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White matter lesions are associated with cortical atrophy more than entorhinal and hippocampal atrophy

An-Tao Du1, Norbert Schuff, Linda L Chao

  • 1Magnetic Resonance Unit (114M), Department of Veterans Affairs Medical Center, 4150, Clement Street, San Francisco, CA 94121, USA.

Neurobiology of Aging
|January 18, 2005
PubMed

Insights

White matter hyperintensities (WMH), a marker of subcortical vascular disease, are linked to brain atrophy in Alzheimer's disease (AD) patients. This suggests vascular disease independently impacts cortical atrophy, regardless of AD pathology.

Area of Science:

  • Neuroimaging
  • Neurology
  • Gerontology

Background:

  • Alzheimer's disease (AD) is a progressive neurodegenerative disorder.
  • Subcortical vascular disease is common in older adults and can coexist with AD.
  • The interplay between vascular disease and AD pathology in brain atrophy is not fully understood.

Purpose of the Study:

  • To investigate the relationship between subcortical vascular disease and brain atrophy in Alzheimer's disease (AD) and mixed dementia patients.
  • To differentiate the effects of white matter hyperintensities (WMH) and lacunes on brain structures.
  • To explore whether subcortical vascular disease impacts brain atrophy independently of AD.

Main Methods:

  • Magnetic Resonance Imaging (MRI) was used to assess brain structure.
  • 77 cognitively normal (CN) subjects, 50 AD patients, and 13 mixed dementia patients were included.
  • White matter hyperintensities (WMH) volume and lacunes quantified subcortical vascular disease.
  • Cortical gray matter (CGM), entorhinal cortex (ERC), and hippocampal volumes measured brain atrophy.

Main Results:

  • Cortical gray matter (CGM) volume showed an inverse relationship with white matter hyperintensities (WMH) volume in all groups.
  • No significant relationship was found between brain atrophy measures and subcortical lacunes.
  • White matter hyperintensities (WMH) affected cortical atrophy independently of diagnostic group (CN, AD, mixed dementia).

Conclusions:

  • Subcortical vascular disease, specifically WMH, is associated with cortical atrophy in individuals with and without Alzheimer's disease.
  • White matter hyperintensities (WMH) appear to influence cortical atrophy more than entorhinal cortex or hippocampal atrophy.
  • Alzheimer's disease pathology and subcortical vascular disease may contribute independently to cortical atrophy.

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