R. Schmidt et al., MAGNETIC-RESONANCE-IMAGING CEREBRAL ABNORMALITIES AND NEUROPSYCHOLOGIC TEST-PERFORMANCE IN ELDERLY HYPERTENSIVE SUBJECTS - A CASE-CONTROL STUDY, Archives of neurology, 52(9), 1995, pp. 905-910
Objective: To search for a morphologic basis of cognitive impairment p
ossibly associated with arterial hypertension using magnetic resonance
imaging and a demanding neuropsychologic test battery. Design: Case-c
ontrol comparison with age, length of education, presence of diabetes,
and presence of cardiac disease as matching criteria. Setting: Austri
an Stroke Prevention Study. Subjects: A total of 89 hypertensive subje
cts and 89 control subjects from a subset of 272 volunteers with no ne
urologic symptoms undergoing extensive diagnostic workup in a large-sc
ale stroke prevention study among randomly selected elderly community
members. Main Outcome Measures: Focal brain abnormalities and size of
ventricles and cortical sulci as assessed by magnetic resonance imagin
g and neuropsychological test scores. Results: Hypertensive subjects m
ore commonly showed areas of white matter hyperintensity and moderatel
y severe ventricular enlargement compared with controls. While no diff
erences were noted between the investigational groups in test results
of memory capacity and conceptualization, hypertensive subjects tended
to perform worse when assessed for attentional and visuopractical ski
lls. These differences became significant when comparing the brain-dam
aged subsets of patients and controls with their counterparts without
cerebral changes. The pattern and extent of neuropsychologic deficits
was similar in hypertensive and normotensive subjects with abnormal ma
gnetic resonance imaging scans. Conclusion: Our data strongly suggest
the high rate of brain abnormalities among hypertensive subjects as th
e cause of their subtle neuropsychological dysfunction.