How Do Different Forms of Vascular Brain Injury Relate to Cognition in a Memory Clinic Population: The TRACE-VCI Study

Jooske M. F. Boomsma; Lieza G. Exalto; TRACE-VCI Study Grp; Frederik Barkhof; Esther van den Berg; Jeroen de Bresser; Rutger Heinen; Anna E. Leeuwis; Niels D. Prins; Philip Scheltens; Henry C. Weinstein; Wiesje M. van der Flier; Geert Jan Biessels; M. R. Benedictus; J. Bremer; J. Leijenaar; B. M. Tijms; M. P. Wattjes; C. E. Teunissen; T. Koene; D. A. Ferro; C. J. M. Frijns; O. N. Groeneveld; N. M. van Kalsbeek; J. H. Verwer; H. J. Kuijf; H. L. Koek

doi:10.3233/JAD-180696

How Do Different Forms of Vascular Brain Injury Relate to Cognition in a Memory Clinic Population: The TRACE-VCI Study

Jooske M. F. Boomsma, Lieza G. Exalto, TRACE-VCI Study Grp, Frederik Barkhof, Esther van den Berg, Jeroen de Bresser, Rutger Heinen, Anna E. Leeuwis, Niels D. Prins, Philip Scheltens, Henry C. Weinstein, Wiesje M. van der Flier, Geert Jan Biessels^*, M. R. Benedictus, J. Bremer, J. Leijenaar, B. M. Tijms, M. P. Wattjes, C. E. Teunissen, T. KoeneD. A. Ferro, C. J. M. Frijns, O. N. Groeneveld, N. M. van Kalsbeek, J. H. Verwer, H. J. Kuijf, H. L. Koek

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

5 Citations (Scopus)

Abstract

Background: Memory clinic patients frequently present with different forms of vascular brain injury due to different etiologies, often co-occurring with Alzheimer's disease (AD) pathology.

Objective: We studied how cognition was affected by different forms of vascular brain injury, possibly in interplay with AD pathology.

Methods: We included 860 memory clinic patients with vascular brain injury on magnetic resonance imaging (MRI), receiving a standardized evaluation including cerebrospinal fluid (CSF) biomarker analyses (n = 541). The cognitive profile of patients with different forms of vascular brain injury on MRI (moderate/severe white matter hyperintensities (WMH) (n = 398), microbleeds (n = 368), lacunar (n = 188) and non-lacunar (n = 96) infarct(s), macrobleeds (n = 16)) was assessed by: 1) comparison of all these different forms of vascular brain injury with a reference group (patients with only mild WMH (n = 205) without other forms of vascular brain injury), using linear regression analyses also stratified for CSF biomarker AD profile and 2) multivariate linear regression analysis.

Results: The cognitive profile was remarkably similar across groups. Compared to the reference group effect sizes on all domains were < 0.2 with narrow 95% confidence intervals, except for non-lacunar infarcts on information processing speed (age, sex, and education adjusted mean difference from reference group (beta: -0.26, p = 0.05). Results were similar in the presence (n = 300) or absence (n = 241) of biomarker co-occurring AD pathology. In multivariate linear regression analysis, higher WMH burden was related to a slightly worse performance on attention and executive functioning (beta: -0.08, p = 0.02) and working memory (beta: -0.08, p = 0.04).

Conclusion: Although different forms of vascular brain injury have different etiologies and different patterns of cerebral damage, they show a largely similar cognitive profile in memory clinic patients regardless of co-occurring AD pathology.

Original language	English
Pages (from-to)	1273-1286
Number of pages	14
Journal	Journal of Alzheimers Disease
Volume	68
Issue number	3
DOIs	https://doi.org/10.3233/JAD-180696
Publication status	Published - 2019

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Boomsma, J. M. F., Exalto, L. G., TRACE-VCI Study Grp, Barkhof, F., van den Berg, E., de Bresser, J., Heinen, R., Leeuwis, A. E., Prins, N. D., Scheltens, P., Weinstein, H. C., van der Flier, W. M., Biessels, G. J., Benedictus, M. R., Bremer, J., Leijenaar, J., Tijms, B. M., Wattjes, M. P., Teunissen, C. E., ... Koek, H. L. (2019). How Do Different Forms of Vascular Brain Injury Relate to Cognition in a Memory Clinic Population: The TRACE-VCI Study. Journal of Alzheimers Disease, 68(3), 1273-1286. https://doi.org/10.3233/JAD-180696

