Journal
JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM
Volume 41, Issue 5, Pages 1162-1174Publisher
SAGE PUBLICATIONS INC
DOI: 10.1177/0271678X20957604
Keywords
Alzheimer's; cerebrospinal fluid; cognitive impairment; decline; small vessel disease; white matter disease
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Funding
- Norwegian Research Council, NASATS (Dementia Disease Initiation)
- JPND (APGeM)
- regional health authority (Helse Sor-Ost)
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Posterior WMH loads were increased in cases with subjective cognitive decline and mild cognitive impairment, while frontal WMHs were associated with vascular risk. This suggests that regional WMH load may serve as an early-stage marker of etiology.
White matter hyperintensities (WMHs) are associated with vascular risk and Alzheimer's disease. In this study, we examined relations between WMH load and distribution, amyloid pathology and vascular risk in 339 controls and cases with either subjective (SCD) or mild cognitive impairment (MCI). Regional deep (DWMH) and periventricular (PWMH) WMH loads were determined using an automated algorithm. We stratified on A beta 1-42 pathology (A beta+/-) and analyzed group differences, as well as associations with Framingham Risk Score for cardiovascular disease (FRS-CVD) and age. Occipital PWMH (p = 0.001) and occipital DWMH (p = 0.003) loads were increased in SCD-A beta+ compared with A beta- controls. In MCI-A beta+ compared with A beta- controls, there were differences in global WMH (p = 0.003), as well as occipital DWMH (p = 0.001) and temporal DWMH (p = 0.002) loads. FRS-CVD was associated with frontal PWMHs (p = 0.003) and frontal DWMHs (p = 0.005), after adjusting for age. There were associations between global and all regional WMH loads and age. In summary, posterior WMH loads were increased in SCD-A beta+ and MCI-A beta+ cases, whereas frontal WMHs were associated with vascular risk. The differences in WMH topography support the use of regional WMH load as an early-stage marker of etiology.
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