Neuropsychiatric symptoms are associated with exacerbated cognitive impairment in covert cerebral small vessel disease

Anne Arola; Tuuli Levänen; Hanna M. Laakso; Johanna Pitkänen; Juha Koikkalainen; Jyrki Lötjönen; Antti Korvenoja; Timo Erkinjuntti; Susanna Melkas; Hanna Jokinen

doi:10.1017/S1355617722000480

Neuropsychiatric symptoms are associated with exacerbated cognitive impairment in covert cerebral small vessel disease

Anne Arola, Tuuli Levänen, Hanna M. Laakso, Johanna Pitkänen, Juha Koikkalainen, Jyrki Lötjönen, Antti Korvenoja, Timo Erkinjuntti, Susanna Melkas, Hanna Jokinen

Research output: Contribution to journal › Article › Scientific › peer-review

Abstract

Objectives: Neuropsychiatric symptoms are related to disease progression and cognitive decline over time in cerebral small vessel disease (SVD)
but their significance is poorly understood in covert SVD. We investigated neuropsychiatric symptoms and their relationships between cognitive
and functional abilities in subjects with varying degrees of white matter hyperintensities (WMH), but without clinical diagnosis of stroke, dementia or significant disability. Methods: The Helsinki Small Vessel Disease Study consisted of 152 subjects, who underwent brain magnetic resonance imaging (MRI) and comprehensive neuropsychological evaluation of global cognition, processing speed, executive functions, and
memory. Neuropsychiatric symptoms were evaluated with the Neuropsychiatric Inventory Questionnaire (NPI-Q, n = 134) and functional abilities with the Amsterdam Instrumental Activities of Daily Living questionnaire (A-IADL, n = 132), both filled in by a close informant. Results:
NPI-Q total score correlated significantly with WMH volume (rs = 0.20, p = 0.019) and inversely with A-IADL score (rs = −0.41, p < 0.001). In
total, 38% of the subjects had one or more informant-evaluated neuropsychiatric symptom. Linear regressions adjusted for age, sex, and education
revealed no direct associations between neuropsychiatric symptoms and cognitive performance. However, there were significant synergistic interactions between neuropsychiatric symptoms andWMH volume on cognitive outcomes. Neuropsychiatric symptoms were also associated with AIADL score irrespective of WMH volume. Conclusions: Neuropsychiatric symptoms are associated with an accelerated relationship between
WMH and cognitive impairment. Furthermore, the presence of neuropsychiatric symptoms is related to worse functional abilities.
Neuropsychiatric symptoms should be routinely assessed in covert SVD as they are related to worse cognitive and functional outcomes

Original language	English
Article number	1355617722000480
Journal	Journal of the International Neuropsychological Society
Volume	29
Issue number	5
Pages (from-to)	431-438
Number of pages	8
ISSN	1355-6177
DOIs	https://doi.org/10.1017/S1355617722000480
Publication status	Published - Jun 2023
MoE publication type	A1 Journal article-refereed

Fields of Science

515 Psychology
3124 Neurology and psychiatry

Access to Document

10.1017/S1355617722000480Licence: CC BY

neuropsychiatric-symptoms-are-associated-with-exacerbated-cognitive-impairment-in-covert-cerebral-small-vessel-diseaseFinal published version, 611 KBLicence: CC BY

Cognitive impairment in cerebral small vessel disease: Early signs and determinants of progression
Jokinen, H.
01/09/2022 → 31/08/2026
Project: Academy of Finland: Clinical Researcher
Cerebral small vessel disease - preparing for RCT
Melkas, S., Erkinjuntti, T. J., Jokinen, H., Laakso, H., Pitkänen, J., Arola, A. M., Korvenoja, A., Vanni, S., Ruuth, R., Lempiäinen, J. & Kartau, M.
01/01/2016 → 31/08/2025
Project: Research project

Cite this

Arola, A., Levänen, T., Laakso, H. M., Pitkänen, J., Koikkalainen, J., Lötjönen, J., Korvenoja, A., Erkinjuntti, T., Melkas, S., & Jokinen, H. (2023). Neuropsychiatric symptoms are associated with exacerbated cognitive impairment in covert cerebral small vessel disease. Journal of the International Neuropsychological Society, 29(5), 431-438. [1355617722000480]. https://doi.org/10.1017/S1355617722000480

