How Do Different Forms of Vascular Brain Injury Relate to Cognition in a Memory Clinic Population: The TRACE-VCI Study

Jooske M. F. Boomsma, Lieza G. Exalto, Frederik Barkhof, Esther van den Berg, Jeroen de Bresser, Rutger Heinen, Anna E. Leeuwis, Niels D. Prins, Philip Scheltens, Henry C. Weinstein, Wiesje M. van der Flier, Geert Jan Biessels

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Memory clinic patients frequently present with different forms of vascular brain injury due to different etiologies, often co-occurring with Alzheimer's disease (AD) pathology. Objective: We studied how cognition was affected by different forms of vascular brain injury, possibly in interplay with AD pathology. Methods: We included 860 memory clinic patients with vascular brain injury on magnetic resonance imaging (MRI), receiving a standardized evaluation including cerebrospinal fluid (CSF) biomarker analyses (n=541). The cognitive profile of patients with different forms of vascular brain injury on MRI (moderate/severe white matter hyperintensities (WMH) (n=398), microbleeds (n=368), lacunar (n=188) and non-lacunar (n=96) infarct(s), macrobleeds (n=16)) was assessed by: 1) comparison of all these different forms of vascular brain injury with a reference group (patients with only mild WMH (n=205) without other forms of vascular brain injury), using linear regression analyses also stratified for CSF biomarker AD profile and 2) multivariate linear regression analysis. Results: The cognitive profile was remarkably similar across groups. Compared to the reference group effect sizes on all domains were <0.2 with narrow 95% confidence intervals, except for non-lacunar infarcts on information processing speed (age, sex, and education adjusted mean difference from reference group (β: - 0.26, p=0.05). Results were similar in the presence (n=300) or absence (n=241) of biomarker co-occurring AD pathology. In multivariate linear regression analysis, higher WMH burden was related to a slightly worse performance on attention and executive functioning (β: - 0.08, p=0.02) and working memory (β: - 0.08, p=0.04). Conclusion: Although different forms of vascular brain injury have different etiologies and different patterns of cerebral damage, they show a largely similar cognitive profile in memory clinic patients regardless of co-occurring AD pathology.
Original languageEnglish
Pages (from-to)1273-1286
JournalJournal of Alzheimer's Disease
Volume68
Issue number3
Early online date18 Mar 2019
DOIs
Publication statusPublished - 2019

Cite this

@article{efad03069d884e2d81bd03efdd74f01a,
title = "How Do Different Forms of Vascular Brain Injury Relate to Cognition in a Memory Clinic Population: The TRACE-VCI Study",
abstract = "Memory clinic patients frequently present with different forms of vascular brain injury due to different etiologies, often co-occurring with Alzheimer's disease (AD) pathology. Objective: We studied how cognition was affected by different forms of vascular brain injury, possibly in interplay with AD pathology. Methods: We included 860 memory clinic patients with vascular brain injury on magnetic resonance imaging (MRI), receiving a standardized evaluation including cerebrospinal fluid (CSF) biomarker analyses (n=541). The cognitive profile of patients with different forms of vascular brain injury on MRI (moderate/severe white matter hyperintensities (WMH) (n=398), microbleeds (n=368), lacunar (n=188) and non-lacunar (n=96) infarct(s), macrobleeds (n=16)) was assessed by: 1) comparison of all these different forms of vascular brain injury with a reference group (patients with only mild WMH (n=205) without other forms of vascular brain injury), using linear regression analyses also stratified for CSF biomarker AD profile and 2) multivariate linear regression analysis. Results: The cognitive profile was remarkably similar across groups. Compared to the reference group effect sizes on all domains were <0.2 with narrow 95{\%} confidence intervals, except for non-lacunar infarcts on information processing speed (age, sex, and education adjusted mean difference from reference group (β: - 0.26, p=0.05). Results were similar in the presence (n=300) or absence (n=241) of biomarker co-occurring AD pathology. In multivariate linear regression analysis, higher WMH burden was related to a slightly worse performance on attention and executive functioning (β: - 0.08, p=0.02) and working memory (β: - 0.08, p=0.04). Conclusion: Although different forms of vascular brain injury have different etiologies and different patterns of cerebral damage, they show a largely similar cognitive profile in memory clinic patients regardless of co-occurring AD pathology.",
author = "Boomsma, {Jooske M. F.} and Exalto, {Lieza G.} and Frederik Barkhof and {van den Berg}, Esther and {de Bresser}, Jeroen and Rutger Heinen and Leeuwis, {Anna E.} and Prins, {Niels D.} and Philip Scheltens and Weinstein, {Henry C.} and {van der Flier}, {Wiesje M.} and Biessels, {Geert Jan}",
year = "2019",
doi = "10.3233/JAD-180696",
language = "English",
volume = "68",
pages = "1273--1286",
journal = "Journal of Alzheimer's Disease",
issn = "1387-2877",
publisher = "IOS Press",
number = "3",

}

How Do Different Forms of Vascular Brain Injury Relate to Cognition in a Memory Clinic Population : The TRACE-VCI Study. / Boomsma, Jooske M. F.; Exalto, Lieza G.; Barkhof, Frederik; van den Berg, Esther; de Bresser, Jeroen; Heinen, Rutger; Leeuwis, Anna E.; Prins, Niels D.; Scheltens, Philip; Weinstein, Henry C.; van der Flier, Wiesje M.; Biessels, Geert Jan.

