ANTICARDIOLIPIN ANTIBODIES IN NORMAL SUBJECTS - NEUROPSYCHOLOGICAL CORRELATES AND MRI FINDINGS

Background and Purpose Our aim was to assess the association of elevat ed anticardiolipin antibody (aCL) titers with silent brain damage and cognitive functioning in middle-aged and elderly normal subjects. Meth ods We determined the IgM and IgG aCL titers from 233 randomly selecte d clinically normal participants of a population-based stroke preventi on study (age range, 44 to 82 years). aCL titers were categorized into negative (0 to 10 U/L), low positive (10 to 20 U/L), and moderately h igh positive (>20 vn). All participants underwent 1.5-T MRI and demand ing neuropsychological testing. Semiautomated measurements of the tota l white matter hyperintensity area and the size of ventricles and cort ical sulci were conducted. Results There were 180 subjects (77.3%) wit h negative, 35 (15.0%) with low positive, and 18 (7.7%) with moderatel y high positive aCL titers. The frequency and extent of focal and diff use brain abnormalities were not related to the aCL status of those ex amined. However, subjects with positive aCL results performed worse th an those with negative findings on almost all tests administered, and this effect was mainly IgG titer related. When an ANCOVA test and part ial correlations to correct for slight group differences in age and fo r the presence of major vascular risk factors were used, values of P<. 05 were noted on tests assessing mnemonic and visuopractical abilities . Conclusions Increased aCL titers in normal elderly persons may be as sociated with subtle neuropsychological dysfunction, but they do not a ppear to cause any morphological changes as demonstrated by MRI.