TY - JOUR
T1 - Presence and progression of white matter hyperintensities and cognition A meta-analysis
AU - Kloppenborg, Raoul P.
AU - Nederkoorn, Paul J.
AU - Geerlings, Mirjam I.
AU - van den Berg, Esther
PY - 2014/6/10
Y1 - 2014/6/10
N2 - 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.
AB - 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.
U2 - 10.1212/WNL.0000000000000505
DO - 10.1212/WNL.0000000000000505
M3 - Review article
C2 - 24814849
SN - 0028-3878
VL - 82
SP - 2127
EP - 2138
JO - Neurology
JF - Neurology
IS - 23
ER -