Regular Research ArticleThe Impact of Strategic White Matter Hyperintensity Lesion Location on Language
Section snippets
INTRODUCTION
Neuropsychological assessment plays a crucial role in detecting loss of cognitive functions and change in behavioral and functional state due to disruption in different neural networks and subnetworks caused by vascular damage.1 Neuropsychological tests include tasks assessing domains considered to reflect “cortical function” for example, language and visuoconstruction and tasks that tap into domains that are especially sensitive to vascular damage in subcortical regions such as attention and
Study Sample
The Epidemiology of Dementia In Singapore (EDIS) is a subsample of the Singapore Epidemiology of Eye Disease (SEED) study, a large population-based study of three major ethnic cohorts: Chinese (Singapore Chinese Eye Study [SCES]), Malay (Singapore Malay Eye Study [SiMES-2]), and Indians (Singapore Indian Eye Study [SINDI-2]).10 A similar protocol was employed for recruitment and assessment of study participants for all the three ethnicities. As part of the first phase of the EDIS study,
RESULTS
Characteristics of the study population are shown in Table 1. The mean age of the participants was 70.2 years and 54% were women. The median WMH was 2.33 mL and the prevalence of lacunes in this sample was 17%. Chinese performed better on language domain and MBNT whereas Malay and Indian had lower scores on language domain and MBNT (Table 2); no differences in VF performance were found among the three ethnicities.
DISCUSSION
This study identified strategic white matter tracts in which WMH are associated with worse performance in language in a population-based setting. More specifically, the left cingulum of the cingulate gyrus was identified as a strategic white matter tract for the MBNT. This suggests that the language is sensitive to ischemic damage in a larger subcortical network than was previously thought.
Previous studies have shown that the total WMH volume only explains a limited proportion of
CONCLUSION
This study demonstrated an association between WMH in the left cingulum and the MBNT. Our findings support the concept that WMH located in these strategic white matter tracts specifically left cingulum disrupt language and suggest that the subcortical network involved in language production is larger than was previously thought. Future studies on the role of sporadic ischemic lesions and vascular cognitive impairment should not only focus on total WMH volume but should also take WMH lesion
AUTHOR CONTRIBUTIONS
Saima Hilal: Conceptualization, Methodology, Formal analysis, Writing- Original draft preparation, Project administration, Funding acquisition. J. Matthijs Biesbroek: Conceptualization, Methodology, Formal analysis, Writing - Review & Editing. Henri Vrooman: Software, Methodology, Formal analysis. Eddie Chong: Methodology, Writing- Reviewing and Editing. Hugo J. Kuijf: Software, Methodology, Formal analysis. NarayanaswamyVenketasubramanian: Supervision. Ching-Yu Cheng: Supervision. Tien Yin
Disclosure
EDIS is supported by the National Medical Research Council (NMRC), Singapore (NMRC/CG/NUHS/2010 [Grant no: R-184-006-184-511]) and (NMRC/CSA/038/2013). Dr. Biessels is supported by Vici Grant 918.16.616 from ZonMw, The Netherlands. This work is additionally supported by bright focus foundation (reference no. A2018165F) [Grant no: R-608-000-248-597] awarded to Dr. Hilal.
Dr. Hilal received travel grant from Internationale Stichting Alzheimer Onderzoek (ISAO), the Netherlands. For the remaining
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