Microstructural damage of normal-appearing white matter in subcortical ischemic vascular dementia is associated with Montreal Cognitive Assessment scores

OBJECTIVES: This study was performed to determine whether multimodal biomarkers are more strongly associated with the Montreal Cognitive Assessment (MoCA) scores compared with the Mini-Mental State Examination (MMSE) scores, and whether they are correlated with the Clinical Dementia Rating (CDR) in patients with subcortical ischemic vascular dementia (SIVD). METHODS: Patients diagnosed with SIVD were enrolled. Peripheral blood hypersensitive C-reactive protein, white matter lesion volume (WMLV), fractional anisotropy (FA)/mean diffusivity (MD) of whole brain white matter (WBWM), and normal-appearing white matter (NAWM) were measured and correlated with MMSE, MoCA, and CDR scores. RESULTS: Bivariate analyses of data from 48 included patients revealed that both MoCA and MMSE were significantly associated with age, education, and FA of NAWM. Only MD of NAWM was correlated with MoCA scores. In partial correlation analysis adjusted for demographic and neuroimaging variables, MD/FA of NAWM and the MoCA scores were significantly correlated. FA/MD of NAWM had a modest trend toward a correlation with the CDR, but it was not significant. CONCLUSIONS: In the patients with SIVD, FA/MD of NAWM were more strongly related to MoCA scores compared with MMSE scores.