Published Online
on July 26, 2007

A more recent version of this article appeared on September 1, 2007

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Submitted on February 28, 2007
Accepted on March 13, 2007

Prevalence of Subcortical Vascular Lesions and Association With Executive Function in Mild Cognitive Impairment Subtypes

Stéphanie Bombois MD; Stéphanie Debette MD; Xavier Delbeuck PhD; Amélie Bruandet MD; Samuel Lepoittevin PsyP; Christine Delmaire MD, PhD; Didier Leys MD, PhD; and Florence Pasquier MD, PhD^*

From the Department of Neurology, EA 2691, Memory Centre (S.B., S.D., X.D., S.L., F.P.) and Stroke Unit (S.D., D.L.) and the Department of Neuroradiology (C.D.), Lille University Hospital; Inserm Unit 744, Pasteur Institute of Lille (A.B.), France.

^* To whom correspondence should be addressed. E-mail: pasquier{at}chru-lille.fr.

Background and Purpose—Subcortical hyperintensities (SH) have not been systematically evaluated in mild cognitive impairment (MCI). We sought to describe their frequency and distribution, and to test their association with cognitive characteristics in MCI patients.

Methods—We performed standardized neuropsychological tests and an MRI scan in 170 consecutive MCI patients. Medial temporal lobe atrophy and SH, including periventricular, lobar white matter, basal ganglia and infratentorial hyperintensities, were assessed with visual semiquantitative scales.

Results—The median age was 68.1 years (range: 45.5 to 87.0), and the median Mini-Mental State Examination score 28.0 (range: 26.0 to 30.0). MCI subtypes were amnestic single domain (21.2%), amnestic multiple domain (52.3%), nonamnestic single domain (21.8%), and nonamnestic multiple domain (4.7%). SH were found in 157 patients (92.6%); periventricular hyperintensities (80.6%) and lobar white matter hyperintensities (83.5%) were the most prominent locations. There was no association between SH and MCI subtypes. Executive dysfunction was independently associated with SH (odds ratio=2.53, 95% CI: 1.20 to 5.32), periventricular hyperintensities (odds ratio=2.51, 95% CI: 1.13 to 5.55), and white matter hyperintensities (odds ratio=2.08, 95% CI: 1.01 to 4.25).

Conclusions—The prevalence of SH is high in MCI patients, irrespective of MCI subtypes. SH (especially periventricular hyperintensities, and lobar white matter hyperintensities) are associated with executive dysfunction.

Key words: cognition • magnetic resonance imaging • mild cognitive impairment • subcortical vascular lesion

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