Fornix volume loss associated with cognitive impairment

Image: PD 

1. Fornix body volume loss and axial diffusivity was associated with cognitive decline in cognitively normal people. 

2. Hippocampal volume was not associated with cognitive decline. 

Evidence Rating Level: 2 (Good) 

Study Rundown: Research in cognitive impairment has increasingly focused on early predictors of future impairment with the hope that early intervention will lead to better outcomes for patients.  Investigators found that there was a significant association between decreased fornix volume and the development of cognitive impairment of both types. Based on their findings, the authors suggest that white matter tract measures may provide an important early indicator of impending cognitive decline. This study is limited by the small size of the study population, with only 20 participants developing cognitive impairment. Furthermore, there was a longer mean follow-up period for those who did develop impairment (4.4 years) than those who did not (3.8 years). Nonetheless, the study raises the need for further research investigating the role of white matter tracts in cognitive impairment.

Click to read the study, published today in JAMA Neurology

Relevant Reading: Microstructural white matter changes in cognitively normal individuals at risk of amnestic MCI

In-Depth [prospective cohort study]: This study prospectively followed 102 cognitively normal participants for 3.8 and 4.4 years for those who did or did not develop cognitive decline during the study period. Participants were initially assessed using the Spanish and English Neuropsychological Assessment Scales, as well as T1-weighted and diffusion tensor imaging MRI. During the study period, 20 participants developed cognitive impairment, 18 with mild cognitive impairment (MCI) and 2 with Alzheimer’s Disease (AD). Patients with decreased fornix volume were more likely to develop cognitive impairment (HR 0.47, 95% CI 0.24-0.89). Similarly, increased fornix body axial diffusivity was associated with future cognitive decline (HR 1.25, 95% CI 1.02-1.46). Other possible factors such as hippocampal volume, MMSE score, and vascular risk factors were not significantly associated with future cognitive impairment.

By Evan Shalen and Rif Rahman

More from this author: Subgroup of ADNI normal controls characterized by atrophy and cognitive decline associated with vascular damage.  The Effect of α-Cyclodextrin on postprandial lipid and glycemic responses to a fat-containing meal.  Effects of systolic blood pressure on white-matter integrity in young adults in the Framingham Heart Study: a cross-sectional study.  Coevolution of white matter hyperintensities and cognition in the elderly.  Sub-Regional Hippocampal Injury is Associated with Fornix Degeneration in Alzheimer’s Disease.

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