Cognitive impairment and white matter damage in hypertension: a pilot study
Article first published online: 16 SEP 2008
Copyright © 2008 The Authors. Journal compilation © 2008 Blackwell Munksgaard
Acta Neurologica Scandinavica
Volume 119, Issue 4, pages 261–268, April 2009
How to Cite
Hannesdottir, K., Nitkunan, A., Charlton, R. A., Barrick, T. R., MacGregor, G. A. and Markus, H. S. (2009), Cognitive impairment and white matter damage in hypertension: a pilot study. Acta Neurologica Scandinavica, 119: 261–268. doi: 10.1111/j.1600-0404.2008.01098.x
- Issue published online: 5 MAR 2009
- Article first published online: 16 SEP 2008
- Accepted for publication July 24, 2008
- diffusion tensor imaging;
- executive functioning;
- psychomotor speed
Objectives – Hypertension has been associated with impaired cognition. Diffusion tensor imaging (DTI) and magnetic resonance spectroscopy were applied to assess white matter abnormalities in treated vs untreated hypertension and if these correlated with neuropsychological performance.
Methods – Subjects were 40 patients with medically treated hypertension (mean age 69.3 years), 10 patients with untreated hypertension (mean age 57.6 years) and 30 normotensive controls (mean age 68.2 years). Hypertension was defined as a previous diagnosis and taking hypertensive medication, or a resting blood pressure of >140/90 mmHg on the day of assessment.
Results – Patients with treated hypertension performed worse on immediate (P = 0.037) as well as delayed memory tasks (P = 0.024) compared with normotensive controls. Cognitive performance was worse in untreated compared with treated hypertension on executive functions (P = 0.041) and psychomotor speed (P = 0.003). There was no significant correlation between cognition and any of the imaging parameters in treated hypertension. However, in untreated hypertension the results revealed a positive correlation between an executive functioning and attention composite score and DTI mean diffusivity values (P = 0.016) and between psychomotor speed and spectroscopy NAA/tCr levels (P = 0.015).
Conclusions – These results suggest there is cognitive impairment in hypertension. Treated hypertension was associated with deficits in memory while untreated hypertension revealed a more ‘subcortical’ pattern of cognitive impairment.