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Research Paper|Volume 12, Issue 9|pp 8506—8522

White matter hyperintensities associated with progression of cerebral small vessel disease: a 7-year Chinese urban community study

Yiwei Xia1, Yi Shen3, Yi Wang1, Lumeng Yang1, Yiqing Wang1, Yu Li3, Xiaoniu Liang2, Qianhua Zhao2, Jianjun Wu1,4, Shuguang Chu5, Zonghui Liang6, Xiaoxiao Wang3, Bensheng Qiu3, Hansheng Ding7, Ding Ding2, Xin Cheng1, Qiang Dong1
  • 1Department of Neurology, National Clinical Research Centre for Aging and Medicine, Huashan Hospital, State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
  • 2Institute of Neurology, National Clinical Research Centre for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
  • 3Centers for Biomedical Engineering, University of Science and Technology of China, Hefei, Anhui, China
  • 4Department of Neurology, Jing’an District Center Hospital, Shanghai, China
  • 5Department of Radiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
  • 6Department of Radiology, Jing’an District Center Hospital, Shanghai, China
  • 7Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, China
* Equal contribution
Received: November 8, 2019Accepted: April 16, 2020Published: May 10, 2020

Copyright © 2020 Xia et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

We aimed to explore the role of white matter hyperintensities (WMH) in progression of cerebral small vessel disease (CSVD) in an urban community in China over a period of 7 years, and to investigate associations between WMH volume (baseline and progression) and cognitive impairment. CSVD markers and neuropsychological tests at baseline and follow-up of 191 participants of the Shanghai Aging Study (SAS) were assessed. WMH volume were assessed by automatic segmentation based on U-net model. Lacunes, cerebral microbleeds (CMBs) and enlarged perivascular spaces (ePVS) were rated manually. Small vessel disease (SVD) score was rated as the total burden of CSVD markers. Global cognitive function and 5 main cognitive domains (memory, language, spatial construction, attention and executive function) were evaluated by neuropsychological tests. We performed multivariable linear regression and binominal logistic regression. Participants with higher baseline WMH volume developed more progression of WMH volume, increased risk of incident lacunes, incident CMBs, and ePVS progression. WMH (baseline and progression) were associated with decline of executive function. WMH were associated with progression of cerebral small vessel disease and decline of executive function in a Chinese urban community study over a period of 7 years.