Regional white matter hyperintensity volume, not hippocampal atrophy, predicts incident Alzheimer disease in the community.
Adam M. Brickman,Frank A. Provenzano,Jordan Muraskin,Jennifer J. Manly,Sonja Blum,Zoltan L. Apa,Yaakov Stern,Truman R. Brown,José A. Luchsinger,Richard Mayeux +9 more
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The findings highlight the regional specificity of the association of white matter hyperintensities with AD, and it is not clear whether parietal WMHs solely represent a marker for cerebrovascular burden or point to distinct injury compared with other regions.Abstract:
Background New-onset Alzheimer disease (AD) is often attributed to degenerative changes in the hippocampus. However, the contribution of regionally distributed small vessel cerebrovascular disease, visualized as white matter hyperintensities (WMHs) on magnetic resonance imaging, remains unclear. Objective To determine whether regional WMHs and hippocampal volume predict incident AD in an epidemiological study. Design A longitudinal community-based epidemiological study of older adults from northern Manhattan, New York. Setting The Washington Heights/Inwood Columbia Aging Project. Participants Between 2005 and 2007, 717 participants without dementia received magnetic resonance imaging scans. A mean (SD) of 40.28 (9.77) months later, 503 returned for follow-up clinical examination and 46 met criteria for incident dementia (45 with AD). Regional WMHs and relative hippocampal volumes were derived. Three Cox proportional hazards models were run to predict incident dementia, controlling for relevant variables. The first included all WMH measurements; the second included relative hippocampal volume; and the third combined the 2 measurements. Main Outcome Measure Incident AD. Results White matter hyperintensity volume in the parietal lobe predicted time to incident dementia (hazard ratio [HR] = 1.194; P = .03). Relative hippocampal volume did not predict incident dementia when considered alone (HR = 0.419; P = .77) or with the WMH measures included in the model (HR = 0.302; P = .70). Including hippocampal volume in the model did not notably alter the predictive utility of parietal lobe WMHs (HR = 1.197; P = .049). Conclusions The findings highlight the regional specificity of the association of WMHs with AD. It is not clear whether parietal WMHs solely represent a marker for cerebrovascular burden or point to distinct injury compared with other regions. Future work should elucidate pathogenic mechanisms linking WMHs and AD pathology.read more
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Dissertation
Alzheimer’s Disease Pathophysiology and Risk Factors with Amyloid Positron Emission Tomography, an Open Science Approach, and the Consideration of Environmental Exposures
TL;DR: A hypothesis that environmental microdose lithium may mitigate Pb toxicity including cognitive impact is outlined with several literature reviews and an open source software package for PET analysis was created to improve transparency in AD research.
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Asociación entre daños en la sustancia blanca y metabolismo de la glucosa cerebral en pacientes con disfunción cognitiva
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Cerebrovascular Disease and Neurodegeneration in Alzheimer's Disease with and without a Strong Family History: A Pilot Magnetic Resonance Imaging Study in Dominican Republic.
Angel Piriz,Dolly Reyes,Atul Narkhede,Vanessa A. Guzman,Fawad Viqar,Irene B. Meier,Mariana Budge,Pedro Mena,Stephen Dashnaw,Joseph K. T. Lee,Christiane Reitz,Jose Gutierrez,Luis Campos,Martin Medrano,Rafael Lantigua,Richard Mayeux,Adam M. Brickman +16 more
TL;DR: The results are consistent with the hypothesis that small vessel cerebrovascular disease represents a core feature of AD dementia, as affected participants had elevated WMH volumes irrespective of family history status.
References
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