Faculty Opinions recommendation of Regional white matter hyperintensity volume, not hippocampal atrophy, predicts incident Alzheimer disease in the community.

Background/Aims: Behavioral and psychological symptoms of dementia (BPSD) are exhibited in most patients with Alzheimer disease (AD). Although white matter hyperintensity (WMH) is often observed with AD, the precise role of WMH in BPSD remains unclear. The current study aimed to identify the impact of regional WMH on specific features of BPSD in persons with mild to moderate AD and amnestic mild cognitive impairment (aMCI). Methods: A sample of 256 female outpatients with AD (n = 217) and aMCI (n = 39) were recruited. We assessed BPSD using the Dementia Behavior Disturbance Scale. WMH and brain atrophy were evaluated using an automatic segmentation program. Regional WMH was evaluated as periventricular hyperintensity (PVH) and deep WMH in frontal, temporal, occipital, and parietal lobes. Results: Whole-brain WMH was associated with verbal aggressiveness. In multivariate analysis, PVH in the frontal lobe was independently associated with verbal aggressiveness after adjustment for brain atrophy and clinical confounders. Conclusion: The current results indicated that PVH in the frontal lobe was independently associated with verbal aggressiveness.

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P4-127: WHITE MATTER HYPERINTENSITY VOLUME IS ASSOCIATED WITH DISPROPORTIONATE PROGRESSIVE HIPPOCAMPAL ATROPHY IN CONTROLS

Alzheimer s & Dementia ◽

10.1016/j.jalz.2014.05.1643 ◽

2014 ◽

Vol 10 ◽

pp. P831-P833

Author(s):

Josephine Barnes ◽

Emily Ndakola Manning ◽

Cassidy Fiford ◽

Manja Lehmann ◽

David M. Cash ◽

...

Keyword(s):

White Matter ◽

White Matter Hyperintensity ◽

Hippocampal Atrophy

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Measuring Cerebral Atrophy and White Matter Hyperintensity Burden to Predict the Rate of Cognitive Decline in Alzheimer Disease

Archives of Neurology ◽

10.1001/archneur.65.9.1202 ◽

2008 ◽

Vol 65 (9) ◽

Cited By ~ 77

Author(s):

Adam M. Brickman ◽

Lawrence S. Honig ◽

Nikolaos Scarmeas ◽

Oksana Tatarina ◽

Linda Sanders ◽

...

Keyword(s):

White Matter ◽

Alzheimer Disease ◽

Cognitive Decline ◽

Cerebral Atrophy ◽

White Matter Hyperintensity

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IC-P-126: WHITE MATTER HYPERINTENSITY VOLUME IS ASSOCIATED WITH DISPROPORTIONATE PROGRESSIVE HIPPOCAMPAL ATROPHY IN CONTROLS

Alzheimer s & Dementia ◽

10.1016/j.jalz.2014.05.132 ◽

2014 ◽

Vol 10 ◽

pp. P71-P73

Author(s):

Josephine Barnes ◽

Emily Ndakola Manning ◽

Cassidy Fiford ◽

Manja Lehmann ◽

David M. Cash ◽

...

Keyword(s):

White Matter ◽

White Matter Hyperintensity ◽

Hippocampal Atrophy

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Corpus Callosum Atrophy, White Matter Lesions, and Frontal Executive Dysfunction in Normal Aging and Alzheimer's Disease. A Community-Based Study: The Tajiri Project

International Psychogeriatrics ◽

10.1017/s104161020300872x ◽

2003 ◽

Vol 15 (1) ◽

pp. 9-25 ◽

Cited By ~ 28

Author(s):

Kenichi Meguro ◽

Jean-Marc Constans ◽

Masumi Shimada ◽

Satoshi Yamaguchi ◽

Junichi Ishizaki ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

White Matter ◽

Corpus Callosum ◽

Executive Dysfunction ◽

Normal Aging ◽

Combined Effect ◽

White Matter Hyperintensity ◽

Control Group ◽

Hippocampal Atrophy

Background and Objectives: Cerebral MRIs of normal aging and Alzheimer's disease (AD) frequently reveal corpus callosum (CC) atrophy, white matter hyperintensity (WMH), and hippocampal atrophy. However, their relationship between these findings and cognitive function has not been fully studied. We investigated the relationship between CC atrophy, WHM, and hippocampal atrophy, together with frontal executive dysfunction in both normal aging and AD. Method: We examined 170 randomly selected residents from a designated community: 99 Clinical Dementia Rating (CDR) 0 (healthy, control group, HC) participants, 54 CDR 0.5 (very mild AD) patients, and 17 CDR 1 & 2 (probable AD) patients. By means of MRI, WMH and CC atrophy were visually rated. Four portions of the CC and the hippocampal width were measured. A Mini-Mental State Examination and Cognitive Abilities Screening Instrument (CASI) were performed to assess global function. For the frontal function, the CASI subitems of attention and word fluency, letter-based fluency, the Digit Symbol test of the WAIS-R, and Trail Making Tests were performed. Results: Those patients with CDR 1 & 2 had both hippocampal and CC atrophy, whereas the CDR 0.5 patients had only hippocampal atrophy. Frontal executive dysfunction was associated with CC atrophy in both the HC and AD groups. Significant Spearman correlations were noted between CC atrophy and WMH in both groups. The combined effect of CC atrophy and WMH was noted only in the verbal fluency tests in the HC group. Conclusion: In both groups, CC atrophy was associated with frontal executive dysfunction. The combined effect of CC atrophy and WMH in normal aging was probably due to subclinical inschemic conditions.

