MRI-leukoaraiosis thresholds and the phenotypic expression of dementia

Catherine C. Price, Sandra M. Mitchell, Babette Brumback, Jared J. Tanner, Ilona Schmalfuss, Melissa Lamar, Tania Giovannetti, Kenneth M. Heilman, David J. Libon

Research output: Contribution to journalArticlepeer-review

38 Scopus citations

Abstract

Objective: To examine the concept of leukoaraiosis thresholds on working memory, visuoconstruction, memory, and language in dementia. Methods: A consecutive series of 83 individuals with insidious onset/progressive dementia clinically diagnosed with Alzheimer disease (AD) or small vessel vascular dementia (VaD) completed neuropsychological measures assessing working memory, visuoconstruction, episodic memory, and language. A clinical MRI scan was used to quantify leukoaraiosis, total white matter, hippocampus, lacune, and intracranial volume. We performed analyses to detect the lowest level of leukoaraiosis associated with impairment on the neuropsychological measures. Results: Leukoaraiosis ranged from 0.63% to 23.74% of participants' white matter. Leukoaraiosis explained a significant amount of variance in working memory performance when it involved 3% or more of the white matter with curve estimations showing the relationship to be nonlinear in nature. Greater leukoaraiosis (13%) was implicated for impairment in visuoconstruction. Relationships between leukoaraiosis, episodic memory, and language measures were linear or flat. Conclusions: Leukoaraiosis involves specific threshold points for working memory and visuoconstructional tests in AD/VaD spectrum dementia. These data underscore the need to better understand the threshold at which leukoaraiosis affects and alters the phenotypic expression in insidious onset dementia syndromes.

Original languageEnglish (US)
Pages (from-to)734-740
Number of pages7
JournalNeurology
Volume79
Issue number8
DOIs
StatePublished - Aug 21 2012

All Science Journal Classification (ASJC) codes

  • Clinical Neurology

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