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White matter hyperintensities in mild lewy body dementia

K Oppedal1, D Aarsland, M J Firbank

  • 1Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway ; Department of Electrical Engineering and Computer Science, University of Stavanger, Stavanger, Norway.

Dementia and Geriatric Cognitive Disorders Extra
|November 29, 2012
PubMed
Abstract

Insights

White matter hyperintensities (WMH) loads were similar in Lewy body dementia (LBD) and Alzheimer's disease (AD). Cognitive function correlated with WMH in AD, but not in LBD patients, suggesting different disease mechanisms.

Area of Science:

  • Neuroimaging
  • Neurology
  • Vascular Dementia

Background:

  • White matter hyperintensities (WMH) are common in neurodegenerative diseases.
  • Understanding WMH load differences between Lewy body dementia (LBD) and Alzheimer's disease (AD) is crucial for diagnosis and treatment.
  • Comparing WMH in LBD, AD, and normal controls (NC) provides insights into disease-specific pathologies.

Purpose of the Study:

  • To quantify and compare the burden of white matter hyperintensities (WMH) in patients diagnosed with Lewy body dementia (LBD).
  • To compare WMH load in LBD patients against those with Alzheimer's disease (AD) and normal elderly controls (NC).
  • To investigate the relationship between WMH load and cognitive performance in LBD and AD.

Main Methods:

  • Diagnosis of LBD and AD was confirmed using consensus criteria and cognitive assessments.
  • Magnetic Resonance Imaging (MRI) FLAIR sequences were used to segment and quantify WMH volumes across brain regions.
  • Non-parametric tests and multivariate regression analyses were employed to compare WMH loads and their association with cognitive scores across patient groups.

Main Results:

  • No significant differences in overall WMH load were observed between patients with LBD and AD.
  • A significant correlation between WMH volume (total and frontal) and cognitive scores (MMSE, verbal fluency) was found in the AD group.
  • This correlation between WMH and cognition was not significant in the LBD group.

Conclusions:

  • The burden of white matter hyperintensities (WMH) in Lewy body dementia (LBD) is comparable to that observed in Alzheimer's disease (AD).
  • Cognitive impairment in AD is associated with WMH, suggesting a contribution of vascular factors.
  • The lack of correlation between WMH and cognition in LBD indicates that vascular disease may not be a primary driver of cognitive decline in this condition, unlike in AD.
Keywords:
Alzheimer's dementiaCerebrovascular diseasesCognitionLewy body dementiaMagnetic resonance imagingParkinson's diseaseWhite matter hyperintensities

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