TY - JOUR
T1 - How Do Different Forms of Vascular Brain Injury Relate to Cognition in a Memory Clinic Population
T2 - The TRACE-VCI Study
AU - Boomsma, Jooske M. F.
AU - Exalto, Lieza G.
AU - Barkhof, Frederik
AU - van den Berg, Esther
AU - de Bresser, Jeroen
AU - Heinen, Rutger
AU - Leeuwis, Anna E.
AU - Prins, Niels D.
AU - Scheltens, Philip
AU - Weinstein, Henry C.
AU - van der Flier, Wiesje M.
AU - Biessels, Geert Jan
N1 - Funding Information: National Institute for Health Research (NIHR) and University College London Hospitals NHS Foundation Trust (UCLH) biomedical research center, London, United Kingdom: Department of Radiology: F. Barkhof. Funding Information: The TRACE-VCI study is supported by Vidi grant 91711384 from ZonMw, The Netherlands, Organisation for Health Research and Development and grant 2010T073 from the Dutch Heart Association to Geert Jan Biessels. Funding Information: Research of the VUMC Alzheimer center is part of the neurodegeneration research program of the Amsterdam Neuroscience. The VUMC Alzheimer Center is supported by Stichting Alzheimer Nederland and Stichting VUMC fonds. The clinical database structure was developed with funding from Stichting Dioraphte. F. Barkhof is supported by the National Publisher Copyright: © 2019 - IOS Press and the authors. All rights reserved. Copyright: Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/4/8
Y1 - 2019/4/8
N2 - 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.
AB - 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.
KW - Cerebral small vessel diseases
KW - cerebrovascular disorders
KW - cognitive disorders
KW - neuropsychological test
UR - http://www.scopus.com/inward/record.url?scp=85064378123&partnerID=8YFLogxK
U2 - https://doi.org/10.3233/JAD-180696
DO - https://doi.org/10.3233/JAD-180696
M3 - Article
C2 - 30909212
SN - 1387-2877
VL - 68
SP - 1273
EP - 1286
JO - Journal of Alzheimer's Disease
JF - Journal of Alzheimer's Disease
IS - 3
ER -