White matter hyperintensities and medial temporal lobe atrophy in clinical subtypes of mild cognitive impairment: the DESCRIPA study.

van de Pol, L. A.; Verhey, F.; Frisoni, G. B.; Tsolaki, M.; Papapostolou, P.; Nobili, F.; Wahlund, L-O.; Minthon, L,; Frölich, L.; Hampel, Harald; Soininen, H.; Knol, D. L.; Barkhof, F.; Scheltens, P. and Visser, P. J. (2009): White matter hyperintensities and medial temporal lobe atrophy in clinical subtypes of mild cognitive impairment: the DESCRIPA study. In: Journal of Neurology, Neurosurgery and Psychiatry, Vol. 80: pp. 1069-1074

Abstract

Background: Clinical subtypes of mild cognitive impairment (MCI) may represent different underlying aetiologies. Methods: This European, multicentre, memory clinic based study (DESCRIPA) of non-demented subjects investigated whether MCI subtypes have different brain correlates on MRI and whether the relation between subtypes and brain pathology is modified by age. Using visual rating scales, medial temporal lobe atrophy (MTA) (0–4) and white matter hyperintensities (WMH) (0–30) were assessed. Results: Severity of MTA differed between MCI subtypes (p,0.001), increasing from a mean of 0.8 (SD 0.7) in subjective complaints (n=77) to 1.3 (0.8) in nonamnestic MCI (n=93), and from 1.4 (0.9) in single domain amnestic MCI (n=70) to 1.7 (0.9) in multiple domain amnestic MCI (n=89). The association between MCI subtype and MTA was modified by age and mainly present in subjects .70 years of age. Severity of WMH did not differ between MCI subtypes (p=0.21). However, the combination of MTA and WMH differed between MCI subtypes (p=0.02) Conclusion: We conclude that MCI subtypes may have different brain substrates, especially in older subjects. Isolated MTA was mainly associated with amnestic MCI subtypes, suggesting AD as the underlying cause. In nonamnestic MCI, the relatively higher prevalence of MTA in combination with WMH may suggest a different pathophysiological origin.

• Item Type: Journal article
• Form of publication: Publisher's Version
• Faculties: Medicine
• Subjects: 600 Technology > 610 Medicine and health
• Alliance/National Licence: This publication is with permission of the rights owner freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively.
• Language: English