In: Journal of Alzheimer's Disease, Vol. 68, No. 3, 2019, p. 1273-1286.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - How Do Different Forms of Vascular Brain Injury Relate to Cognition in a Memory Clinic Population

T2 - The TRACE-VCI Study

AU - Boomsma, Jooske M. F.

AU - Exalto, Lieza G.

AU - Barkhof, Frederik

AU - van den Berg, Esther

AU - de Bresser, Jeroen

AU - Heinen, Rutger

AU - Leeuwis, Anna E.

AU - Prins, Niels D.

AU - Scheltens, Philip

AU - Weinstein, Henry C.

AU - van der Flier, Wiesje M.

AU - Biessels, Geert Jan

PY - 2019

Y1 - 2019

N2 - Memory clinic patients frequently present with different forms of vascular brain injury due to different etiologies, often co-occurring with Alzheimer's disease (AD) pathology. Objective: We studied how cognition was affected by different forms of vascular brain injury, possibly in interplay with AD pathology. Methods: We included 860 memory clinic patients with vascular brain injury on magnetic resonance imaging (MRI), receiving a standardized evaluation including cerebrospinal fluid (CSF) biomarker analyses (n=541). The cognitive profile of patients with different forms of vascular brain injury on MRI (moderate/severe white matter hyperintensities (WMH) (n=398), microbleeds (n=368), lacunar (n=188) and non-lacunar (n=96) infarct(s), macrobleeds (n=16)) was assessed by: 1) comparison of all these different forms of vascular brain injury with a reference group (patients with only mild WMH (n=205) without other forms of vascular brain injury), using linear regression analyses also stratified for CSF biomarker AD profile and 2) multivariate linear regression analysis. Results: The cognitive profile was remarkably similar across groups. Compared to the reference group effect sizes on all domains were <0.2 with narrow 95% confidence intervals, except for non-lacunar infarcts on information processing speed (age, sex, and education adjusted mean difference from reference group (β: - 0.26, p=0.05). Results were similar in the presence (n=300) or absence (n=241) of biomarker co-occurring AD pathology. In multivariate linear regression analysis, higher WMH burden was related to a slightly worse performance on attention and executive functioning (β: - 0.08, p=0.02) and working memory (β: - 0.08, p=0.04). Conclusion: Although different forms of vascular brain injury have different etiologies and different patterns of cerebral damage, they show a largely similar cognitive profile in memory clinic patients regardless of co-occurring AD pathology.

AB - Memory clinic patients frequently present with different forms of vascular brain injury due to different etiologies, often co-occurring with Alzheimer's disease (AD) pathology. Objective: We studied how cognition was affected by different forms of vascular brain injury, possibly in interplay with AD pathology. Methods: We included 860 memory clinic patients with vascular brain injury on magnetic resonance imaging (MRI), receiving a standardized evaluation including cerebrospinal fluid (CSF) biomarker analyses (n=541). The cognitive profile of patients with different forms of vascular brain injury on MRI (moderate/severe white matter hyperintensities (WMH) (n=398), microbleeds (n=368), lacunar (n=188) and non-lacunar (n=96) infarct(s), macrobleeds (n=16)) was assessed by: 1) comparison of all these different forms of vascular brain injury with a reference group (patients with only mild WMH (n=205) without other forms of vascular brain injury), using linear regression analyses also stratified for CSF biomarker AD profile and 2) multivariate linear regression analysis. Results: The cognitive profile was remarkably similar across groups. Compared to the reference group effect sizes on all domains were <0.2 with narrow 95% confidence intervals, except for non-lacunar infarcts on information processing speed (age, sex, and education adjusted mean difference from reference group (β: - 0.26, p=0.05). Results were similar in the presence (n=300) or absence (n=241) of biomarker co-occurring AD pathology. In multivariate linear regression analysis, higher WMH burden was related to a slightly worse performance on attention and executive functioning (β: - 0.08, p=0.02) and working memory (β: - 0.08, p=0.04). Conclusion: Although different forms of vascular brain injury have different etiologies and different patterns of cerebral damage, they show a largely similar cognitive profile in memory clinic patients regardless of co-occurring AD pathology.

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UR - https://www.ncbi.nlm.nih.gov/pubmed/30909212

U2 - 10.3233/JAD-180696

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