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Distinct profiles of cognitive impairment associated with different silent cerebrovascular lesions in hypertensive elderly Chinese

      Highlights

      • Strictly lobar cerebral microbleeds are linked to impaired language function.
      • Periventricular hyperintensities are associated with poor executive function.
      • Periventricular hyperintensities are linked to slow information processing speed.
      • Silent lacunes are not independently associated with cognitive deficits.
      • Different silent lesions may cause different patterns of cognitive impairment.

      Abstract

      Background/objectives

      Silent cerebrovascular lesions (SCLs) and their underlying pathology are now recognized as important causes of cognitive impairment in the elderly. However, the distinct profile of cognitive deficits associated with each type of SCLs remains unclear.

      Methods

      Of 497 otherwise healthy hypertensive elderly Chinese, 398 participants (mean age 72.0, ranging from 65 to 99, SD = 5.1) successfully completed a battery of structured neuropsychological tests and a multi-sequence 3 T MRI scanning. SCLs were rated independently. Correlations between each MRI marker and cognitive function were assessed using a series of linear regression models.

      Results

      Strictly lobar cerebral microbleeds were linked to impaired language function (B = −0.231, p < 0.05). Silent lacunes were associated with poor executive function, but the association disappeared after additional adjustment for white matter hyperintensities. White matter hyperintensities (especially periventricular hyperintensities) were associated with poor executive function (B = −0.126, p < 0.05) and slower information processing speed (B = −0.149, p < 0.05).

      Conclusion

      Different SCLs were associated with different patterns of cognitive deficits, indicating that different SCLs may have distinct impacts on cognitive performance.

      Keywords

      Abbreviations:

      CMBs (cerebral microbleeds), DWMHs (deep white matter hyperintensities), EF (executive function), IPS (information processing speed), PVHs (periventricular hyperintensities), SCLs (Silent cerebrovascular lesions), SLs (silent lacunes, WMHs - white matter hyperintensities)
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