Neurology: MRI reveals brain damage that may predict future memory loss

Areas of brain damage, indicated through white matter hyperintensity (WMH) volume and infarcts seen on brain MRI, which were originally thought to be related to stroke, may help doctors predict a person's risk of memory problems in old age, according to research published in today's issue of Neurology.

José Luchsinger, MD, from Columbia University Medical Center in New York City, and colleagues performed a brain MRI on 679 people age 65 years and older without dementia but with mild cognitive impairment. Participants underwent the brain scans, allowing scientists to look for small areas of brain damage called WMHs, often referred to as ministrokes. They also looked for infarcts, or areas of dead tissue usually called strokes.

The study found that people with WMH were nearly twice as likely to have mild cognitive impairment that included memory loss. However, people who revealed infarcts on their brain MRI were more likely to experience mild cognitive impairment in abilities other than memory loss.

The results remained the same regardless of a person's age, gender, ethnic group, education and if they had a gene thought to be a strong risk factor for dementia, called the ApoEe4 gene.

"The most interesting finding in this study was that white matter hyperintensities, or ministrokes, predicted memory problems, while strokes predicted non-memory problems," said Luchsinger.

"Traditionally, ministrokes and strokes are thought to have a common origin and to more strongly predict non-memory cognitive problems. There are an increasing number of studies challenging the idea that all WMHs are similar to strokes. The fact that WMHs more strongly predicted memory problems could challenge traditional views that WMHs are milder versions of stroke that are produced only by conditions such as high blood pressure," said Luchsinger.

Luchsinger said that more work is needed to understand WMHs and to identify which are related to stroke and which are related to other conditions, such as Alzheimer's disease. He believes this could eventually help doctors and researchers design preventive strategies for memory and other types of cognitive impairment.

The National Institutes of Health supported the study.

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