White matter hyperintensity progression is associated with incident probable dementia or mild cognitive impairment

作     者：Adam de Havenon Kevin N Sheth Sharon D Yeatts Tanya N Turan Shyam Prabhakaran 

作者机构：NeurologyYale UniversityNew HavenConnecticutUSA Public Health SciencesMUSCCharlestonSouth CarolinaUSA NeurologyMUSCCharlestonSouth CarolinaUSA NeurologyUniversity of Chicago Pritzker School of MedicineChicagoIllinoisUSA 

出 版 物：《Stroke & Vascular Neurology》 (卒中与血管神经病学（英文）)

年 卷 期：2022年第7卷第4期

页      面：364-366页

核心收录：

学科分类：1002[医学-临床医学] 100205[医学-精神病与精神卫生学] 10[医学] 

主　　题：impairment Blood incident 

摘      要：Background White matter hyperintensity(WMH)on brain MRI is associated with developing dementia or mild cognitive impairment(MCI),but WMH progression over time has not been fully investigated as an independent risk factor.Methods We performed a post hoc analysis of the Systolic Blood Pressure Intervention Trial-Memory and Cognition in Decreased Hypertension(SPRINT MIND)trial.The primary outcome was incident probable dementia or MCI(dementia/MCI)before the follow-up MRI at 48 months from enrolment.The primary predictor was WMH progression,defined as the Z score difference between the follow-up and baseline WMH volumes.The secondary predictor was a binary WMH progression threshold(≥1.4 mL vs1.4 mL).Results Among the 433 included patients,33(7.6%)developed dementia/MCI.There were 156(36.0%)patients who met the WMH progression threshold of≥1.4 mL,in whom the rate of dementia/MCI was 12.8%(20/156)vs 4.7%(13/277)of patients with1.4 mL WMH progression(p=0.002).In multivariable logistic regression,the Z score of WMH progression was associated with dementia/MCI(OR 1.51,95%CI 1.12 to 2.04,p=0.007)as was the WMH progression threshold of≥1.4 mL(OR 2.89,95%CI 1.23 to 6.81,p=0.015).Conclusions In this post hoc analysis of SPRINT MIND,WMH progression over 48 months was associated with the development of probable dementia or MCI.