The Impact of Strategic White Matter Hyperintensity Lesion Location on Language.
Am J Geriatr Psychiatry
; 29(2): 156-165, 2021 02.
Article
em En
| MEDLINE
| ID: mdl-32651052
ABSTRACT
OBJECTIVE:
The impact of white matter hyperintensities (WMH) on language possibly depends on lesion location through disturbance of strategic white matter tracts. We examined the impact of WMH location on language in elderly Asians.DESIGN:
Cross-sectional.SETTING:
Population-based.PARTICIPANTS:
Eight-hundred nineteen residents of Singapore, ages (≥65 years). MEASUREMENTS Clinical, cognitive and 3T magnetic resonance imaging assessments were performed on all participants. Language was assessed using the Modified Boston Naming Test (MBNT) and Verbal Fluency (VF). Hypothesis-free region-of-interest-based (ROI) analyses based on major white matter tracts were used to determine the association between WMH location and language. Conditional dependencies between the regional WMH volumes and language were examined using Bayesian-network analysis.RESULTS:
ROI-based analyses showed that WMH located within the anterior thalamic radiation (mean difference -0.12, 95% confidence interval [CI] -0.22; -0.02, pâ¯=â¯0.019) and uncinate fasciculus (mean difference -0.09, 95% CI -0.18; -0.01, pâ¯=â¯0.022) in the left hemisphere were significantly associated with worse VF but did not survive multiple testing. Conversely, WMH volume in the left cingulum of cingulate gyrus was significantly associated with MBNT performance (mean difference -0.09, 95% CI -0.17; -0.02, pâ¯=â¯0.016). Bayesian-network analyses confirmed the left cingulum of cingulate gyrus as a direct determinant of MBNT performance.CONCLUSION:
Our findings identify the left cingulum of cingulate gyrus as a strategic white matter tract for MBNT, suggesting that language - is sensitive to subcortical ischemic damage. Future studies on the role of sporadic ischemic lesions and vascular cognitive impairment should not only focus on total WMH volume but should also take WMH lesion location into account when addressing language.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Substância Branca
/
Idioma
Tipo de estudo:
Observational_studies
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Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
País/Região como assunto:
Asia
Idioma:
En
Revista:
Am J Geriatr Psychiatry
Assunto da revista:
GERIATRIA
/
PSIQUIATRIA
Ano de publicação:
2021
Tipo de documento:
Article