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Increase in periventricular white matter hyperintensities parallels decline in mental processing speed in a non-demented elderly population
  1. D M J van den Heuvel1,
  2. V H ten Dam2,
  3. A J M de Craen2,
  4. F Admiraal-Behloul3,
  5. H Olofsen3,
  6. E L E M Bollen4,
  7. J Jolles5,
  8. H M Murray6,
  9. G J Blauw2,
  10. R G J Westendorp2,
  11. M A van Buchem1
  1. 1Departments of Radiology, Leiden University Medical Center, The Netherlands
  2. 2General Internal Medicine Division of Geriatrics/Gerontology, Leiden University Medical Center, The Netherlands
  3. 3Division of Image Processing, Leiden University Medical Center, The Netherlands
  4. 4Division of Neurology, Leiden University Medical Center, The Netherlands
  5. 5The department of Psychiatry and Neuropsychology, University of Maastricht, The Netherlands
  6. 6The Robertson Centre for Biostatistics, University of Glasgow, UK
  1. Correspondence to:
 Dr A J M de Craen
 Department of Gerontology and Geriatrics, C2-R, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands; craen{at}


Objective: To investigate the influence of deep white matter hyperintensities (DWMH) and periventricular white matter hyperintensities (PVWMH) on progression of cognitive decline in non-demented elderly people.

Methods: All data come from the nested MRI sub-study of the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER). We performed a 3 year follow up study on 554 subjects of the PROSPER study using both repeated magnetic resonance imaging and cognitive testing. Cognitive decline and its dependency on WMH severity was assessed using linear regression models adjusted for sex, age, education, treatment group, and test version when applicable.

Results: We found that the volume of PVWMH at baseline was longitudinally associated with reduced mental processing speed (p = 0.0075). In addition, we found that the progression in PVWMH volume paralleled the decline in mental processing speed (p = 0.024). In contrast, neither presence nor progression of DWMH was associated with change in performance on any of the cognitive tests.

Conclusion: PVWMH should not be considered benign but probably underlie impairment in cognitive processing speed.

  • DWMH, deep white matter hyperintensities
  • FLAIR, fluid attenuated inversion recovery
  • LDCT, Letter Digit Coding Test
  • MRI, magnetic resonance imaging
  • PROSPER, PROspective Study of Pravastatin in the Elderly at Risk
  • PVWMH, periventricular white matter hyperintensities
  • WMH, white matter hyperintensities
  • MRI
  • aging
  • cognition
  • white matter hyperintensities

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  • Competing interests: none

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