Cerebral white matter lesions and cognitive function: The Rotterdam scan study

Authors

  • Jan Cees De Groot MD,

    1. Department of Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands
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  • Frank-Erik De Leeuw MD,

    1. Department of Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands
    2. University Department of Neurology, Utrecht, The Netherlands
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  • Matthijs Oudkerk MD,

    1. Department of Radiology, Daniel de Hoed Cancer Clinic, Erasmus University Medical School, Rotterdam, The Netherlands
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  • Jan Van Gijn FRCPE,

    1. University Department of Neurology, Utrecht, The Netherlands
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  • Albert Hofman MD,

    1. Department of Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands
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  • Jellemer Jolles PhD,

    1. Department of Neuropsychology, Neuropsychiatry and Psychobiology, University Maastricht, Maastricht, The Netherlands
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  • Monique M. B. Breteler MD

    Corresponding author
    1. Department of Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands
    • Department of Epidemiology and Biostatistics, Erasmus University Medical School, PO Box 1738, 3000 DR Rotterdam, The Netherlands
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Abstract

Cerebral white matter lesions (WMLs) have been associated with cognitive dysfunction. Whether periventricular or subcortical WMLs relate differently to cognitive function is still uncertain. In addition, it is unclear whether WMLs are related to specific cognitive domains such as memory or psychomotor speed. We examined the relationship between periventricular and subcortical WMLs and cognitive functioning in 1,077 elderly subjects randomly sampled from the general population. Quantification of WMLs was assessed by means of an extensive rating scale on 1.5-T magnetic resonance imaging scans. Cognitive function was assessed by using multiple neuropsychological tests from which we constructed compound scores for psychomotor speed, memory performance, and global cognitive function. When analyzed separately, both periventricular and subcortical WMLs were related to all neuropsychological measures. When periventricular WMLs were analyzed conditional on subcortical WMLs and vice versa, the relationship between periventricular WMLs and global cognitive function remained unaltered whereas the relationship with subcortical WMLs disappeared. Subjects with most severe periventricular WMLs performed nearly 1 SD below average on tasks involving psychomotor speed, and more than 0.5 SD below average for global cognitive function. Tasks that involve speed of cognitive processes appear to be more affected by WMLs than memory tasks. Ann Neurol 2000;47:145–151.

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