@article{3587d8302e7643998bc850b95fb70b49,

title = "Neuropsychiatric symptoms are associated with exacerbated cognitive impairment in covert cerebral small vessel disease",

abstract = "Objectives: Neuropsychiatric symptoms are related to disease progression and cognitive decline over time in cerebral small vessel disease (SVD)but their significance is poorly understood in covert SVD. We investigated neuropsychiatric symptoms and their relationships between cognitiveand functional abilities in subjects with varying degrees of white matter hyperintensities (WMH), but without clinical diagnosis of stroke, dementia or significant disability. Methods: The Helsinki Small Vessel Disease Study consisted of 152 subjects, who underwent brain magnetic resonance imaging (MRI) and comprehensive neuropsychological evaluation of global cognition, processing speed, executive functions, andmemory. Neuropsychiatric symptoms were evaluated with the Neuropsychiatric Inventory Questionnaire (NPI-Q, n = 134) and functional abilities with the Amsterdam Instrumental Activities of Daily Living questionnaire (A-IADL, n = 132), both filled in by a close informant. Results:NPI-Q total score correlated significantly with WMH volume (rs = 0.20, p = 0.019) and inversely with A-IADL score (rs = −0.41, p < 0.001). Intotal, 38% of the subjects had one or more informant-evaluated neuropsychiatric symptom. Linear regressions adjusted for age, sex, and educationrevealed no direct associations between neuropsychiatric symptoms and cognitive performance. However, there were significant synergistic interactions between neuropsychiatric symptoms andWMH volume on cognitive outcomes. Neuropsychiatric symptoms were also associated with AIADL score irrespective of WMH volume. Conclusions: Neuropsychiatric symptoms are associated with an accelerated relationship betweenWMH and cognitive impairment. Furthermore, the presence of neuropsychiatric symptoms is related to worse functional abilities.Neuropsychiatric symptoms should be routinely assessed in covert SVD as they are related to worse cognitive and functional outcomes",

keywords = "515 Psychology, 3124 Neurology and psychiatry",

author = "Anne Arola and Tuuli Lev{\"a}nen and Laakso, {Hanna M.} and Johanna Pitk{\"a}nen and Juha Koikkalainen and Jyrki L{\"o}tj{\"o}nen and Antti Korvenoja and Timo Erkinjuntti and Susanna Melkas and Hanna Jokinen",

year = "2023",

month = jun,

doi = "10.1017/S1355617722000480",

language = "English",

volume = "29",

pages = "431--438",

journal = "Journal of the International Neuropsychological Society",

issn = "1355-6177",

publisher = "Cambridge University Press",

number = "5",

}

Arola, A, Levänen, T, Laakso, HM, Pitkänen, J, Koikkalainen, J, Lötjönen, J, Korvenoja, A , Erkinjuntti, T , Melkas, S & Jokinen, H 2023, 'Neuropsychiatric symptoms are associated with exacerbated cognitive impairment in covert cerebral small vessel disease', Journal of the International Neuropsychological Society, vol. 29, no. 5, 1355617722000480, pp. 431-438. https://doi.org/10.1017/S1355617722000480

Neuropsychiatric symptoms are associated with exacerbated cognitive impairment in covert cerebral small vessel disease. / Arola, Anne; Levänen, Tuuli; Laakso, Hanna M. et al.

In: Journal of the International Neuropsychological Society, Vol. 29, No. 5, 1355617722000480, 06.2023, p. 431-438.

Research output: Contribution to journal › Article › Scientific › peer-review

TY - JOUR

T1 - Neuropsychiatric symptoms are associated with exacerbated cognitive impairment in covert cerebral small vessel disease

AU - Arola, Anne

AU - Levänen, Tuuli

AU - Laakso, Hanna M.

