Cerebral white matter changes are associated with abnormalities on neurological examination in non-disabled elderly: the LADIS study

Anna Poggesi; Alida Gouw; Wiesje van der Flier; Giovanni Pracucci; Hugues Chabriat; Timo Erkinjuntti; Franz Fazekas; José M Ferro; Michael Hennerici; Peter Langhorne; John T O'Brien; Marieke C Visser; Lars-Olof Wahlund; Gunhild Waldemar; Anders Wallin; Philip Scheltens; Domenico Inzitari; Leonardo Pantoni

doi:10.1007/s00415-012-6748-3

Cerebral white matter changes are associated with abnormalities on neurological examination in non-disabled elderly: the LADIS study

Anna Poggesi, Alida Gouw, Wiesje van der Flier, Giovanni Pracucci, Hugues Chabriat, Timo Erkinjuntti, Franz Fazekas, José M Ferro, Michael Hennerici, Peter Langhorne, John T O'Brien, Marieke C Visser, Lars-Olof Wahlund, Gunhild Waldemar, Anders Wallin, Philip Scheltens, Domenico Inzitari, Leonardo Pantoni

Department of Clinical Medicine

28 Citations (Scopus)

Abstract

Cerebral white matter changes (WMC) are associated with motor, cognitive, mood, urinary disturbances, and disability, but little is known about the prevalence of neurological signs in patients with these brain lesions. We assessed the presence and occurrence of neurological abnormalities over a 3-year period and their possible associations with WMC in a cohort of initially non-disabled elderly subjects. Data from the multicenter Leukoaraiosis And DISability study were used. A standard neurological examination was performed at baseline and at each of the annual follow-up visits. A standard MRI scan was performed at baseline and after 3-years. WMC severity was graded as mild, moderate, or severe on the Fazekas scale, while the Rotterdam scale was used to assess progression. Infarcts and their occurrence were also assessed. Six hundred and thirty-nine non-disabled subjects were enrolled (mean age 74.1 ± 5.0, M/F: 288/351). Severe WMC at baseline were associated with gait and stance abnormalities, upper motor signs, and fingertap slowing. This effect was independent of age, sex, lacunar and non-lacunar infarcts. The occurrence of stance abnormalities, upper motor signs, primitive reflexes and fingertap slowing during the 3-year follow-up period was associated with both baseline WMC load and their progression. The occurrence of the same abnormalities plus extrapyramidal and primitive reflexes was associated with incident lacunar infarcts. In our cohort of non-disabled elders, severe WMC were associated with the presence and the occurrence of neurological signs, independently of other vascular brain lesions, confirming that these lesions have clinical relevance.

Original language	English
Journal	Journal of Neurology
Volume	260
Issue number	4
Pages (from-to)	1014-21
Number of pages	8
ISSN	0340-5354
DOIs	https://doi.org/10.1007/s00415-012-6748-3
Publication status	Published - 1 Apr 2013

Keywords

Faculty of Health and Medical Sciences

Access to Document

10.1007/s00415-012-6748-3

Cite this

Poggesi, A., Gouw, A., van der Flier, W., Pracucci, G., Chabriat, H., Erkinjuntti, T., Fazekas, F., Ferro, J. M., Hennerici, M., Langhorne, P., O'Brien, J. T., Visser, M. C., Wahlund, L-O., Waldemar, G., Wallin, A., Scheltens, P., Inzitari, D., & Pantoni, L. (2013). Cerebral white matter changes are associated with abnormalities on neurological examination in non-disabled elderly: the LADIS study. Journal of Neurology, 260(4), 1014-21. https://doi.org/10.1007/s00415-012-6748-3

Poggesi, A, Gouw, A, van der Flier, W, Pracucci, G, Chabriat, H, Erkinjuntti, T, Fazekas, F, Ferro, JM, Hennerici, M, Langhorne, P, O'Brien, JT, Visser, MC, Wahlund, L-O, Waldemar, G, Wallin, A, Scheltens, P, Inzitari, D & Pantoni, L 2013, 'Cerebral white matter changes are associated with abnormalities on neurological examination in non-disabled elderly: the LADIS study', Journal of Neurology, vol. 260, no. 4, pp. 1014-21. https://doi.org/10.1007/s00415-012-6748-3

@article{85a4c907f8114c14930dd620ca076aee,

title = "Cerebral white matter changes are associated with abnormalities on neurological examination in non-disabled elderly: the LADIS study",

abstract = "Cerebral white matter changes (WMC) are associated with motor, cognitive, mood, urinary disturbances, and disability, but little is known about the prevalence of neurological signs in patients with these brain lesions. We assessed the presence and occurrence of neurological abnormalities over a 3-year period and their possible associations with WMC in a cohort of initially non-disabled elderly subjects. Data from the multicenter Leukoaraiosis And DISability study were used. A standard neurological examination was performed at baseline and at each of the annual follow-up visits. A standard MRI scan was performed at baseline and after 3-years. WMC severity was graded as mild, moderate, or severe on the Fazekas scale, while the Rotterdam scale was used to assess progression. Infarcts and their occurrence were also assessed. Six hundred and thirty-nine non-disabled subjects were enrolled (mean age 74.1 ± 5.0, M/F: 288/351). Severe WMC at baseline were associated with gait and stance abnormalities, upper motor signs, and fingertap slowing. This effect was independent of age, sex, lacunar and non-lacunar infarcts. The occurrence of stance abnormalities, upper motor signs, primitive reflexes and fingertap slowing during the 3-year follow-up period was associated with both baseline WMC load and their progression. The occurrence of the same abnormalities plus extrapyramidal and primitive reflexes was associated with incident lacunar infarcts. In our cohort of non-disabled elders, severe WMC were associated with the presence and the occurrence of neurological signs, independently of other vascular brain lesions, confirming that these lesions have clinical relevance.",

