Regional associations between cerebrovascular disease and cholinergic white matter pathways in the Lewy body...

Area of Science:

• Neuroscience
• Neurology
• Cerebrovascular Disease Research

Background:

• Cerebrovascular disease is prevalent in Lewy body (LB) continuum disorders, including dementia with Lewy bodies (DLB) and prodromal-DLB.
• Patients with LB continuum exhibit higher white matter signal abnormality (WMSA) volume globally and within cholinergic white matter compared to controls.
• The cause of increased WMSA in cholinergic white matter remains unclear: selective vulnerability or a consequence of global WMSA.

Purpose of the Study:

• To investigate whether higher WMSA in cholinergic white matter of LB continuum patients is due to selective vulnerability or global WMSA.
• To analyze the association between cholinergic WMSA, neurodegeneration, white matter pathway integrity, and cognitive performance.

Main Methods:

• Utilized MRI to model cingulate and external capsule cholinergic white matter pathways.
• Segmented WMSA overlapping cholinergic pathways and by brain lobe.
• Compared WMSA volume and proportion in cholinergic white matter between LB continuum patients (n=33) and controls (n=36).

Main Results:

• LB continuum patients showed significantly higher volume and proportion of WMSA in cholinergic white matter, independent of global WMSA.
• Cholinergic WMSA correlated with basal forebrain neurodegeneration and reduced integrity of cingulate and external capsule pathways.
• Increased cholinergic WMSA was associated with poorer attention and memory performance.

Conclusions:

• Findings suggest a selective vulnerability of cholinergic pathways in patients with Lewy body continuum disorders.
• This selective vulnerability may contribute to the observed cerebrovascular disease burden and cognitive deficits in DLB and prodromal-DLB.