Abstract
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 MRI WMH 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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1347-1360 |
| Number of pages | 14 |
| Journal | Journal of Alzheimer's Disease |
| Volume | 63 |
| Issue number | 4 |
| DOIs | |
| State | Published - Jan 1 2018 |
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Keywords
- Alzheimer's disease
- Alzheimer's disease neuropathology
- cerebrovascular disease
- dementia
- magnetic resonance imaging
- white matter hyperintensities
ASJC Scopus subject areas
- Neuroscience(all)
- Clinical Psychology
- Geriatrics and Gerontology
- Psychiatry and Mental health
Cite this
A Clinicopathological Investigation of White Matter Hyperintensities and Alzheimer's Disease Neuropathology. / Alosco, Michael L.; Sugarman, Michael A.; Besser, Lilah M.; Tripodis, Yorghos; Martin, Brett; Palmisano, Joseph N.; Kowall, Neil W.; Au, Rhoda; Mez, Jesse; DeCarli, Charles; Stein, Thor D.; McKee, Ann C.; Killiany, Ronald J.; Stern, Robert A.
In: Journal of Alzheimer's Disease, Vol. 63, No. 4, 01.01.2018, p. 1347-1360.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A Clinicopathological Investigation of White Matter Hyperintensities and Alzheimer's Disease Neuropathology
AU - Alosco, Michael L.
AU - Sugarman, Michael A.
AU - Besser, Lilah M.
AU - Tripodis, Yorghos
AU - Martin, Brett
AU - Palmisano, Joseph N.
AU - Kowall, Neil W.
AU - Au, Rhoda
AU - Mez, Jesse
AU - DeCarli, Charles
AU - Stein, Thor D.
AU - McKee, Ann C.
AU - Killiany, Ronald J.
AU - Stern, Robert A.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - 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 MRI WMH 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.
AB - 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 MRI WMH 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.
KW - Alzheimer's disease
KW - Alzheimer's disease neuropathology
KW - cerebrovascular disease
KW - dementia
KW - magnetic resonance imaging
KW - white matter hyperintensities
UR - http://www.scopus.com/inward/record.url?scp=85048604485&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85048604485&partnerID=8YFLogxK
U2 - 10.3233/JAD-180017
DO - 10.3233/JAD-180017
M3 - Article
C2 - 29843242
AN - SCOPUS:85048604485
VL - 63
SP - 1347
EP - 1360
JO - Journal of Alzheimer's Disease
JF - Journal of Alzheimer's Disease
SN - 1387-2877
IS - 4
ER -