Analysis of Causative Factors and Effects to Cognitive Functions of Cerebral White Matter Changes

ABSTRACT

BACKGROUND: The aim of this study was to identify causative factors for cerebral white matter changes on MRI and relationship between cerebral white matter changes and cognitive function. METHODS: The patients who were admitted to the Department of Neurology ward or visited to outpatient clinic at the Chungnam National University Hospital from September 1999 to July 2000 were selected. All patients underwent brain MRI with 1.5 T for determination of degree and distribution of cerebral white matter changes. The patients were evaluated their cognitive function with the Mini Mental State Examination (MMSE) and the Modified Mini-Mental State Examination (3MS), which has more extensive and detailed tool for fluency and memory domains of cognition compared with the MMSE. Statistical analyses were performed to identify whether there was difference in causative factors and cognitive status between patients with white matter change and patients without white matter changes. RESULTS: White matter changes were significantly more common in patients with hypertension and women. On correlation analyses, hypertension and aging were significantly related with cerebral white matter changes. General cognitive status in patients with white matter changes were worse than those of patients without white matter changes and of control group. Frontal lobe functions like fluency, attention, and visuo-constructive function were especially affected by white matter changes on the 3MS. CONCLUSIONS: Hypertension, female sex and aging may contribute to the development of cerebral white matter changes. Cerebral white matter changes may be responsible for the general cognitive decline. (J Korean Neurol Assoc 19(5)471~477, 2001)