White matter hyperintensities mediate the association between blood-brain barrier leakage and information processing speed

Whitney M. Freeze, Heidi I. L. Jacobs, Joost J. de Jong, Inge C. M. Verheggen, Ed H. B. M. Gronenschild, Walter M. Palm, Erik I. Hoff, Joanna M. Wardlaw, Jacobus F. A. Jansen, Frans R. Verhey, Walter H. Backes*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Blood-brain barrier (BBB) leakage is considered an important underlying process in both cerebral small vessel disease (cSVD) and Alzheimer's disease (AD). The objective of this study was to examine associations between BBB leakage, cSVD, neurodegeneration, and cognitive performance across the spectrum from normal cognition to dementia. Leakage was measured with dynamic contrast-enhanced magnetic resonance imaging in 80 older participants (normal cognition, n = 32; mild cognitive impairment, n 34; clinical AD-type dementia, n = 14). Associations between leakage and white matter hyperintensity (WMH) volume, hippocampal volume, and cognition (information processing speed and memory performance) were examined with multivariable linear regression and mediation analyses. Leakage within the gray and white matter was positively associated with WMH volume (gray matter, p = 0.03; white matter, p = 0.01). A negative association was found between white matter BBB leakage and information processing speed performance, which was mediated by WMH volume. Leakage was not associated with hippocampal volume. WMH pathology is suggested to form a link between leakage and decline of information processing speed in older individuals with and without cognitive impairment. (C) 2019 Elsevier Inc. All rights reserved.

Original languageEnglish
Pages (from-to)113-122
Number of pages10
JournalNeurobiology of Aging
Volume85
DOIs
Publication statusPublished - Jan 2020

Keywords

  • Blood-brain barrier
  • Cognition
  • Hippocampus
  • Small vessel disease
  • White matter hyperintensities
  • SMALL-VESSEL DISEASE
  • MILD COGNITIVE IMPAIRMENT
  • PARTICIPANTS AGED 24-81
  • ALZHEIMERS-DISEASE
  • NATIONAL INSTITUTE
  • NORMATIVE DATA
  • DIAGNOSTIC GUIDELINES
  • SIGNAL ABNORMALITIES
  • DEMENTIA
  • EDUCATION

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