Association between white matter lesions and the cerebral glucose metabolism in patients with cognitive impairment

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Updated: Jan 25, 2026

DTI of the Visual Pathway - White Matter Tracts and Cerebral Lesions
10:05

DTI of the Visual Pathway - White Matter Tracts and Cerebral Lesions

Published on: August 26, 2014

14.6K

Hyun-Jung No1, Hyon-Ah Yi2, Kyoung Sook Won1

  • 1Department of Nuclear Medicine, Keimyung University Dongsan Medical Center, Daegu, República de Corea.

Revista Espanola De Medicina Nuclear E Imagen Molecular
|May 5, 2019
PubMed
Abstract

Insights

White matter lesions (WMLs) are linked to reduced brain glucose metabolism in patients with cognitive impairment. This suggests small vessel disease, alongside amyloid pathology, contributes to Alzheimer's disease cognitive decline.

Area of Science:

  • Neuroimaging
  • Neurology
  • Alzheimer's Disease Research

Background:

  • White matter lesions (WMLs) on MRI are markers of small vessel disease and potential contributors to cognitive impairment.
  • The interplay between WMLs, amyloid-beta (Aβ) pathology, and cognitive decline in Alzheimer's disease (AD) requires further elucidation.
  • Understanding these relationships is crucial for developing targeted therapeutic strategies for AD.

Purpose of the Study:

  • To investigate the association between WMLs and cerebral glucose metabolism in individuals with cognitive impairment.
  • To determine if WMLs contribute to cognitive impairment independently of cerebral Aβ burden.
  • To clarify the role of small vessel disease in the pathophysiology of Alzheimer's disease.

Main Methods:

  • Cross-sectional study of 83 subjects with varying cognitive performance.
  • Brain MRI for WML quantification (Fazekas scale) and 18F-fluorodeoxyglucose PET for glucose metabolism assessment.
  • 18F-florbetaben PET for Aβ burden measurement, with statistical analysis adjusted for age, sex, and Aβ burden.

Main Results:

  • Higher WML burden (Fazekas scale ≥2) was associated with significantly reduced glucose metabolism in frontal, temporal, parietal, and limbic regions.
  • A significant negative correlation was observed between WML severity and regional glucose metabolism.
  • WMLs independently predicted reduced glucose metabolism in frontal, temporal, and limbic areas.

Conclusions:

  • WMLs are significantly associated with decreased cerebral glucose metabolism in patients with cognitive impairment.
  • Small vessel disease, indicated by WMLs, may play a crucial role in the cognitive deficits seen in Alzheimer's disease, independent of Aβ pathology.
  • These findings highlight the importance of considering WMLs in the comprehensive assessment and management of Alzheimer's disease.
Keywords:
(18)F-FDG PETAlzheimer's diseaseDaños en la sustancia blancaEnfermedad de AlzheimerEnfermedad de pequeños vasosPET con (18)F-FDGSmall vessel diseaseWhite matter lesionβ-Amiloideβ-Amyloid

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