Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz

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Gewählte Publikation:

Schoenfelder, M.
White matter lesion progression, brain atrophy and cognition
[ Dissertation ] Medical University of Graz; 2005. pp.


Autor*innen der Med Uni Graz:
Kapeller Peter
Schmidt Reinhold

White matter lesions are patchy changes in the cerebral white matter of the centrum semi-ovale or directly adjacent to the ventricles. These changes are commonly seen in elderly subjects. White matter lesions are supposed to be associated with global and selective cognitive changes, gait impairment, balance impairment, depressed mood and urinary dysfunctions. All these factors may lead to disability in the elderly. Aims of Current Study: White matter lesions progress over time, but little is known about the impact of white matter lesions on cognition. Cross sectional studies found that white matter lesion volumes correlate with cognitive impairment and that they are associated with global brain atrophy but there exists no longitudinal data as to how white matter lesion progression and brain atrophy interact on cognitive functions in order to better understand the role of white matter damage on cognitive functioning and to shed light on the interactions between vascular and primary degenerative brain lesions on cognitive functions of older persons. Methods: The study population consisted of participants of the Austrian Stroke Prevention Study, a single centre, prospective follow-up study on the cerebral effects of vascular risk factors in the elderly population of the city of Graz, Austria. The study is purely descriptive. 329 elderly community-dwelling volunteers without previous strokes and dementia underwent serial MRI scanning and cognitive testing at baseline and 3- and 6-years follow-up. Changes in white matter lesion and brain prenchymal volumes were measured. Neuropsychological testing included Bäumlers Lern- und Gedächtnistest assessing for learning capacity and intermediate memory, the Wisconsin Card Sorting Test measuring conceptional reasoning, the Alters-Konzentrations-Test of Gatterer, form B of the Trail making Test, the Digit Span form the Wechsler Adult Intelligence Scale-Revised and a complex reaction time task assessing attention and speed, and the Perdues Pegboard test evaluating visuopractical skills. Results: After 6 years, the median white matter lesion load was 0.2 cm3 (IQR 0.0 to 0.80cm3) with a maximum of 31.4cm3. The median loss of brain volume was 2.3% (IQR 1.13 to 3.58%). Progression of white matter lesion volume at 3-year and 6-year follow-up was significantly correlated with loss of brain volume (p<0.0001).

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