@article{d57e5c8a65544a93ba75ae27584b0949,

title = "How Do Different Forms of Vascular Brain Injury Relate to Cognition in a Memory Clinic Population: The TRACE-VCI Study",

abstract = "Background: Memory clinic patients frequently present with different forms of vascular brain injury due to different etiologies, often co-occurring with Alzheimer's disease (AD) pathology.Objective: We studied how cognition was affected by different forms of vascular brain injury, possibly in interplay with AD pathology.Methods: We included 860 memory clinic patients with vascular brain injury on magnetic resonance imaging (MRI), receiving a standardized evaluation including cerebrospinal fluid (CSF) biomarker analyses (n = 541). The cognitive profile of patients with different forms of vascular brain injury on MRI (moderate/severe white matter hyperintensities (WMH) (n = 398), microbleeds (n = 368), lacunar (n = 188) and non-lacunar (n = 96) infarct(s), macrobleeds (n = 16)) was assessed by: 1) comparison of all these different forms of vascular brain injury with a reference group (patients with only mild WMH (n = 205) without other forms of vascular brain injury), using linear regression analyses also stratified for CSF biomarker AD profile and 2) multivariate linear regression analysis.Results: The cognitive profile was remarkably similar across groups. Compared to the reference group effect sizes on all domains were < 0.2 with narrow 95% confidence intervals, except for non-lacunar infarcts on information processing speed (age, sex, and education adjusted mean difference from reference group (beta: -0.26, p = 0.05). Results were similar in the presence (n = 300) or absence (n = 241) of biomarker co-occurring AD pathology. In multivariate linear regression analysis, higher WMH burden was related to a slightly worse performance on attention and executive functioning (beta: -0.08, p = 0.02) and working memory (beta: -0.08, p = 0.04).Conclusion: Although different forms of vascular brain injury have different etiologies and different patterns of cerebral damage, they show a largely similar cognitive profile in memory clinic patients regardless of co-occurring AD pathology.",

author = "Boomsma, {Jooske M. F.} and Exalto, {Lieza G.} and {TRACE-VCI Study Grp} and Frederik Barkhof and {van den Berg}, Esther and {de Bresser}, Jeroen and Rutger Heinen and Leeuwis, {Anna E.} and Prins, {Niels D.} and Philip Scheltens and Weinstein, {Henry C.} and {van der Flier}, {Wiesje M.} and Biessels, {Geert Jan} and Benedictus, {M. R.} and J. Bremer and J. Leijenaar and Tijms, {B. M.} and Wattjes, {M. P.} and Teunissen, {C. E.} and T. Koene and Ferro, {D. A.} and Frijns, {C. J. M.} and Groeneveld, {O. N.} and {van Kalsbeek}, {N. M.} and Verwer, {J. H.} and Kuijf, {H. J.} and Koek, {H. L.}",

year = "2019",

doi = "10.3233/JAD-180696",

language = "English",

volume = "68",

pages = "1273--1286",

journal = "Journal of Alzheimers Disease",

issn = "1387-2877",

publisher = "IOS Press BV",

number = "3",

}

Boomsma, JMF, Exalto, LG, TRACE-VCI Study Grp, Barkhof, F, van den Berg, E, de Bresser, J, Heinen, R, Leeuwis, AE, Prins, ND, Scheltens, P, Weinstein, HC, van der Flier, WM, Biessels, GJ, Benedictus, MR, Bremer, J, Leijenaar, J, Tijms, BM, Wattjes, MP, Teunissen, CE, Koene, T, Ferro, DA, Frijns, CJM, Groeneveld, ON, van Kalsbeek, NM, Verwer, JH, Kuijf, HJ & Koek, HL 2019, 'How Do Different Forms of Vascular Brain Injury Relate to Cognition in a Memory Clinic Population: The TRACE-VCI Study', Journal of Alzheimers Disease, vol. 68, no. 3, pp. 1273-1286. https://doi.org/10.3233/JAD-180696

TY - JOUR

T1 - How Do Different Forms of Vascular Brain Injury Relate to Cognition in a Memory Clinic Population

T2 - The TRACE-VCI Study

AU - Boomsma, Jooske M. F.

AU - Exalto, Lieza G.

AU - TRACE-VCI Study Grp

AU - Barkhof, Frederik

AU - van den Berg, Esther

AU - de Bresser, Jeroen

AU - Heinen, Rutger

AU - Leeuwis, Anna E.

AU - Prins, Niels D.

AU - Scheltens, Philip

AU - Weinstein, Henry C.

