A Threshold of White Matter Hyperintensities Volume Ratio Doubling the Risk of Cognitive Decline in Patients with Stroke or Transient Ischemic Attack
Refereed conference paper presented and published in conference proceedings

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The threshold of white matter hyperintensities (WMH) burden that predicts longitudinal cognitive decline remains unknown.

Two hundred and forty five stroke or transient ischemic attack (TIA) patients were followed over a mean period of 37.4 months. The Montreal Cognitive Assessment (MoCA) was administered at baseline (mean 5.1 months [SD=1.1] post event) and follow-up (42.5 [1.4] months). Change in MoCA score was calculated as follow up minus baseline and significant cognitive decline was defined as a drop of ≥3 points on the MoCA over 3 years. WMH burden was expressed using 1) visual rating by Age-Related White Matter Changes Scale Global score; 2) raw WMH volume measured on MRI; 3) highest quartile of raw WMH volume; 4) WMH volume corrected for intracranial volume (ICV) to account for differences in head size; and 5) highest quartile of ICV-corrected WMH volume. WMH volume was quantified by BrainNow. The association between WMH burden and decline in MoCA was tested using multivariable binomial regression models corrected for age, sex, education and baseline MoCA scores.

Highest quartile of ICV-corrected WMH volume (0.91% of ICV) was most strongly associated with MoCA decline (Odds Ratio 2.05, 95% Confidence Interval 1.08-3.90; Figure). ARWMC Global score, raw WMH volume and its highest quartile as well as linear measure of ICV-corrected WMH volume, were not significantly associated with MoCA decline.

Approximately 1% of WMH relative to intracranial volume doubled the risk of cognitive decline over 3 years in patients with stroke or TIA. This volume ratio may represent a threshold for cognitive decline in these patients. Linear measure of volume of WMH per se, with and without correction for ICV, or visual rating using ARWMC scale, did not predict cognitive decline.
All Author(s) ListWong A, Abrigo J, Shi L, Lam BYK, Chu WCW, Lo ESK, Liu W, Mok VCT
Name of ConferenceAlzheimer’s Association International Conference 2016
Start Date of Conference22/07/2016
End Date of Conference28/07/2016
Place of ConferenceToronto
Country/Region of ConferenceCanada
Proceedings TitleAlzheimer's & Dementia
Volume Number12
Issue Number7 Supplement
PublisherElsevier Inc
PagesP727 - P727
LanguagesEnglish-United Kingdom

Last updated on 2020-18-10 at 00:52