Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2019, vol. 28, nr 12, December, p. 1705–1710

doi: 10.17219/acem/110324

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Cognitive features of white matter lesions accompanied by different risk factors of cerebrovascular diseases

Yafei Shangguan1,A,C,D,E,F, Tao Xiong1,B,C,F, Changwei Jiang1,C,F, Wei Chen1,C,F, Yan Zhang1,B,F, Yongpin Zhao1,B,F, Guiyin Zhou1,C,F, Yulan Fan1,C,F, Weimin Liu1,E,F

1 First People’s Hospital of Guiyang, China


Background. The relationship between different risk factors and the cognitive impairment of white matter lesions (WML) remains poorly understood.
Objectives. To investigate the features of cognitive impairment of patients diagnosed with WML accompanied by different risk factors of cerebrovascular diseases.
Material and Methods. A total of 157 cases of WML patients were divided into no risk factor group (n = 26), hypertension group (n = 35), diabetes mellitus group (n = 27), dyslipidemia group (n = 30), and mixed factors group (n = 39).
Results. The severity of WML (Fazekas score) in the hypertension and mixed factors groups was higher than in the non-risk factors group. The Montreal Cognitive Assessment (MoCA) scores in the hypertension and mixed factors groups were lower than in the non-risk factors group. The scores of MoCA, immediate memory and delayed recall in the hypertension and mixed factors groups with Fazekas score ≥3 were lower than in the peer group with Fazekas score <3. The scores of MoCA and immediate memory in the hypertension and mixed factors groups with Fazekas score ≥3 were lower than in the non-risk factors group with Fazekas score ≥3.
Conclusion. Hypertension aggravates the severity of WML and cognitive impairment. The severity of WML is positively correlated with the severity of cognitive impairment accompanied by these risk factors.

Key words

cerebrovascular disease, cognitive impairment, atherosclerosis risk factors, white matter lesions

References (33)

