White matter hyperintensities and medial temporal lobe atrophy in clinical subtypes of mild cognitive impairment: the DESCRIPA study
- L A van de Pol1,
- F Verhey2,
- G B Frisoni3,
- M Tsolaki4,
- P Papapostolou5,
- F Nobili6,
- L-O Wahlund7,
- L Minthon8,
- L Frölich9,
- H Hampel10,
- H Soininen11,
- D L Knol12,
- F Barkhof13,
- P Scheltens1,
- P J Visser2
- 1Department of Neurology, Alzheimer Centre, VU Medical Centre, Amsterdam, The Netherlands
- 2Department of Psychiatry and Neuropsychology, University of Maastricht, The Netherlands
- 3IRCCS San Giovanni, Laboratory of Epidemiology and Neuroimaging, Brescia, Italy
- 4Aristotle University of Thessaloniki, Memory and Dementia Centre, 3rd Department of Neurology, G Papanicolaore General Hospital, Thessaloniki, Greece
- 5Papageorgiou Hospital, Department of Radiology, Thessaloniki, Greece
- 6Clinical Neurophysiology Service, Department of Endocrinological and Metabolic Sciences, University of Genoa, Genoa, Italy
- 7NVS Department, Karolinska Institutet, Karolinska University Hospital, Huddinge, Sweden
- 8Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Sweden
- 9Department of Geriatric Psychiatry, Zentralinstitut für Seelische Gesundheit, University of Heidelberg, Mannheim, Germany
- 10Alzheimer Memorial Centre and Geriatric Psychiatry Branch, Dementia and Neuroimaging Section Department of Psychiatry, Ludwig-Maximilian University, Munich, Germany
- 11University of Kuopio, Department of Neurology, Kuopio University Hospital, Kuopio, Finland
- 12Department of Clinical Epidemiology and Biostatistics, VU Medical Centre, Amsterdam, The Netherlands
- 13Department of Radiology, Alzheimer Centre, VU Medical Centre, Amsterdam, The Netherlands
- Correspondence to Dr Laura A van de Pol, VUMC, Department of Neurology, PO Box 7057, 1007 MB Amsterdam, The Netherlands; L.vandepol{at}vumc.nl
- Received 21 August 2008
- Revised 19 May 2009
- Accepted 21 May 2009
- Published Online First 18 June 2009
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 non-amnestic 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 non-amnestic MCI, the relatively higher prevalence of MTA in combination with WMH may suggest a different pathophysiological origin.
Footnotes
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For numbered affiliations see end of article
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Funding The study was funded by the European Commission within the 5th framework programme (QLRT-2001-2455). The study was partly supported (HS) by EVO grant from Kuopio University Hospital, Kuopio, Finland, 5772720. The European commission funded the study as a concerted action but had no role in study design or analysis of the data.
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Competing interests None.
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Ethics approval The study was approved by the local medical ethics committee in each centre.
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Provenance and Peer review Not commissioned; externally peer reviewed.
