White matter hyperintensities: a possible link between sarcopenia and cognitive impairment in patients with mild to
Xiaofen Weng1,2, Shanwen Liu1, Meng Li3
1Department of Neurology, The Second Affiliated Hospital of Soochow University, 1055 San Xiang Road, Suzhou, 215004, Jiangsu, China.
Purpose:
Alzheimer's disease (AD) has been reported to be associated with sarcopenia. White matter hyperintensities (WMH) are common in AD patients. However, the effect of WMH on sarcopenia in AD remains unclear. We hence aimed to investigate the possible association between regional WMH volumes and sarcopenic parameters in AD.
Methods:
57 mild to moderate AD patients and 22 normal controls (NC) were enrolled. Sarcopenic parameters were assessed, including appendicular skeletal mass index (ASMI), grip strength, 5-times sit-to-stand (5-STS) time, and gait speed. The volumes of periventricular hyperintensities (PVH) and deep white matter hyperintensities (DWMH) were quantified using 3D-slicer software.
Results:
AD subjects exhibited a lower ASMI, a slower gait speed, an increased 5-STS time, and larger volumes of PVH and DWMH than those in the NC group. In AD subjects, total WMH and PVH volumes were related to cognitive impairment, particularly executive function decline. Moreover, total WMH volume and PVH volume were negatively correlated with gait speed across various clinical stages of AD. Multiple linear regression analysis showed that PVH volume was independently associated with 5-STS time and gait speed, whereas DWMH volume was only independently associated with gait speed.
Conclusion:
WMH volume was associated with cognitive decline and various sarcopenic parameters. It thereby suggested that WMH may serve as the connection between sarcopenia and cognitive dysfunction in AD. Further studies are needed to confirm these findings and to determine whether sarcopenia interventions reduce WMH volume and improve cognitive function in AD.
Insights
White matter hyperintensities (WMH) in Alzheimer's disease (AD) are linked to muscle weakness and slower movement. These brain changes may connect physical decline with cognitive issues in AD patients.
Area of Science:
- Neurology
- Gerontology
- Neuroimaging
Background:
- Alzheimer's disease (AD) is often accompanied by sarcopenia, a loss of muscle mass and strength.
- White matter hyperintensities (WMH) are frequently observed in AD patients, but their specific impact on sarcopenia is not well understood.
Purpose of the Study:
- To investigate the association between regional white matter hyperintensity (WMH) volumes and sarcopenic parameters in individuals with Alzheimer's disease (AD).
Main Methods:
- The study included 57 AD patients and 22 normal controls (NC).
- Sarcopenic parameters such as appendicular skeletal mass index (ASMI), grip strength, 5-times sit-to-stand (5-STS) time, and gait speed were assessed.
- Volumes of periventricular (PVH) and deep white matter hyperintensities (DWMH) were quantified using 3D-slicer software.
Main Results:
- AD patients showed lower ASMI, slower gait speed, longer 5-STS time, and larger PVH and DWMH volumes compared to NC.
- In AD subjects, WMH and PVH volumes correlated with cognitive impairment, especially executive function decline.
- PVH volume was independently associated with 5-STS time and gait speed, while DWMH volume was independently associated with gait speed in AD patients.
Conclusions:
- WMH volume is associated with cognitive decline and sarcopenic parameters in AD.
- WMH may act as a link between sarcopenia and cognitive dysfunction in Alzheimer's disease.
- Further research is needed to confirm these findings and explore potential interventions.
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