The Analysis Of Correlation Between White Matter Hyperintensities And Cognitive Impairment

Objectives:The study aimed to reveal the incidence and regional distribution of white matter hyperintensities(WMH),to analyze its correlation with common vascular risk factors such as age,hypertension,diabetes,hyperlipidemia,etc,and to explore the relationship between regional distribution of WMH and MoCA scores,in order to find the relationship between WMH and cognitive impairment and its corresponding risk factors.Methods:1.142 subjects were divided into 3 groups: Alzheimer’s disease group(AD group),amnestic mild cognitive impairment group(aMCI group),and normal control group(NC group).The WMH of head MRI of all subjects were evaluated by 2 radiologists and 1 neurologist who didn’t know medical history using a modified Scheltens score.2.The incidence of WMH in three groups was calculated and the clinical data(including age,gender,hypertension,diabetes,hyperlipidemia,heart disease,smoking history,drinking history,MMSE scores,MoCA scores,WMH cases,and WMH total scores)of the three groups were compared to analyze whether there was any difference between the groups.3.The WMH scores of the whole brain and each brain region of the three groups were compared to analyze whether there was any difference between the groups.4.Correlation analysis of WMH scores: to explore the correlation between age,gender,hypertension,diabetes,hyperlipidemia,heart disease,smoking history,drinking history and WMH.5.Risk factors analysis of MoCA scores: multiple linear regression was conducted with MoCA scores as the dependent variable and age,gender,hypertension,diabetes,hyperlipidemia,heart disease,smoking history,drinking history and WMH total scores as the independent variables to analyze the risk factors influencing MoCA scores.6.To compare the influence of WMH in different parts on each cognitive domain: to compare the differences of WMH of different parts in the total scores of MoCA and scores of each component which including visual space and executive ability,naming,attention,reading,calculation,language,abstraction,delayed recall and orientation.Results:1.There were 69 subjects in the AD group,the incidence of WMH was 49.3%;36 subjects in the aMCI group,the incidence was 27.8%;37 subjects in the NC group,the incidence was 21.6%.There were statistically significant differences among the three groups in terms of age,gender,MMSE scores,MoCA scores,number of WMH,and total scores of WMH.2.In terms of WMH scores of whole brain,there are significant differences between the AD group and the NC group;In terms of WMH scores of periventricular,there are significant differences between the AD group and the NC group,the AD group and the aMCI group.In terms of WMH score of frontal lobe,there are significant differences between the AD group and the NC group;In terms of WMH scores of parietal,there are significant differences between the AD group and the NC group,the AD group and the aMCI group.3.WMH scores of the whole brain were positively correlated with age,and the older the subject was,the higher the WMH scores of the whole brain were.4.Age,gender,and total WMH scores had a significant influence on MoCA scores.And among them,age had a significant negative effect on MoCA scores,the older the age,the lower the MoCA scores;gender had a significant negative effect on MoCA scores.Compared with men,women had lower MoCA scores than that of men;the total WMH scores had a significant negative effect on MoCA scores.The higher the total WMH scores,the lower the MoCA scores.5.There were significant differences in total MoCA scores,visual space and executive function,naming,attention,reading,calculation,language,abstraction,delayed recall,and orientation scores between WMH group and non-WMH group in the periventricular;There were significant differences in the total MoCA scores,visual space and executive function,naming,calculation,abstraction and delayed recall scores between WMH group and non-WMH group in the frontal lobe.There were significant differences in total MoCA scores,visual space and executive function,reading and typing,calculation,abstraction,delayed recall,and directional scores between WMH group and non-WMH group in the parietal lobe.There were significant differences in calculation scores between WMH group and non-WMH group in the temporal lobe.Conclusions:1.Different parts of WMH had different damage to cognitive domain;The total WMH scores were significantly correlated with cognitive function.The higher the total WMH scores were,the lower the MoCA scores were,and the more severe the cognitive impairment was.2.WMH scores of the whole brain were positively correlated with age,and the older the subject was,the higher WMH scores of the whole brain were.3.Comparing AD group with aMCI group and AD group with NC group,there were statistical differences in periventricular and parietal lobe WMH,so periventricular and parietal lobe WMH were expected to be candidate indicators for AD diagnosis.