  1. O’Brien JT. Clinical significance of white matter changes. Am J Geriatr Psychiatry. 2014;22(2):133–137.
  2. Miki Y, Sakamoto S. Age-related white matter lesions (leukoaraiosis): An update [in Japanese]. Brain Nerve. 2013;65(7):789–799.
  3. Scott JA, Braskie MN, Tosun D, et al; Alzheimer’s Disease Neuroimaging Initiative. Cerebral amyloid and hypertension are independently associated with white matter lesions in elderly. Front Aging Neurosci. 2015;7:221.
  4. Bowler JV. The concept of vascular cognitive impairment. J Neurol Sci. 2002;203–204:11–15.
  5. Akiguchi I, Yamamoto Y. Vascular mechanisms of cognitive impairment: Roles of hypertension and subsequent small vessel disease under sympathetic influences. Hypertens Res. 2010;33(1):29–31.
  6. Xu W, Qiu C, Gatz M, Pedersen NL, Johansson B, Fratiglioni L. Mid- and late-life diabetes in relation to the risk of dementia: A population-based twin study. Diabetes. 2009;58(1):71–77.
  7. Brickman AM, Zimmerman ME, Paul RH, et al. Regional white matter and neuropsychological functioning across the adult lifespan. Biol Psychiatry. 2006;60(5):444–453.
  8. Fazekas F, Chawluk JB, Alavi A, Hurtig HI, Zimmerman RA. MR signal abnormalities at 1.5 T in Alzheimer’s dementia and normal aging. AJR Am J Roentgenol. 1987;149(2):351–356.
  9. Prins ND, van Dijk EJ, den Heijer T, et al. Cerebral small-vessel disease and decline in information processing speed, executive function and memory. Brain. 2005;128(Pt 9):2034–2041.
  10. Benedictus MR, van Harten AC, Leeuwis AE, et al. White matter hyperintensities relate to clinical progression in subjective cognitive decline. Stroke. 2015;46(9):2661–2664.
  11. Li J, Hu W. Glucose metabolism measured by positron emission tomography is reduced in patients with white matter presumably ischemic lesions. Med Sci Monit. 2014;20:1525–1530.
  12. Sierra C. Essential hypertension, cerebral white matter pathology and ischemic stroke. Curr Med Chem. 2014;21(19):2156–2164.
  13. Hanon O. Hypertension and dementia [in French]. Ann Cardiol Angeiol (Paris). 2014;63(3):204–208.
  14. Liu Z, Zhao Y, Zhang H, et al. Excessive variability in systolic blood pressure that is self-measured at home exacerbates the progression of brain white matter lesions and cognitive impairment in the ­oldest old. Hypertens Res. 2016;39(4):245–253.
  15. Peng J, Lu F, Wang Z, et al. Excessive lowering of blood pressure is not beneficial for progression of brain white matter hyperintensive and cognitive impairment in elderly hypertensive patients: 4-year follow-up study. J Am Med Dir Assoc. 2014;15(12):904–910.
  16. Tullberg M, Fletcher E, DeCarli C, et al. White matter lesions impair frontal lobe function regardless of their location. Neurology. 2004;63(2):246–253.
  17. Williamson JD, Launer LJ, Bryan RN, et al; Action to Control Cardiovascular Risk in Diabetes Memory in Diabetes Investigators. Cognitive function and brain structure in persons with type 2 diabetes mellitus after intensive lowering of blood pressure and lipid levels: A randomized clinical trial. JAMA Intern Med. 2014;174(3):324–333.
  18. Defrancesco M, Marksteiner J, Deisenhammer E, Kemmler G, Djurdjevic T, Schocke M. Impact of white matter lesions and cognitive deficits on conversion from mild cognitive impairment to Alzheimer’s disease. J Alzheimers Dis. 2013;34(3):665–672.
  19. Devine ME, Fonseca JA, Walker Z. Do cerebral white matter lesions influence the rate of progression from mild cognitive impairment to dementia? Int Psychogeriatr. 2013;25(1):120–127.
  20. Maillard P, Carmichael O, Fletcher E, Reed B, Mungas D, DeCarli C. Coevolution of white matter hyperintensities and cognition in the elderly. Neurology. 2012;79(5):442–448.
  21. Prins ND, van Dijk EJ, den Heijer T, et al. Cerebral white matter lesions and the risk of dementia. Arch Neurol. 2004;61(10):1531–1534.
  22. Loeb C, Gandolfo C, Croce R, Conti M. Dementia associated with lacunar infarction. Stroke. 1992;23(9):1225–1229.
  23. Te M, Zhao E, Zheng X, Sun Q, Qu C. Leukoaraiosis with mild cognitive impairment. Neurol Res. 2015;37(5):410–414.
  24. Zi W, Duan D, Zheng J. Cognitive impairments associated with periventricular white matter hyperintensities are mediated by cortical atrophy. Acta Neurol Scand. 2014;130(3):178–187.
  25. Vasquez BP, Zakzanis KK. The neuropsychological profile of vascular cognitive impairment not demented: A meta-analysis. J Neuropsychol. 2015;9(1):109–136.
  26. Mortamais M, Artero S, Ritchie K. Cerebral white matter hyperintensities in the prediction of cognitive decline and incident dementia. Int Rev Psychiatry. 2013;25(6):686–698.
  27. Mortamais M, Portet F, Brickman AM, et al. Education modulates the impact of white matter lesions on the risk of mild cognitive impairment and dementia. Am J Geriatr Psychiatry. 2014;22(11):1336–1345.
  28. Pantoni L, Fierini F, Poggesi A. Impact of cerebral white matter changes on functionality in older adults: An overview of the LADIS Study results and future directions. Geriatr Gerontol Int. 2015;15(Suppl 1):10–16.
  29. Morley JE. White matter lesions (leukoaraiosis): A major cause of falls. J Am Med Dir Assoc. 2015;16(6):441–443.
  30. Ogama N, Sakurai T, Shimizu A, Toba K. Regional white matter lesions predict falls in patients with amnestic mild cognitive impairment and Alzheimer’s disease. J Am Med Dir Assoc. 2014;15(1):36–41.
  31. Al-Mashhadi S, Simpson JE, Heath PR, et al; Medical Research Council Cognitive Function and Ageing Study. Oxidative glial cell damage associated with white matter lesions in the aging human brain. Brain Pathol. 2015;25(5):565–574.
  32. Ueno Y, Koike M, Shimada Y, et al. L-carnitine enhances axonal plasticity and improves white-matter lesions after chronic hypoperfusion in rat brain. J Cereb Blood Flow Metab. 2015;35(3):382–391.
  33. Calabro RS, Gervasi G, Baglieri A, Furnari A, Marino S, Bramanti P. Is high oral dose L-arginine intake effective in leukoaraiosis? Preliminary data, study protocol and expert’s opinion. Curr Aging Sci. 2013;6(2):170–177.