Higher White-Matter Volume Linked to Mild Cognitive Impairment - EMJ

Higher White-Matter Volume Linked to Mild Cognitive Impairment

MRI has shown that increases in the white matter of the brain and ventricle volume may be risk factors for the progression of mild cognitive impairment (MCI) in recently published research. The USA-based team additionally found that presence of Type 2 diabetes (T2D) and abnormal beta-amyloid ratios in the cerebrospinal fluid (CSF) were associated with accelerated brain atrophy and earlier progression to MCI.  

This cohort study involved extracting data from the Biomarkers for Older Controls at Risk for Dementia (BIOCARD) cohort, initiated at the National Institutes of Health (NIH) from 1995–2005, and continued at Johns Hopkins University, Baltimore, Maryland, USA, from 2015–2023. All participants were cognitively normal at baseline. The participants whose structural magnetic brain imaging (MRI) of the brain and cerebrospinal fluid (CSF) measures were available for over 10 years were included. 

The research team found that study participants with high levels of atrophy in the white matter and enlargement in the ventricles demonstrated earlier progression from normal cognition to MCI symptom onset (hazard ratio [HR] for white matter: 1.86, and for ventricles: 1.71). There was an association between type 2 diabetes and progression to MCI (HR, 1.41) and with low CSF beta-amyloid peptide 42 to beta-amyloid 40 ratio (HR: 1.48); the combination of both of these risk factors had an even higher HR of 1.55. 

These findings have demonstrated that white-matter volume changes are “closely associated with cognitive function in ageing, suggesting that white-matter degeneration may play a crucial role in cognitive decline,” according to the authors. “[Our] results support the importance of identifying individuals who have accelerated brain atrophy to optimize strategies to prevent MCI,” they added. 

Reference  

Uchida Y et al. Acceleration of brain atrophy and progression from normal cognition to mild cognitive impairment. JAMA Netw Open. 2024;7(10):e2441505. 

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