keywords = "Faculty of Health and Medical Sciences, White matter changes, Cerebrovascular diseases, Neurological examination, Neurological abnormalities, MRI",

author = "Anna Poggesi and Alida Gouw and {van der Flier}, Wiesje and Giovanni Pracucci and Hugues Chabriat and Timo Erkinjuntti and Franz Fazekas and Ferro, {Jos{\'e} M} and Michael Hennerici and Peter Langhorne and O'Brien, {John T} and Visser, {Marieke C} and Lars-Olof Wahlund and Gunhild Waldemar and Anders Wallin and Philip Scheltens and Domenico Inzitari and Leonardo Pantoni",

year = "2013",

month = apr,

day = "1",

doi = "10.1007/s00415-012-6748-3",

language = "English",

volume = "260",

pages = "1014--21",

journal = "Deutsche Zeitschrift fur Nervenheilkunde",

issn = "0939-1517",

publisher = "Springer Medizin",

number = "4",

}

TY - JOUR

T1 - Cerebral white matter changes are associated with abnormalities on neurological examination in non-disabled elderly

T2 - the LADIS study

AU - Poggesi, Anna

AU - Gouw, Alida

AU - van der Flier, Wiesje

AU - Pracucci, Giovanni

AU - Chabriat, Hugues

AU - Erkinjuntti, Timo

AU - Fazekas, Franz

AU - Ferro, José M

AU - Hennerici, Michael

AU - Langhorne, Peter

AU - O'Brien, John T

AU - Visser, Marieke C

AU - Wahlund, Lars-Olof

AU - Waldemar, Gunhild

AU - Wallin, Anders

AU - Scheltens, Philip

AU - Inzitari, Domenico

AU - Pantoni, Leonardo

PY - 2013/4/1

Y1 - 2013/4/1

N2 - Cerebral white matter changes (WMC) are associated with motor, cognitive, mood, urinary disturbances, and disability, but little is known about the prevalence of neurological signs in patients with these brain lesions. We assessed the presence and occurrence of neurological abnormalities over a 3-year period and their possible associations with WMC in a cohort of initially non-disabled elderly subjects. Data from the multicenter Leukoaraiosis And DISability study were used. A standard neurological examination was performed at baseline and at each of the annual follow-up visits. A standard MRI scan was performed at baseline and after 3-years. WMC severity was graded as mild, moderate, or severe on the Fazekas scale, while the Rotterdam scale was used to assess progression. Infarcts and their occurrence were also assessed. Six hundred and thirty-nine non-disabled subjects were enrolled (mean age 74.1 ± 5.0, M/F: 288/351). Severe WMC at baseline were associated with gait and stance abnormalities, upper motor signs, and fingertap slowing. This effect was independent of age, sex, lacunar and non-lacunar infarcts. The occurrence of stance abnormalities, upper motor signs, primitive reflexes and fingertap slowing during the 3-year follow-up period was associated with both baseline WMC load and their progression. The occurrence of the same abnormalities plus extrapyramidal and primitive reflexes was associated with incident lacunar infarcts. In our cohort of non-disabled elders, severe WMC were associated with the presence and the occurrence of neurological signs, independently of other vascular brain lesions, confirming that these lesions have clinical relevance.

AB - Cerebral white matter changes (WMC) are associated with motor, cognitive, mood, urinary disturbances, and disability, but little is known about the prevalence of neurological signs in patients with these brain lesions. We assessed the presence and occurrence of neurological abnormalities over a 3-year period and their possible associations with WMC in a cohort of initially non-disabled elderly subjects. Data from the multicenter Leukoaraiosis And DISability study were used. A standard neurological examination was performed at baseline and at each of the annual follow-up visits. A standard MRI scan was performed at baseline and after 3-years. WMC severity was graded as mild, moderate, or severe on the Fazekas scale, while the Rotterdam scale was used to assess progression. Infarcts and their occurrence were also assessed. Six hundred and thirty-nine non-disabled subjects were enrolled (mean age 74.1 ± 5.0, M/F: 288/351). Severe WMC at baseline were associated with gait and stance abnormalities, upper motor signs, and fingertap slowing. This effect was independent of age, sex, lacunar and non-lacunar infarcts. The occurrence of stance abnormalities, upper motor signs, primitive reflexes and fingertap slowing during the 3-year follow-up period was associated with both baseline WMC load and their progression. The occurrence of the same abnormalities plus extrapyramidal and primitive reflexes was associated with incident lacunar infarcts. In our cohort of non-disabled elders, severe WMC were associated with the presence and the occurrence of neurological signs, independently of other vascular brain lesions, confirming that these lesions have clinical relevance.

KW - Faculty of Health and Medical Sciences

KW - White matter changes

KW - Cerebrovascular diseases

KW - Neurological examination

KW - Neurological abnormalities

KW - MRI

U2 - 10.1007/s00415-012-6748-3

DO - 10.1007/s00415-012-6748-3

M3 - Journal article

C2 - 23180181

SN - 0939-1517

VL - 260

SP - 1014

EP - 1021

JO - Deutsche Zeitschrift fur Nervenheilkunde

JF - Deutsche Zeitschrift fur Nervenheilkunde

IS - 4

ER -

Cerebral white matter changes are associated with abnormalities on neurological examination in non-disabled elderly: the LADIS study

Abstract

Keywords

Access to Document

Fingerprint

Cite this