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Heterogeneity in mild cognitive impairment: Differences in neuropsychological profile and associated white matter lesion pathology

Published online by Cambridge University Press:  01 November 2009

LISA DELANO-WOOD ,
MARK W. BONDI ,
JOSHUA SACCO ,
NORM ABELES ,
AMY J. JAK ,
DAVID J. LIBON  and
ANDREA BOZOKI
LISA DELANO-WOOD*
Affiliation:
Department of Psychiatry, School of Medicine, University of California–San Diego, La Jolla, California Psychology Service, VA San Diego Healthcare System, La Jolla, California
MARK W. BONDI
Affiliation:
Department of Psychiatry, School of Medicine, University of California–San Diego, La Jolla, California Psychology Service, VA San Diego Healthcare System, La Jolla, California
JOSHUA SACCO
Affiliation:
Deparment of Psychology, Michigan State University, East Lansing, Michigan
NORM ABELES
Affiliation:
Deparment of Psychology, Michigan State University, East Lansing, Michigan
AMY J. JAK
Affiliation:
Department of Psychiatry, School of Medicine, University of California–San Diego, La Jolla, California Psychology Service, VA San Diego Healthcare System, La Jolla, California
DAVID J. LIBON
Affiliation:
Department of Neurology, Drexel University, Philadelphia, Pennsylvania
ANDREA BOZOKI
Affiliation:
Department of Neurology, Michigan State University, East Lansing, Michigan
*
*Correspondence and reprint requests to: Lisa Delano-Wood, Ph.D., VA San Diego Healthcare System, Building 13 – 151B, 3350 La Jolla Village Drive, San Diego, CA 92161. E-mail: ldelano@ucsd.edu
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Abstract

This study examined whether distinct neuropsychological profiles could be delineated in a sample with Mild Cognitive Impairment (MCI) and whether white matter lesion (WML) burden contributed to MCI group differences. A heterogeneous, clinical sample of 70 older adults diagnosed with MCI was assessed using cognitive scores, and WML was quantified using a semi-automated, volumetric approach on T2-weighted fluid-attenuated inversion recovery (FLAIR) images. Using cluster and discriminant analyses, three distinct groups (Memory/Language, Executive/Processing Speed, and Pure Memory) were empirically derived based on cognitive scores. Results also showed a dose dependent relationship of WML burden to MCI subgroup, with the Executive/Processing Speed subgroup demonstrating significantly higher levels of WML pathology when compared to the other subgroups. In addition, there was a dissociation of lesion type by the two most impaired subgroups (Memory/Language and Executive/Processing Speed) such that the Memory/Language subgroup showed higher periventricular lesion (PVL) and lower deep white matter lesion (DWML) volumes, whereas the Executive/Processing Speed demonstrated higher DWML and lower PVL volumes. Results demonstrate that distinct MCI subgroups can be empirically derived and reliably differentiated from a heterogeneous MCI sample, and that these profiles differ according to WML burden. Overall, findings suggest different underlying pathologies within MCI and contribute to our understanding of MCI subtypes. (JINS, 2009, 15, 906–914.)

Keywords

Mild cognitive impairmentMCINeuropsychologyWMLWhite matter lesionWhite matter hyperintensityAgingCognition
Type
MCI Series
Information
Journal of the International Neuropsychological Society , Volume 15 , Issue 6 , November 2009 , pp. 906 - 914
Copyright
Copyright © The International Neuropsychological Society 2009

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