期刊
JOURNAL OF ALZHEIMERS DISEASE
卷 63, 期 4, 页码 1347-1360出版社
IOS PRESS
DOI: 10.3233/JAD-180017
关键词
Alzheimer's disease; Alzheimer's disease neuropathology; cerebrovascular disease; dementia; magnetic resonance imaging; white matter hyperintensities
资金
- NIA/NIH [U01 AG016976]
- NIA [P30AG019610, P30 AG013846, P50 AG008702, P50 AG025688, P30 AG010133, P50 AG005146, P50 AG005134, P50AG016574, P50 AG005138, P30 AG008051, P30 AG013854, P30 AG008017]
- NIH [P30 AG13846, R01 NS078337, R56 9500304025, U01 NS093334, U01NS086659-01, 1F32NS096803-01, K23AG046377, RF1AG05416]
- National Center for Advancing Translational Sciences, National Institutes of Health, through BU-CTSI [1UL1TR001430]
- The NIA [P30 AG010161, P30 AG010129, P50 AG016573, P50 AG016570, P50 AG005131, P50AG023501, P30 AG035982, P30AG028383, P30 AG010124, P50 AG005133, P50 AG005142, P30 AG012300, P50 AG005136, P50 AG033514, P50 AG005681]
Background: White matter hyperintensities (WMH) on magnetic resonance imaging (MRI) have been postulated to be a core feature of Alzheimer's disease. Clinicopathological studies are needed to elucidate and confirm this possibility. Objective: This study examined: 1) the association between antemortem WMH and autopsy-confirmed Alzheimer's disease neuropathology (ADNP), 2) the relationship between WMH and dementia in participants with ADNP, and 3) the relationships among cerebrovascular disease, WMH, and ADNP. Methods: The sample included 82 participants from the National Alzheimer's Coordinating Center's Data Sets who had quantitated volume of WMH from antemortem FLAIR MRI and available neuropathological data. The Clinical Dementia Rating (CDR) scale (from MRI visit) operationalized dementia status. ADNP+ was defined by moderate to frequent neuritic plaques and Braak stage III-VI at autopsy. Cerebrovascular disease neuropathology included infarcts or lacunes, microinfarcts, arteriolosclerosis, atherosclerosis, and cerebral amyloid angiopathy. Results: 60/82 participants were ADNP+. Greater volume of WMH predicted increased odds for ADNP (p = 0.037). In ADNP+ participants, greater WMH corresponded with increased odds for dementia (CDR >= 1; p = 0.038). WMH predicted cerebral amyloid angiopathy, microinfarcts, infarcts, and lacunes (ps < 0.04). ADNP+ participants were more likely to have moderate-severe arteriolosclerosis and cerebral amyloid angiopathy compared to ADNP-participants (ps < 0.04). Conclusions: This study found a direct association between total volume of WMH and increased odds for having ADNP. In patients with Alzheimer's disease, FLAIR MRIWMH may be able to provide key insight into disease severity and progression. The association between WMH and ADNP may be explained by underlying cerebrovascular disease.
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