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Clinical Manifestations.

Patti Curl1, Rod L Walker2, Christine L Mac Donald3

  • 1University of Washington Department of Radiology, Seattle, WA, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 26, 2025
PubMed
Summary
This summary is machine-generated.

Alzheimer's disease (AD) dementia subtypes show varying white matter hyperintensities (WMH). Visuospatial and executive subtypes exhibit more WMH, suggesting different underlying mechanisms for cognitive decline in AD.

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Area of Science:

  • Neuroimaging
  • Neuropathology
  • Cognitive Neuroscience

Background:

  • Alzheimer's disease (AD) dementia is increasingly recognized as heterogeneous.
  • Previous studies linked cognitive performance subtypes to distinct brain volumes and neuropathology.

Purpose of the Study:

  • To investigate the association between AD dementia cognitive subtypes and white matter hyperintensities (WMH).
  • To explore if differing patterns of WMH correlate with specific cognitive deficits in AD patients.

Main Methods:

  • Utilized data from the Adult Changes in Thought (ACT) prospective cohort study.
  • Classified AD participants into memory, executive, language, or visuospatial deficit subgroups based on cognitive testing.
  • Analyzed MRI scans for WMH using ordinal logistic regression, comparing AD subgroups to controls.

Main Results:

  • AD-Visuospatial subgroup showed increased occipital lobe WMH compared to AD-Memory.
  • AD-Executive subgroup exhibited more occipital, temporal, infratentorial, and basal ganglia WMH than other AD subgroups or controls.
  • AD-Memory and AD-Language subgroups had relatively low temporal lobe WMH.

Conclusions:

  • Increased occipital WMH in AD-Visuospatial subgroup may indicate white matter damage contributing to visuospatial impairment.
  • WMH patterns in AD-Executive subgroup suggest widespread white matter involvement.
  • Lower temporal lobe WMH in AD-Memory and AD-Language subgroups implies white matter damage may be less central to these impairments.