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Widespread white matter degeneration preceding the onset of dementia

Klaus H Maier-Hein1, Carl-Fredrik Westin2, Martha E Shenton3

  • 1Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Junior Group Medical Image Computing, German Cancer Research Center, Heidelberg, Germany; Junior Group Quantitative Image-based Disease Characterization, German Cancer Research Center, Heidelberg, Germany.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|July 19, 2014
PubMed
Abstract

Insights

Free-water correction in diffusion tensor imaging reveals early white matter changes in mild cognitive impairment (MCI) that predict progression to Alzheimer's disease (AD). These findings suggest a potential new biomarker for early AD detection.

Area of Science:

  • Neuroimaging
  • Neurodegeneration
  • Biomarkers

Background:

  • Brain atrophy in mild cognitive impairment (MCI) complicates diffusion tensor imaging (DTI) by causing partial volume effects.
  • Accurate correction of these effects is crucial for detecting early white matter degeneration, a potential precursor to Alzheimer's disease (AD).

Purpose of the Study:

  • To investigate if free-water (FW) corrected DTI measures can identify microstructural degeneration preceding dementia.
  • To evaluate the potential of these corrected measures as early biomarkers for Alzheimer's disease (AD).

Main Methods:

  • Forty-eight participants (18 MCI, 15 AD, 15 controls) underwent MRI scans and clinical evaluations over 36 months.
  • MCI subjects were categorized into converters (to AD) and non-converters.
  • Free-water (FW) corrected and uncorrected white matter skeleton measures were compared between groups.

Main Results:

  • FW-corrected radial diffusivity was significantly increased in MCI subjects who converted to AD compared to non-converters.
  • Uncorrected radial diffusivity did not show this difference.
  • The observed increases in FW-corrected radial diffusivity were comparable to those seen when comparing AD patients to controls.

Conclusions:

  • Eliminating partial volume effects through FW correction reveals pre-dementia microstructural alterations.
  • These findings suggest that FW-corrected DTI measures may serve as effective and feasible early biomarkers for AD.
Keywords:
Alzheimer's diseaseDiffusion tensor imagingFree-water imagingMild cognitive impairmentPartial volume elimination

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