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Subclinical Cognitive and Neuropsychiatric Correlates and Hippocampal Volume Features of Brain White Matter Hyperintensity in Healthy People

Journal of Personalized Medicine ◽

10.3390/jpm10040172 ◽

2020 ◽

Vol 10 (4) ◽

pp. 172

Author(s):

Gianfranco Spalletta ◽

Mariangela Iorio ◽

Daniela Vecchio ◽

Federica Piras ◽

Valentina Ciullo ◽

...

Keyword(s):

White Matter ◽

Brain Aging ◽

Hippocampal Volume ◽

Volumetric Analysis ◽

White Matter Hyperintensity ◽

Multivariable Logistic Regression Analysis ◽

Magnetic Resonance Imaging Scan ◽

Hippocampal Atrophy ◽

Brain White Matter ◽

The Right

White matter hyperintensities (WMH) are associated with brain aging and behavioral symptoms as a possible consequence of disrupted white matter pathways. In this study, we investigated, in a cohort of asymptomatic subjects aged 50 to 80, the relationship between WMH, hippocampal atrophy, and subtle, preclinical cognitive and neuropsychiatric phenomenology. Thirty healthy subjects with WMH (WMH+) and thirty individuals without (WMH−) underwent comprehensive neuropsychological and neuropsychiatric evaluations and 3 Tesla Magnetic Resonance Imaging scan. The presence, degree of severity, and distribution of WMH were evaluated with a semi-automated algorithm. Volumetric analysis of hippocampal structure was performed through voxel-based morphometry. A multivariable logistic regression analysis indicated that phenomenology of subclinical apathy and anxiety was associated with the presence of WMH. ROI-based analyses showed a volume reduction in the right hippocampus of WMH+. In healthy individuals, WMH are associated with significant preclinical neuropsychiatric phenomenology, as well as hippocampal atrophy, which are considered as risk factors to develop cognitive impairment and dementia.

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Clinical phenotype, atrophy, and small vessel disease in APOEε2 carriers with Alzheimer disease

Neurology ◽

10.1212/wnl.0000000000006503 ◽

2018 ◽

Vol 91 (20) ◽

pp. e1851-e1859 ◽

Cited By ~ 16

Author(s):

Colin Groot ◽

Carole H. Sudre ◽

Frederik Barkhof ◽

Charlotte E. Teunissen ◽

Bart N.M. van Berckel ◽

...

Keyword(s):

White Matter ◽

Alzheimer Disease ◽

Gray Matter ◽

Small Vessel Disease ◽

Clinical Phenotype ◽

Small Vessel ◽

White Matter Hyperintensity ◽

Language Functions ◽

Vessel Disease ◽

Gray Matter Atrophy

ObjectiveTo examine the clinical phenotype, gray matter atrophy patterns, and small vessel disease in patients who developed prodromal or probable Alzheimer disease dementia, despite carrying the protective APOEε2 allele.MethodsWe included 36 β-amyloid-positive (by CSF or PET) APOEε2 carriers (all ε2/ε3) with mild cognitive impairment or dementia due to Alzheimer disease who were matched for age and diagnosis (ratio 1:2) to APOEε3 homozygotes and APOEε4 carriers (70% ε3/ε4 and 30% ε4/ε4). We assessed neuropsychological performance across 4 cognitive domains (memory, attention, executive, and language functions), performed voxelwise and region of interest analyses of gray matter atrophy on T1-weighted MRI, used fluid-attenuated inversion recovery images to automatically quantify white matter hyperintensity volumes, and assessed T2*-weighted images to identify microbleeds. Differences in cognitive domain scores, atrophy, and white matter hyperintensities between ε2 carriers, ε3 homozygotes, and ε4 carriers were assessed using analysis of variance analyses, and Pearson χ2 tests were used to examine differences in prevalence of microbleeds.ResultsWe found that ε2 carriers performed worse on nonmemory domains compared to both ε3 homozygotes and ε4 carriers but better on memory compared to ε4 carriers. Voxelwise T1-weighted MRI analyses showed asymmetric (left > right) temporoparietal-predominant atrophy with subtly less involvement of medial–temporal structures in ε2 carriers compared to ε4 carriers. Finally, ε2 carriers had larger total white matter hyperintensity volumes compared to ε4 carriers (mean 10.4 vs 7.3 mL) and a higher prevalence of microbleeds compared to ε3 homozygotes (37.5% vs 18.3%).ConclusionAPOEε2 carriers who develop Alzheimer disease despite carrying the protective allele display a nonamnestic clinical phenotype with more severe small vessel disease.

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