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Principal Investigator  
Principal Investigator's Name: Mirthe Coenen
Institution: UMC Utrecht, The Netherlands
Department: Department of Neurology
Country:
Proposed Analysis: Background White matter hyperintensities (WMH) are a common manifestation of cerebral small vessel disease and a major cause of cognitive decline and dementia. The impact of WMH on cognition depends on location, as has been recently demonstrated in community-dwelling individuals, memory clinic patients and patients with CADASIL. Taking WMH location into account might be particularly relevant in patients with cognitive symptoms attending a memory clinic, as it is often difficult to determine to what degree WMH contribute to the cognitive symptoms in these patients. The single study that was performed in a memory clinic setting demonstrated that WMH in strategic white matter tracts explain 2-3 times more variance in cognitive functioning than global WMH volume. However, despite having included almost 200 patients, this study still had limited lesion coverage in the brain, i.e. large parts of the white matter were lesioned in too few patients to be included in the analysis. In order to obtain a complete picture of the role of strategic WMH in cognitive decline and dementia, a large multicenter study including thousands of patients is needed to study white matter regions that are more rarely affected and increase statistical power. Furthermore, no studies have as of yet determined whether WMH location predicts further cognitive decline in memory clinic patients. Objectives of the study 1) To identify strategic white matter regions where WMH are associated with cognitive impairment in memory clinic patients. 2) To determine whether WMH in strategic white matter regions have prognostic value, i.e. predict cognitive decline in cohorts with longitudinal cognitive data.
Additional Investigators  
Investigator's Name: Matthijs Biesbroek
Proposed Analysis: Background: White matter hyperintensities (WMH) are a common manifestation of cerebral small vessel disease and a major cause of cognitive decline and dementia. The impact of WMH on cognition depends on location, as has been recently demonstrated in community-dwelling individuals, memory clinic patients and patients with CADASIL. Taking WMH location into account might be particularly relevant in patients with cognitive symptoms attending a memory clinic, as it is often difficult to determine to what degree WMH contribute to the cognitive symptoms in these patients. The single study that was performed in a memory clinic setting demonstrated that WMH in strategic white matter tracts explain 2-3 times more variance in cognitive functioning than global WMH volume. However, despite having included almost 200 patients, this study still had limited lesion coverage in the brain, i.e. large parts of the white matter were lesioned in too few patients to be included in the analysis. In order to obtain a complete picture of the role of strategic WMH in cognitive decline and dementia, a large multicenter study including thousands of patients is needed to study white matter regions that are more rarely affected and increase statistical power. Furthermore, no studies have as of yet determined whether WMH location predicts further cognitive decline in memory clinic patients. Objectives 1) To identify strategic white matter regions where WMH are associated with cognitive impairment in memory clinic patients. 2) To determine whether WMH in strategic white matter regions have prognostic value, i.e. predict cognitive decline in cohorts with longitudinal cognitive data.