Study: MRI-detected lesions could predict dementia later in life

White matter hyperintensities present at midlife may allow scientists to more easily predict which individuals may develop cognitive impairment later in life, according to study results published Oct. 21 in PLoS One.

“The association between brain white matter lesions and cognitive impairment in old age is well established," wrote David Bunce, PhD, from the Centre for Mental Health Research at Australian National University in Canberra, Australia, and his colleagues. “However, little is known about this association in midlife.”

The authors focused their research on healthy, community-dwelling adults between the ages of 44 and 48 years and assessed whether an association between non-periventricular frontal, temporal, parietal and occipital lobe white matter hyperintensities identified via MRI and cognitive deficits could be observed in this younger cohort. They also assessed the effect white matter lesions had on performance of a range of cognitive measures.

Leveraging the PATH Through Life Project--a large-scale population-based study of age, cognition and health, biological and individual difference variables--the researchers offered MRI scans to a randomly selected subsample of 656 middle-aged participants. Of the 503 individuals that accepted, data from 428 with a mean age of 46.6 were used, consisting of 232 female and 196 male residents of the city of Canberra and surrounding areas.

The authors reported no difference in age, sex and years of education between those who had an MRI scan and those who did not and apart from white matter hyperintensities, no additional neuropathology was indicated by MRI.   

The participants were then administered both simple and choice reaction tasks and cognitive tasks, and the researchers measured intraindividual mean reaction time, attention and variability.

Frontal white matter lesions were significantly associated with greater intraindividual reaction time variability in women, while temporal white matter hyperintensities were associated with face recognition deficits in men, according to the authors. Parietal and occipital lobe lesions remained unrelated to cognitive performance, and the researchers noted that none of the findings differed when education and a range of health variables were taken into account.

While Bunce noted it is not certain whether middle-aged individuals presenting with white matter hyperintensities will go on to develop dementia, the study found that lesions in areas of the brain that deteriorate in dementia are present in some adults in their 40s.

In addition, while the lesions were detected via MRI, the researchers were able to predict which individuals had them based on the results of the reaction and cognitive tasks, as “significant correlations indicated white matter hyperintensities to be associated with poorer cognitive performance.” 

“The study lays open possibilities for screening, early detection and intervention in healthcare settings,” said Bunce. “The earlier we can intervene with people vulnerable to eventual dementia, the greater the chances of preventing or delaying the disease onset,” he concluded.

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