Presence and progression of white matter hyperintensities and cognition: a meta-analysis
| Autor: | Mirjam I. Geerlings, Paul J. Nederkoorn, Raoul P. Kloppenborg, Esther van den Berg |
|---|---|
| Přispěvatelé: | Neurology, ACS - Amsterdam Cardiovascular Sciences |
| Rok vydání: | 2014 |
| Předmět: |
education.field_of_study
medicine.medical_specialty business.industry Population Neuropsychology Cognition Audiology Executive functions Hyperintensity Leukoencephalopathies Meta-analysis Disease Progression Medicine Humans Neurology (clinical) Cognitive skill Cognitive decline business education Cognition Disorders |
| Zdroj: | Neurology, 82(23), 2127-2138. Lippincott Williams and Wilkins |
| ISSN: | 1526-632X 0028-3878 |
| Popis: | Objective: We aimed to quantify the effects of white matter hyperintensities (WMHs) on specific cognitive functions with particular attention to WMH progression and localization. Methods: PubMed (January 1990–July 2013) and bibliographies from included articles were used. Studies that were included (1) used MRI; (2) had a population-based or case-control design with a healthy control group that could be used for analysis; (3) matched/adjusted for age, sex, and education; and (4) addressed ≥1 predefined cognitive domains with ≥1 validated neuropsychological tests. Data were independently extracted by 2 investigators. Pearson r was extracted/calculated and used as the common metric for the effect size across studies. Results: Twenty-three cross-sectional and 14 longitudinal studies were included with a total of 8,685 and 7,731 participants. Presence of WMHs was significantly associated with concurrent cognitive deficits in all examined domains: general intelligence (Fisher z −0.10, 95% confidence interval [CI] −0.19 to −0.04), memory (−0.08, −0.13 to −0.06), processing speed (−0.11, −0.17 to −0.07), attention and executive functions (−0.11, −0.16 to −0.07), and perception/construction (−0.15, −0.21 to −0.07). Similar effect sizes were observed for cognitive decline over time. WMH progression was associated with greater cognitive decline, particularly for general intelligence (Fisher z −0.31, 95% CI −0.5 to −0.02) and attention and executive functions (−0.32, −0.34 to −0.28). Conclusions: The small but robust and consistent effects of WMHs on all cognitive domains suggest a more global effect on cognition than previously thought. Progression of WMHs was associated with even worse cognitive functioning, most pronounced in attention and executive functioning. |
| Databáze: | OpenAIRE |
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