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. 2012 Oct;8(5 Suppl):S71-7.
doi: 10.1016/j.jalz.2012.04.006.

Cerebral white matter disease is associated with Alzheimer pathology in a prospective cohort

Abhay Moghekar  1 , Michael Kraut, Wendy Elkins, Juan Troncoso, Alan B Zonderman, Susan M Resnick, Richard J O'Brien
Affiliations

Cerebral white matter disease is associated with Alzheimer pathology in a prospective cohort

Abhay Moghekar et al. Alzheimers Dement. 2012 Oct.

Abstract

Background: Although magnetic resonance imaging (MRI)-detected white matter disease has been correlated with cognitive decline in the elderly individuals, it is unclear whether white matter disease is primarily responsible for the cognitive deterioration or whether another process is common to both white matter disease and dementia.

Methods: We examined the relationship between Alzheimer-type brain pathology at autopsy and MRI-detected cerebral white matter disease in 50 participants from the Baltimore Longitudinal Study of Aging Autopsy Program, a prospective study of aging that includes detailed cognitive assessments.

Results: White matter disease was quantitated in pre- and postmortem MRI scans using the Cardiovascular Health Study (CHS) criteria in a blinded manner. We found that several measures of Alzheimer's disease (AD) pathology, including the Consortium to Establish a Registry for Alzheimer's Disease score, Braak score, and a composite AD pathology score, along with hypertension, were significantly associated with CHS white matter score using univariate and multivariate ordinal regression. In contrast, amyloid angiopathy was not independently associated with CHS score. Although a clinical diagnosis of dementia was associated with CHS score in univariate analysis, the association disappeared after accounting for AD pathology.

Conclusion: AD pathology at autopsy is associated with MRI-detected cerebral white matter disease. This relationship may explain, in part, the association between cerebral white matter disease and cognitive decline in the elderly individuals.

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Conflict of interest statement

Conflicts of Interest: None

Figures

Figure 1
Figure 1. Distribution of Pre and Postmortem CHS White Matter Scores
The CHS white matter scores of 24 premortem MRI scans and 31 postmortem MRI scans on 50 subjects are shown. Using Komogorov-Smirnov analysis, these histograms do not differ (P=0.9).
Figure 2
Figure 2. White Matter Disease and Alzheimer Pathology
In A, premortem and postmortem MRI scans from Subject 5 of Table 1B were obtained 16 months apart. In B, the relationship between Dementia, AD Pathology and Cardiovascular Health Study (CHS) white matter ratings are shown for all 50 subjects in the study. Composite AD pathology refers to a weighted sum of the Braak and CERAD scores.
See this image and copyright information in PMC

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