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Heterogeneity in mild cognitive impairment: Differences in neuropsychological profile and associated white matter lesion pathology
Open accessAbstract
This study examined whether distinct neuropsychological profiles could be delineated in a sample with Mild Cognitive Impairment (MCI) and whether white matter lesion (WML) burden contributed to MCI group differences. A heterogeneous, clinical sample of 70 older adults diagnosed with MCI was assessed using cognitive scores, and WML was quantified using a semi-automated, volumetric approach on T 2-weighted fluid-attenuated inversion recovery (FLAIR) images. Using cluster and discriminant analyses, three distinct groups (Memory/Language, Executive/Processing Speed, and Pure Memory) were empirically derived based on cognitive scores. Results also showed a dose dependent relationship of WML burden to MCI subgroup, with the Executive/Processing Speed subgroup demonstrating significantly higher levels of WML pathology when compared to the other subgroups. In addition, there was a dissociation of lesion type by the two most impaired subgroups (Memory/Language and Executive/Processing Speed) such that the Memory/Language subgroup showed higher periventricular lesion (PVL) and lower deep white matter lesion (DWML) volumes, whereas the Executive/Processing Speed demonstrated higher DWML and lower PVL volumes. Results demonstrate that distinct MCI subgroups can be empirically derived and reliably differentiated from a heterogeneous MCI sample, and that these profiles differ according to WML burden. Overall, findings suggest different underlying pathologies within MCI and contribute to our understanding of MCI subtypes. (JINS, 2009,15, 906–914.)
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“Applying these methods to different samples of individuals with clinically-diagnosed MCI, Delano-Wood et al. [27] and Libon et al. [28] independently identified three clusters that represented amnestic, dysexecutive, and mixed (i.e., memory and language deficits) MCI subtypes.”
From Neuropsychological Criteria for Mild Cognitive Impairment Improves Diagnostic Precision, Biomarker Associations, and Progression Rates (2014) · cites this paper as [27]
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“For instance, amnestic MCI is associated with greater cortical thinning of temporal structures,(44) while MCI with deficits in executive functioning is associated with white matter lesions.(45)”
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“[46] the “Executive/Processing Speed” subgroup had greater WML burden than the other subgroups, which would be consistent with the pattern of our findings in the vascular MCI group.”
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“…standpoint, the ability of neuropsychological criteria to capture these co-occurring processes could improve early detection of high-risk cognitive phenotypes, allowing for more precise prognostic counseling and earlier intervention (Delano-Wood et al., 2010; Ye et al., 2017; Zhang et al., 2015).”
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Metadata
- Authors
- DELANO-WOOD, L., BONDI, M. W., SACCO, J., ABELES, N., JAK, A. J., LIBON, D. J., & BOZOKI, A.
- Affiliations
- University of California San Diego (US)
- Michigan State University (US)
- Drexel University (US)
- Venue
- Journal of the International Neuropsychological Society
- Publisher
- Cambridge University Press (CUP)
- Published
- 2009-11
- Volume
- 15
- Issue
- 6
- Pages
- 906-914
- ISSN
- 1355-6177 (ISSN-L)
- 1469-7661
- PMC
- PMC3034688
- OpenAlex
- W2022434347
- Semantic Scholar
- 9643c2f0ad3e905372f28afdbac9c929a53e6e30
- Cited by
- 155
- References
- 59
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 6 · 2023: 9 · 2022: 6 · 2021: 22 · 2020: 11 · 2019: 16 · 2018: 11 · 2017: 11 · 2016: 8 · 2015: 10 · 2014: 11 · 2013: 5 · 2012: 11
- FWCI
- 4.73
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the International Neuropsychological Society (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- University of California, San Diego
- National Institute on Aging (R01AG012674, K24AG026431)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
- Health Sciences › Medicine › Oncology › Cancer-related cognitive impairment studies
- Keywords
- mild cognitive impairment, MCI subtypes, white matter lesions, neuropsychological profile, executive function, processing speed, memory impairment, language impairment, periventricular white matter lesions, deep white matter lesions, FLAIR MRI, older adults, dementia risk
- MeSH terms
- Aged, Aged, 80 and over, Analysis of Variance, Brain, Cognition Disorders, Female, Humans, Magnetic Resonance Imaging, Male, Memory, Nerve Fibers, Myelinated, Neuropsychological Tests, Visual Perception, Discriminant Analysis
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