O1-02-02 White matter lesions are associated with cortical atrophy more than entorhinal and hippocampal atrophy

Magnetic Resonance Unit (114M), Department of Veterans Affairs Medical Center, 4150, Clement Street, San Francisco, CA 94121, USA.
Neurobiology of Aging (Impact Factor: 5.01). 05/2005; 26(4):553-9. DOI: 10.1016/j.neurobiolaging.2004.05.002
Source: PubMed


The goal of this study was to examine the relationship between subcortical vascular disease and brain atrophy in patients with Alzheimer's disease (AD) and mixed dementia (i.e., AD and subcortical vascular disease together). MRI was performed on 77 cognitively normal (CN) subjects, 50 AD and 13 mixed dementia patients. Subcortical vascular disease was determined by white matter hyperintensities (WMH) volume and presence of subcortical lacunes. Brain atrophy was measured using total brain cortical gray matter (CGM), entorhinal cortex (ERC) and hippocampal volumes. CGM volume, but not ERC or hippocampal volume was inversely related to WMH volume in patients and controls. In contrast, no relationship was detected between CGM, ERC, or hippocampal volumes and subcortical lacunes. Furthermore, no interaction was found between WMH and diagnosis on cortical atrophy, implying that WMH affect cortical atrophy indifferently of group. These results suggest that subcortical vascular disease, manifested as WMH, may affect cortical atrophy more than ERC and hippocampal atrophy. Further, AD pathology and subcortical vascular disease may independently affect cortical atrophy.

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Available from: Linda L Chao, Mar 25, 2015
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    • "Individuals with AD show significant cortical and hippocampal atrophy relative to non-demented age matched controls (Alavi et al., 1993; Raz et al., 1998) and losses in brain volume correlate with cognitive decline (Ezekiel et al., 2004; Du et al., 2005). Similar events are seen in aged canines. "
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    • "This is consistent to a previous study that showed that neither the number or volume of lacunes was associated with cGM volume [35]. Another study also found no such relationship in patients with Alzheimer's disease and mixed dementia, which may reflect a more prominent degenerative cause for cGM in these patients [8]. "
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    • "It was thus proposed that cognitive decline in patients with WMC was mediated by brain atrophy [96]. The hypothesized mechanisms of how WMC induce cortical atrophy include demyelination of axons leading to cortical-subcortical deafferentation and subsequent secondary cortical neuronal loss, [99, 100] hypoperfusion, and hypometabolism [101, 102], as well as concomitant cortical microinfarct, which its detection is beyond the ability of current neuroimaging techniques [102].A recent study also showed that severe WMC were associated with hippocampus atrophy [103]. Moreover, Smith et al. study in community residents revealed that WMC progression might predict normal to mild cognitive impairment, whereas global atrophy predicted mild cognitive impairment to dementia [104]. "
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