AU - van der Flier, Wiesje M.

AU - Biessels, Geert Jan

AU - Benedictus, M. R.

AU - Bremer, J.

AU - Leijenaar, J.

AU - Tijms, B. M.

AU - Wattjes, M. P.

AU - Teunissen, C. E.

AU - Koene, T.

AU - Ferro, D. A.

AU - Frijns, C. J. M.

AU - Groeneveld, O. N.

AU - van Kalsbeek, N. M.

AU - Verwer, J. H.

AU - Kuijf, H. J.

AU - Koek, H. L.

PY - 2019

Y1 - 2019

N2 - Background: Memory clinic patients frequently present with different forms of vascular brain injury due to different etiologies, often co-occurring with Alzheimer's disease (AD) pathology.Objective: We studied how cognition was affected by different forms of vascular brain injury, possibly in interplay with AD pathology.Methods: We included 860 memory clinic patients with vascular brain injury on magnetic resonance imaging (MRI), receiving a standardized evaluation including cerebrospinal fluid (CSF) biomarker analyses (n = 541). The cognitive profile of patients with different forms of vascular brain injury on MRI (moderate/severe white matter hyperintensities (WMH) (n = 398), microbleeds (n = 368), lacunar (n = 188) and non-lacunar (n = 96) infarct(s), macrobleeds (n = 16)) was assessed by: 1) comparison of all these different forms of vascular brain injury with a reference group (patients with only mild WMH (n = 205) without other forms of vascular brain injury), using linear regression analyses also stratified for CSF biomarker AD profile and 2) multivariate linear regression analysis.Results: The cognitive profile was remarkably similar across groups. Compared to the reference group effect sizes on all domains were < 0.2 with narrow 95% confidence intervals, except for non-lacunar infarcts on information processing speed (age, sex, and education adjusted mean difference from reference group (beta: -0.26, p = 0.05). Results were similar in the presence (n = 300) or absence (n = 241) of biomarker co-occurring AD pathology. In multivariate linear regression analysis, higher WMH burden was related to a slightly worse performance on attention and executive functioning (beta: -0.08, p = 0.02) and working memory (beta: -0.08, p = 0.04).Conclusion: Although different forms of vascular brain injury have different etiologies and different patterns of cerebral damage, they show a largely similar cognitive profile in memory clinic patients regardless of co-occurring AD pathology.

AB - Background: Memory clinic patients frequently present with different forms of vascular brain injury due to different etiologies, often co-occurring with Alzheimer's disease (AD) pathology.Objective: We studied how cognition was affected by different forms of vascular brain injury, possibly in interplay with AD pathology.Methods: We included 860 memory clinic patients with vascular brain injury on magnetic resonance imaging (MRI), receiving a standardized evaluation including cerebrospinal fluid (CSF) biomarker analyses (n = 541). The cognitive profile of patients with different forms of vascular brain injury on MRI (moderate/severe white matter hyperintensities (WMH) (n = 398), microbleeds (n = 368), lacunar (n = 188) and non-lacunar (n = 96) infarct(s), macrobleeds (n = 16)) was assessed by: 1) comparison of all these different forms of vascular brain injury with a reference group (patients with only mild WMH (n = 205) without other forms of vascular brain injury), using linear regression analyses also stratified for CSF biomarker AD profile and 2) multivariate linear regression analysis.Results: The cognitive profile was remarkably similar across groups. Compared to the reference group effect sizes on all domains were < 0.2 with narrow 95% confidence intervals, except for non-lacunar infarcts on information processing speed (age, sex, and education adjusted mean difference from reference group (beta: -0.26, p = 0.05). Results were similar in the presence (n = 300) or absence (n = 241) of biomarker co-occurring AD pathology. In multivariate linear regression analysis, higher WMH burden was related to a slightly worse performance on attention and executive functioning (beta: -0.08, p = 0.02) and working memory (beta: -0.08, p = 0.04).Conclusion: Although different forms of vascular brain injury have different etiologies and different patterns of cerebral damage, they show a largely similar cognitive profile in memory clinic patients regardless of co-occurring AD pathology.

U2 - 10.3233/JAD-180696

DO - 10.3233/JAD-180696

M3 - Article

SN - 1387-2877

VL - 68

SP - 1273

EP - 1286

JO - Journal of Alzheimers Disease

JF - Journal of Alzheimers Disease

IS - 3

ER -

How Do Different Forms of Vascular Brain Injury Relate to Cognition in a Memory Clinic Population: The TRACE-VCI Study

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