AU - Pitkänen, Johanna

AU - Koikkalainen, Juha

AU - Lötjönen, Jyrki

AU - Korvenoja, Antti

AU - Erkinjuntti, Timo

AU - Melkas, Susanna

AU - Jokinen, Hanna

PY - 2023/6

Y1 - 2023/6

N2 - Objectives: Neuropsychiatric symptoms are related to disease progression and cognitive decline over time in cerebral small vessel disease (SVD)but their significance is poorly understood in covert SVD. We investigated neuropsychiatric symptoms and their relationships between cognitiveand functional abilities in subjects with varying degrees of white matter hyperintensities (WMH), but without clinical diagnosis of stroke, dementia or significant disability. Methods: The Helsinki Small Vessel Disease Study consisted of 152 subjects, who underwent brain magnetic resonance imaging (MRI) and comprehensive neuropsychological evaluation of global cognition, processing speed, executive functions, andmemory. Neuropsychiatric symptoms were evaluated with the Neuropsychiatric Inventory Questionnaire (NPI-Q, n = 134) and functional abilities with the Amsterdam Instrumental Activities of Daily Living questionnaire (A-IADL, n = 132), both filled in by a close informant. Results:NPI-Q total score correlated significantly with WMH volume (rs = 0.20, p = 0.019) and inversely with A-IADL score (rs = −0.41, p < 0.001). Intotal, 38% of the subjects had one or more informant-evaluated neuropsychiatric symptom. Linear regressions adjusted for age, sex, and educationrevealed no direct associations between neuropsychiatric symptoms and cognitive performance. However, there were significant synergistic interactions between neuropsychiatric symptoms andWMH volume on cognitive outcomes. Neuropsychiatric symptoms were also associated with AIADL score irrespective of WMH volume. Conclusions: Neuropsychiatric symptoms are associated with an accelerated relationship betweenWMH and cognitive impairment. Furthermore, the presence of neuropsychiatric symptoms is related to worse functional abilities.Neuropsychiatric symptoms should be routinely assessed in covert SVD as they are related to worse cognitive and functional outcomes

AB - Objectives: Neuropsychiatric symptoms are related to disease progression and cognitive decline over time in cerebral small vessel disease (SVD)but their significance is poorly understood in covert SVD. We investigated neuropsychiatric symptoms and their relationships between cognitiveand functional abilities in subjects with varying degrees of white matter hyperintensities (WMH), but without clinical diagnosis of stroke, dementia or significant disability. Methods: The Helsinki Small Vessel Disease Study consisted of 152 subjects, who underwent brain magnetic resonance imaging (MRI) and comprehensive neuropsychological evaluation of global cognition, processing speed, executive functions, andmemory. Neuropsychiatric symptoms were evaluated with the Neuropsychiatric Inventory Questionnaire (NPI-Q, n = 134) and functional abilities with the Amsterdam Instrumental Activities of Daily Living questionnaire (A-IADL, n = 132), both filled in by a close informant. Results:NPI-Q total score correlated significantly with WMH volume (rs = 0.20, p = 0.019) and inversely with A-IADL score (rs = −0.41, p < 0.001). Intotal, 38% of the subjects had one or more informant-evaluated neuropsychiatric symptom. Linear regressions adjusted for age, sex, and educationrevealed no direct associations between neuropsychiatric symptoms and cognitive performance. However, there were significant synergistic interactions between neuropsychiatric symptoms andWMH volume on cognitive outcomes. Neuropsychiatric symptoms were also associated with AIADL score irrespective of WMH volume. Conclusions: Neuropsychiatric symptoms are associated with an accelerated relationship betweenWMH and cognitive impairment. Furthermore, the presence of neuropsychiatric symptoms is related to worse functional abilities.Neuropsychiatric symptoms should be routinely assessed in covert SVD as they are related to worse cognitive and functional outcomes

KW - 515 Psychology

KW - 3124 Neurology and psychiatry

U2 - 10.1017/S1355617722000480

DO - 10.1017/S1355617722000480

M3 - Article

VL - 29

SP - 431

EP - 438

JO - Journal of the International Neuropsychological Society

JF - Journal of the International Neuropsychological Society

SN - 1355-6177

IS - 5

M1 - 1355617722000480

ER -

Neuropsychiatric symptoms are associated with exacerbated cognitive impairment in covert cerebral small vessel disease

Abstract

Fields of Science

Access to Document

Projects

Cognitive impairment in cerebral small vessel disease: Early signs and determinants of progression

Cerebral small vessel disease - preparing for RCT

Cite this