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The relationship of subcortical MRI hyperintensities and brain volume to cognitive function in vascular dementia

Published online by Cambridge University Press:  12 November 2002

RONALD A. COHEN
Affiliation:
Department of Psychiatry, Brown Medical School, Providence, Rhode Island
ROBERT H. PAUL
Affiliation:
Department of Psychiatry, Brown Medical School, Providence, Rhode Island
BRIAN R. OTT
Affiliation:
Department of Neurology, Brown Medical School, Providence, Rhode Island
DAVID J. MOSER
Affiliation:
Department of Psychiatry, University of Iowa, College of Medicine, Iowa City
TRICIA M. ZAWACKI
Affiliation:
Department of Psychiatry, Brown Medical School, Providence, Rhode Island
WILLIAM STONE
Affiliation:
Department of Neurology, Brown Medical School, Providence, Rhode Island
NORMAN GORDON
Affiliation:
Department of Neurology, Brown Medical School, Providence, Rhode Island

Abstract

The relationship between MRI findings (i.e., subcortical hyperintensities; SH, whole brain volume) and the cognitive dysfunction of vascular dementia (VaD) was examined. Participants included 24 persons that met NINDS-AIREN criteria for VaD (MMSE = 19.9 ± 4.2) and underwent comprehensive neuropsychological assessment and MRI brain imaging. The volume of subcortical hyperintensities (SH) was strongly associated with executive–psychomotor performance, but not with performance across other cognitive domains or global cognitive functional level. Conversely, WBV was strongly associated with global cognitive functioning and performance across most cognitive domains (memory, language, visual integration), but not with executive–psychomotor functioning. The failure of SH to account for either the global dementia evident in these VaD patients or impairments across most cognitive domains suggests that deep subcortical white matter disease may only indirectly contribute to the global cognitive dysfunction of VaD. That WBV emerged as a stronger correlate of dementia raises further questions regarding the cerebral mechanisms that contribute to the development of VaD. (JINS, 2002, 8, 743–752.)

Type
Research Article
Copyright
© 2002 The International Neuropsychological Society

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