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Specific risk factors for microbleeds and white matter hyperintensities in Alzheimer's disease

Marije R Benedictus1, Jeroen D C Goos, Maja A A Binnewijzend

  • 1Department of Neurology and Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands. m.benedictus@vumc.nl

Neurobiology of Aging
|June 5, 2013
PubMed

Insights

In Alzheimer's disease (AD), white matter hyperintensities (WMH) link to vascular factors, while microbleeds associate with amyloid burden, suggesting differing underlying pathologies. This distinction aids in understanding AD progression and potential therapeutic targets.

Area of Science:

  • Neurology
  • Neuroimaging
  • Alzheimer's Disease Research

Background:

  • Alzheimer's disease (AD) is characterized by complex pathologies including vascular factors and amyloid deposition.
  • Microbleeds and white matter hyperintensities (WMH) are common neuroimaging findings in AD patients.
  • Understanding the distinct associations of these markers with risk factors is crucial for elucidating AD pathogenesis.

Purpose of the Study:

  • To investigate whether microbleeds and WMH in probable AD patients are associated with conventional vascular risk factors or with factors reflecting amyloid burden.
  • To differentiate the etiological underpinnings of WMH and microbleeds in the context of AD.

Main Methods:

  • Retrospective analysis of 371 patients with probable AD.
  • Assessment of WMH (Fazekas 2 or 3) and microbleeds using neuroimaging.
  • Multivariate regression models to identify independent associations with vascular and amyloid-related risk factors.

Main Results:

  • WMH were present in 29% and microbleeds in 26% of patients.
  • WMH showed independent associations with age, hypertension, smoking, and lacunes.
  • Microbleeds were independently associated with male gender, higher blood pressure, lower CSF Aβ42, and APOE ε4 homozygosity.
  • Lobar microbleeds drove the associations with amyloid burden markers.

Conclusions:

  • WMH in AD are primarily linked to conventional vascular risk factors.
  • Microbleeds, particularly in lobar locations, are associated with markers of amyloid burden in AD.
  • These findings suggest that microbleeds may be indicative of cerebral amyloid angiopathy in AD, distinct from WMH pathology.
Keywords:
Alzheimer's diseaseApoEMicrobleedsMicrohemorrhageRisk factorsSmall vessel diseaseWhite matter hyperintensities

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