P., D.L., H.A.K., F.E.C., K.R.P., K.E.O., K.A.G., T.J.H., M.S.S., A.L.J.), Department of Neurology (K.R.P., K.E.O., K.A.G., T.J.H., M.S.S., A.L.J.), Department of Biostatistics (D.L.), and Radiology & Radiological Sciences (L.T.D.), Vanderbilt University Medical Center; and Vanderbilt University School of Medicine (B.S.P.), Nashville, TN
| | - Timothy J Hohman
- From the Vanderbilt Memory & Alzheimer's Center (B.S.P., D.L., H.A.K., F.E.C., K.R.P., K.E.O., K.A.G., T.J.H., M.S.S., A.L.J.), Department of Neurology (K.R.P., K.E.O., K.A.G., T.J.H., M.S.S., A.L.J.), Department of Biostatistics (D.L.), and Radiology & Radiological Sciences (L.T.D.), Vanderbilt University Medical Center; and Vanderbilt University School of Medicine (B.S.P.), Nashville, TN
| | - Matthew S Schrag
- From the Vanderbilt Memory & Alzheimer's Center (B.S.P., D.L., H.A.K., F.E.C., K.R.P., K.E.O., K.A.G., T.J.H., M.S.S., A.L.J.), Department of Neurology (K.R.P., K.E.O., K.A.G., T.J.H., M.S.S., A.L.J.), Department of Biostatistics (D.L.), and Radiology & Radiological Sciences (L.T.D.), Vanderbilt University Medical Center; and Vanderbilt University School of Medicine (B.S.P.), Nashville, TN
| | - L Taylor Davis
- From the Vanderbilt Memory & Alzheimer's Center (B.S.P., D.L., H.A.K., F.E.C., K.R.P., K.E.O., K.A.G., T.J.H., M.S.S., A.L.J.), Department of Neurology (K.R.P., K.E.O., K.A.G., T.J.H., M.S.S., A.L.J.), Department of Biostatistics (D.L.), and Radiology & Radiological Sciences (L.T.D.), Vanderbilt University Medical Center; and Vanderbilt University School of Medicine (B.S.P.), Nashville, TN
| | - Angela L Jefferson
- From the Vanderbilt Memory & Alzheimer's Center (B.S.P., D.L., H.A.K., F.E.C., K.R.P., K.E.O., K.A.G., T.J.H., M.S.S., A.L.J.), Department of Neurology (K.R.P., K.E.O., K.A.G., T.J.H., M.S.S., A.L.J.), Department of Biostatistics (D.L.), and Radiology & Radiological Sciences (L.T.D.), Vanderbilt University Medical Center; and Vanderbilt University School of Medicine (B.S.P.), Nashville, TN.
| |
Collapse
|