COGNITIVE CORRELATES OF VENTRICULAR ENLARGEMENT AND CEREBRAL WHITE-MATTER LESIONS ON MAGNETIC-RESONANCE-IMAGING - THE ROTTERDAM STUDY

Background and Purpose Ventricular enlargement and white matter lesion s are frequent findings on cerebral magnetic resonance imaging scans o f elderly subjects. In demented subjects they seem related to the seve rity of the dementia, but in nondemented subjects their clinical signi ficance is less clear. We investigated the relation of size of the lat eral ventricles and white matter lesions with cognitive function in a population-based random sample of nondemented elderly persons. Methods The study population consisted of 90 subjects, aged 65 to 84 years, w ho were randomly selected from the cohort of the Rotterdam Study, and who were not demented. The presence of white matter lesions and the ve ntricle-to-brain ratio were assessed on magnetic resonance scans. Part icipants were tested with a neuropsychological battery that covered a broad range of cognitive functions. Results Ventricular enlargement an d white matter lesions were both and independently associated with poo rer performance on all tests. After adjustment for age and sex, ventri cular enlargement was significantly associated with worse scores on te sts assessing global cognitive function (Mini-Mental State Examination , P=.02; Groninger Intelligence Test, P=.01), memory (Word List Learni ng delayed recall, P=.03), and executive control functions (Stroop par t II, P=.02; Trail Making Test B, P<.01); for white matter lesions the differences were significant for tests measuring executive control fu nctions and mental speed (Trail Making Test A and B, P=.01 and P<.01, respectively; verbal fluency, P=.01), and memory (Word List Learning d elayed recall, P=.04). Conclusions This study suggests that white matt er lesions are primarily related to impairment of subcorticofrontal fu nctions, whereas enlargement of the lateral ventricles is associated w ith disturbances of cortical functions as well.