White matter hyperintensity progression is associated with incident probable dementia or mild cognitive impairment

Stroke and Vascular Neurology

article

Adam de Havenon¹  Kevin N Sheth¹  Sharon D Yeatts²  Tanya N Turan³  Shyam Prabhakaran⁴ 

[1] Neurology , Yale University;Public Health Sciences;Neurology;Neurology , University of Chicago Pritzker School of Medicine

关键词: Brain;    Cognitive Dysfunction;    Magnetic Resonance Imaging;   

DOI  :  10.1136/svn-2021-001357

学科分类：社会科学、人文和艺术（综合）

来源: BMJ Publishing Group

【 摘 要 】

Background White matter hyperintensity (WMH) on brain MRI is associated with developing dementia or mild cognitive impairment (MCI), but WMH progression over time has not been fully investigated as an independent risk factor.Methods We performed a post hoc analysis of the Systolic Blood Pressure Intervention Trial - Memory and Cognition in Decreased Hypertension (SPRINT MIND) trial. The primary outcome was incident probable dementia or MCI (dementia/MCI) before the follow-up MRI at 48 months from enrolment. The primary predictor was WMH progression, defined as the Z score difference between the follow-up and baseline WMH volumes. The secondary predictor was a binary WMH progression threshold (≥1.4 mL vs <1.4 mL).Results Among the 433 included patients, 33 (7.6%) developed dementia/MCI. There were 156 (36.0%) patients who met the WMH progression threshold of ≥1.4 mL, in whom the rate of dementia/MCI was 12.8% (20/156) vs 4.7% (13/277) of patients with <1.4 mL WMH progression (p=0.002). In multivariable logistic regression, the Z score of WMH progression was associated with dementia/MCI (OR 1.51, 95% CI 1.12 to 2.04, p=0.007) as was the WMH progression threshold of ≥1.4 mL (OR 2.89, 95% CI 1.23 to 6.81, p=0.015).Conclusions In this post hoc analysis of SPRINT MIND, WMH progression over 48 months was associated with the development of probable dementia or MCI.

【 授权许可】

CC BY-NC|CC BY|CC BY-NC-ND