White matter hyperintensities and cognition: Testing the reserve hypothesis

NEUROBIOLOGY OF AGING

卷:32

Article

Brickman, Adam M.^1,2,3  Siedlecki, Karen L.¹  Muraskin, Jordan¹  Manly, Jennifer J.^1,2,3  Luchsinger, Jose A.^1,3,4,5  Yeung, Lok-Kin¹  Brown, Truman R.^6,7  DeCarli, Charles^8,9  Stern, Yaakov^1,2,3,10 

[1] Columbia Univ, Coll Phys & Surg, Taub Inst Res Alzheimers Dis & Aging Brain, New York, NY 10032 USA

[2] Columbia Univ, Coll Phys & Surg, Dept Neurol, New York, NY 10032 USA

[3] Columbia Univ, Coll Phys & Surg, Gertrude H Sergievsky Ctr, New York, NY 10032 USA

[4] Columbia Univ, Dept Epidemiol, Joseph P Mailman Sch Publ Hlth, New York, NY 10032 USA

[5] Columbia Univ, Coll Phys & Surg, Dept Med, New York, NY 10032 USA

[6] Columbia Univ, Coll Phys & Surg, Dept Radiol, New York, NY 10032 USA

[7] Columbia Univ, Dept Biomed Engn, New York, NY 10032 USA

[8] Univ Calif, Ctr Neurosci, Dept Neurol, Sacramento, CA 95817 USA

[9] Univ Calif, Ctr Neurosci, Imaging Dementia & Aging Lab, Sacramento, CA 95817 USA

[10] Columbia Univ, Coll Phys & Surg, Dept Psychiat, New York, NY 10032 USA

关键词: White matter hyperintensities;    Cognitive reserve;    MRI;    Cognition;    Aging;   

DOI  :  10.1016/j.neurobiolaging.2009.10.013

来源: Elsevier

【 摘 要 】

Objective: White matter hyperintensities (WMH), visualized on T2-weighted MRI, are thought to reflect small-vessel vascular disease. Much like other markers of brain disease, the association between WMH and cognition is imperfect. The concept of reserve may account for this imperfect relationship. The purpose of this study was to test the reserve hypothesis in the association between WMH severity and cognition. We hypothesized that individuals with higher amounts of reserve would be able to tolerate greater amounts of pathology than those with lower reserve. Methods: Neurologically healthy older adults (n = 717) from a community-based study received structural MRI, neuropsychological assessment, and evaluation of reserve. WMH volume was quantified algorithmically. We derived latent constructs representing four neuropsychological domains, a measure of cognitive reserve, and a measure of brain reserve. Measures of cognitive and brain reserve consisted of psychosocial (e.g., education) and anthropometric (e.g., craniometry) variables, respectively. Results: Increased WMH volume was associated with poorer cognition and higher cognitive and brain reserve were associated with better cognition. Controlling for speed/executive function or for language function, those with higher estimates of cognitive reserve had significantly greater degrees of WMH volume, particularly among women. Controlling for cognitive functioning across all domains, individuals with higher estimates of brain reserve had significantly greater WMH volume. Conclusions: For any given level of cognitive function, those with higher reserve had more pathology in the form of WMH, suggesting that they are better able to cope with pathology than those with lower reserve. Both brain reserve and cognitive reserve appear to mitigate the impact of pathology on cognition. (C) 2009 Elsevier Inc. All rights reserved.

【 授权许可】

Free