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White matter microstructural changes in pure Alzheimer's disease and subcortical vascular dementia

Y J Kim1, H K Kwon, J-M Lee

  • 1Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Neuroscience Center, Samsung Medical Center, Seoul, Korea.

European Journal of Neurology
|January 22, 2015
PubMed
Abstract

Insights

Pure Alzheimer's disease (AD) and subcortical vascular dementia (SVaD) show distinct white matter (WM) changes. Diffusion tensor imaging reveals differing patterns of microstructural alterations in WM for AD and SVaD patients.

Area of Science:

  • Neuroimaging
  • Neurology
  • Dementia Research

Background:

  • Alzheimer's disease (AD) and subcortical vascular dementia (SVaD) involve white matter (WM) microstructural changes.
  • Previous studies often failed to isolate pure AD or SVaD, confounding results with mixed pathologies.

Purpose of the Study:

  • To investigate the distinct topographical patterns of WM microstructural changes in pure Alzheimer's disease (AD) and pure subcortical vascular dementia (SVaD).
  • To differentiate WM alterations between AD and SVaD, excluding mixed pathology cases.

Main Methods:

  • Recruited 40 Pittsburgh compound B (PiB) positive AD patients (PiB(+) AD) without WM hyperintensities.
  • Recruited 32 PiB negative SVaD patients (PiB(-) SVaD) and 56 cognitively normal controls (NC).
  • Utilized tract-based spatial statistics of diffusion tensor imaging to analyze fractional anisotropy (FA) and mean diffusivity (MD) patterns.

Main Results:

  • PiB(+) AD showed reduced FA in frontal, temporal, and parietal WM, and genu/splenium of corpus callosum, with increased MD in left frontal/temporal WM compared to NC.
  • PiB(-) SVaD exhibited reduced FA and increased MD across most WM regions compared to NC.
  • PiB(-) SVaD demonstrated significantly decreased FA and increased MD in nearly all WM regions compared to PiB(+) AD.

Conclusions:

  • Pure AD and pure SVaD exhibit divergent patterns of white matter (WM) microstructural changes.
  • These distinct patterns extend to normally appearing white matter, aiding in differential diagnosis.
Keywords:
Alzheimer's diseasediffuse tensor imagingsubcortical vascular dementiawhite matter microstructural changes

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