Journal
STROKE
Volume 39, Issue 3, Pages 800-805Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/STROKEAHA.107.484147
Keywords
leukoaraiosis; silent stroke; vascular cognitive impairment
Categories
Funding
- NCRR NIH HHS [M01 RR00645, M01 RR000645] Funding Source: Medline
- NIA NIH HHS [L30 AG024818-01, P30 AG010129-18, P30 AG010129, L30 AG024818-02, L30 AG024818] Funding Source: Medline
- NINDS NIH HHS [R01 NS029993-15, R01 NS 29993, R01 NS029993] Funding Source: Medline
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Background and Purpose - We examined white matter hyperintensity volume ( WMHV) and subclinical infarction ( no history of clinical stroke; SI) in relation to performance on tests of sequencing, cognitive flexibility, and sensorimotor ability. Methods - The Northern Manhattan Study includes a stroke-free community-based sample of Hispanic, Black, and White participants. A subsample ( n = 656) has undergone measurement of WMHV, SI, and neuropsychological testing. Linear regression was used to examine WMHV and SI in relation to performance on tests of sequencing as measured by Color Trails 1, cognitive flexibility as measured by Color Trails 2, and sensorimotor ability as measured by Grooved Pegboard, using generalized estimating equations ( GEE) to account for the correlation among the cognitive tests and other covariates. Results - Considering performance on the tests of sequencing, cognitive flexibility, and sensorimotor ability simultaneously using GEE, WMHV and subclinical infarction were each associated with worse cognitive performance globally. There was a threshold effect for WMHV with those in the upper quartile performing significantly worse on the tests of cognitive flexibility and sensorimotor ability. Those with frontal SI performed worse on the test of cognitive flexibility and those with deep SI, worse on the test of sequencing. Conclusions - Both SI and WMHV were associated with globally worse cognitive performance. Participants with WMH affecting more than 0.75% of cranial volume had significantly slower performance on a task of cognitive flexibility and sensorimotor ability than those in the lowest quartile. The effects of SI on cognitive performance varied by location.
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