Joint effect of white matter lesions and hippocampal volumes on severity of cognitive decline: The 3C-Dijon MRI study

Ophélia Godin, Christophe Tzourio, Olivier Rouaud, Yicheng Zhu, Pauline Maillard, Florence Pasquier, Fabrice Crivello, Annick Alpérovitch, Bernard Mazoyer, Carole Dufouil
JAD. 2010-04-01; 20(2): 453-463
DOI: 10.3233/JAD-2010-1389

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1. J Alzheimers Dis. 2010;20(2):453-63. doi: 10.3233/JAD-2010-1389.

Joint effect of white matter lesions and hippocampal volumes on severity of
cognitive decline: the 3C-Dijon MRI study.

Godin O(1), Tzourio C, Rouaud O, Zhu Y, Maillard P, Pasquier F, Crivello F,
Alpérovitch A, Mazoyer B, Dufouil C.

Author information:
(1)Inserm, U708 Neuroepidemiology, Paris, France.

Several brain magnetic resonance imaging (MRI) changes are observed in older
individuals including white matter lesions (WML), silent brain infarcts (SBI),
and cerebral atrophy. Few studies, however, have assessed the combined
association of these changes on the severity of future cognitive decline. In the
prospective population-based 3C-Dijon MRI study, 1701 non-demented participants
aged 65 to 80 years at entry had a brain MRI. Information on WML, hippocampal
volumes, SBI presence, and brain parenchymal fraction were obtained. At 4-year
follow-up, participants were screened for cognitive decline and dementia.
Severity of cognitive decline was defined as none, moderate, or severe calculated
from neuropsychological test performance change. The relation between brain MRI
markers and longitudinal change in cognition was studied using polytomous
logistic regression and multiple linear regression models controlling for
potential confounders. Two-by-two interactions were tested including with the
apolipoprotein E genotype. At follow-up, 46 participants showed severe cognitive
deterioration and 224 participants showed moderate cognitive deterioration. In
multivariable analyses, risk of severe cognitive deterioration as well as the
cognitive decline rate were significantly increased in participants with higher
WML volume (p< 0.01) and smaller hippocampal volume (p< 0.01). The results
suggested that WML and hippocampal volumes had a cumulative effect on the future
level of cognitive decline. The APOE genotype was found to be an effect modifier
of this association. Vascular brain changes and degenerative processes coexist in
normal older individuals. The co-occurrence of degenerative and non-degenerative
pathologies could strongly affect the course of dementia expression.

DOI: 10.3233/JAD-2010-1389
PMID: 20164560 [Indexed for MEDLINE]

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