How Do Different Forms of Vascular Brain Injury Relate to Cognition in a Memory Clinic Population: The TRACE-VCI Study

Jooske M. F. Boomsma, Lieza G. Exalto, Frederik Barkhof, Esther van den Berg, Jeroen de Bresser, Rutger Heinen, Anna E. Leeuwis, Niels D. Prins, Philip Scheltens, Henry C. Weinstein, Wiesje M. van der Flier, Geert Jan Biessels

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5 Citations (Scopus)


Memory clinic patients frequently present with different forms of vascular brain injury due to different etiologies, often co-occurring with Alzheimer's disease (AD) pathology. Objective: We studied how cognition was affected by different forms of vascular brain injury, possibly in interplay with AD pathology. Methods: We included 860 memory clinic patients with vascular brain injury on magnetic resonance imaging (MRI), receiving a standardized evaluation including cerebrospinal fluid (CSF) biomarker analyses (n=541). The cognitive profile of patients with different forms of vascular brain injury on MRI (moderate/severe white matter hyperintensities (WMH) (n=398), microbleeds (n=368), lacunar (n=188) and non-lacunar (n=96) infarct(s), macrobleeds (n=16)) was assessed by: 1) comparison of all these different forms of vascular brain injury with a reference group (patients with only mild WMH (n=205) without other forms of vascular brain injury), using linear regression analyses also stratified for CSF biomarker AD profile and 2) multivariate linear regression analysis. Results: The cognitive profile was remarkably similar across groups. Compared to the reference group effect sizes on all domains were <0.2 with narrow 95% confidence intervals, except for non-lacunar infarcts on information processing speed (age, sex, and education adjusted mean difference from reference group (β: - 0.26, p=0.05). Results were similar in the presence (n=300) or absence (n=241) of biomarker co-occurring AD pathology. In multivariate linear regression analysis, higher WMH burden was related to a slightly worse performance on attention and executive functioning (β: - 0.08, p=0.02) and working memory (β: - 0.08, p=0.04). Conclusion: Although different forms of vascular brain injury have different etiologies and different patterns of cerebral damage, they show a largely similar cognitive profile in memory clinic patients regardless of co-occurring AD pathology.

Original languageEnglish
Pages (from-to)1273-1286
Number of pages14
JournalJournal of Alzheimer's Disease
Issue number3
Early online date18 Mar 2019
Publication statusPublished - 8 Apr 2019


  • Cerebral small vessel diseases
  • cerebrovascular disorders
  • cognitive disorders
  • neuropsychological test

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