Background White matter hyperintensities (WMHs) is the most frequent type of cerebral small vessel diseases and a common incidental finding in MRI films of the geriatric population. The objectives of this work were to study the existence of occult cognitive and balance impairments in subjects with accidentally discovered WMHs. Methods The study was conducted on 44 subjects with accidentally discovered WMHs and 24 non-WMHs subjects submitted to the advanced activity of daily living scale (AADLs), a neurocognitive battery assessing different cognitive domains, Berg balance test (BBT), computerized dynamic posturography (CDP), and brain MRI diffusion tensor tractography (DTT). Results WMHs subjects showed a significant decrease in AADLs as well as visual and vestibular ratios of CDP. Regarding the neurocognitive battery, there were significant decreases in MoCA as well as arithmetic test and block design of Wechsler adult intelligence scale-IV in WMHs compared to non-WMHs subjects’ groups ( p value < 0.001). Concerning Wisconsin Card Sorting subtests, each preservative response, preservative errors, non-preservative errors and trials to complete the 1st category showed a highly significant increase in WMHs compared to non-WMHs subjects ( p values < 0.001). DTT showed a substantial reduction in fractional anisotropy (FA) of each corticospinal tract, thalamocortical connectivity, and arcuate fasciculi. Conclusion Subjects with WMHs have lower cognitive performance and subtle balance impairment which greatly impair their ADLs.

中文翻译：

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偶发性白质高信号患者的认知和平衡障碍

背景白质高信号 (WMH) 是最常见的脑小血管疾病类型，也是老年人 MRI 影像中常见的偶然发现。这项工作的目的是研究意外发现 WMH 的受试者是否存在隐匿性认知和平衡障碍。方法 该研究对 44 名意外发现 WMHs 的受试者和 24 名非 WMHs 受试者进行了高级日常生活活动量表 (AADLs)、评估不同认知领域的神经认知电池、伯格平衡测试 (BBT)、计算机动态姿势描记法。 CDP) 和脑 MRI 弥散张量纤维束成像 (DTT)。结果 WMH 受试者的 AADL 以及 CDP 的视觉和前庭比率显着降低。关于神经认知电池，与非 WMHs 受试者组相比，WMHs 中的 MoCA 以及 Wechsler 成人智力量表-IV 的算术测试和块设计显着下降（p 值 < 0.001）。关于威斯康星卡片分类子测试，与非 WMH 受试者相比，每个防腐剂反应、防腐剂错误、非防腐剂错误和完成第一类的试验都显示 WMH 显着增加（p 值 < 0.001）。DTT 显示每个皮质脊髓束、丘脑皮质连接和弓状束的各向异性分数 (FA) 显着减少。结论 WMHs 受试者认知能力较低，平衡障碍轻微，极大地损害了他们的 ADL。