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White matter changes associated with psychotic symptoms in Alzheimer's disease patients

Dong Young Lee1, Il Han Choo, Ki Woong Kim

  • 1Department of Neuropsychiatry, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, Korea.

The Journal of Neuropsychiatry and Clinical Neurosciences
|May 25, 2006
PubMed

Insights

White matter changes on MRI scans in Alzheimer's disease patients correlate with specific psychotic symptoms, particularly delusional misidentification. These brain changes may contribute to the development of these symptoms.

Area of Science:

  • Neurology
  • Neuroimaging
  • Psychiatry

Background:

  • Alzheimer's disease (AD) is a progressive neurodegenerative disorder.
  • Neuropsychiatric symptoms (NPS) are common in AD and impact quality of life.
  • The underlying neurobiology of NPS in AD, particularly psychotic symptoms, requires further investigation.

Purpose of the Study:

  • To investigate the association between white matter integrity and neuropsychiatric symptoms in Alzheimer's disease.
  • To identify specific white matter changes linked to psychotic symptoms in AD patients.

Main Methods:

  • Magnetic resonance imaging (MRI) was used to assess white matter changes.
  • Behavioral Rating Scale for Dementia (BRSD) was employed to evaluate neuropsychiatric symptoms.
  • Fifty-five probable Alzheimer's disease patients participated in the study.

Main Results:

  • Significant correlations were found between white matter changes in specific brain regions (bilateral frontal/parieto-occipital, left basal ganglia) and the Psychotic Symptoms subscale of the BRSD.
  • White matter changes were specifically associated with delusional misidentification, but not with paranoid delusions or hallucinations.
  • These findings highlight a potential neuroanatomical basis for delusional misidentification in AD.

Conclusions:

  • White matter alterations in Alzheimer's disease are implicated in the pathogenesis of certain psychotic symptoms.
  • Delusional misidentification in AD may be linked to white matter damage in distinct cerebral areas.
  • Further research into the neurobiological underpinnings of NPS in AD is warranted.

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