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Yuyue Qiu1, Jialu Bao1, Tianyi Wang1

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In Alzheimer's disease (AD) patients, white matter hyperintensities (WMH) are linked to AD pathology and cognitive decline. Paraventricular WMH specifically correlate with worsening cognition, independent of brain atrophy.

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Area of Science:

  • Neurology
  • Neuroimaging
  • Alzheimer's Disease Research

Background:

  • White matter hyperintensities (WMH) are common in elderly individuals and Alzheimer's disease (AD) patients.
  • The underlying causes and cognitive impact of WMH in AD are not fully understood.

Purpose of the Study:

  • To investigate the relationship between WMH (global and regional) and AD-related pathologies in biologically diagnosed AD patients.
  • To explore the association of WMH burden with cognitive performance, particularly Mini-Mental State Examination (MMSE) scores.

Main Methods:

  • Cross-sectional study of 170 AD patients with cerebrospinal fluid (CSF) biomarkers, MRI, and cognitive assessments.
  • Semiquantitative scales used for WMH and atrophy assessment; linear regression models employed to analyze associations with age, AD biomarkers, cerebral microbleeds (CMB), and vascular risk factors.
  • MMSE scores analyzed against WMH and atrophy burden, adjusting for demographic factors.

Main Results:

  • Global WMH severity correlated with older age, lower CSF Aβ42 levels, and more severe CMB.
  • Regional WMH (paraventricular, frontal, parietal) associated with age, CMB grade, and CSF Aβ42 levels.
  • Lower MMSE scores linked to increased medial temporal atrophy (MTA) and higher paraventricular WMH burden, independent of age, sex, and education.

Conclusions:

  • WMH in AD patients, especially in frontal, parietal, and paraventricular regions, are associated with AD pathology (CSF Aβ42, CMB), not vascular risk factors or CSF tau.
  • Paraventricular WMH show a significant independent association with cognitive decline in AD patients.