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. 2016;49(3):633-43.
doi: 10.3233/JAD-150502.

Characterizing White Matter Tract Degeneration in Syndromic Variants of Alzheimer's Disease: A Diffusion Tensor Imaging Study

Ajay Madhavan  1 , Christopher G Schwarz  1 , Joseph R Duffy  2 , Edythe A Strand  2 , Mary M Machulda  3 , Daniel A Drubach  4 , Kejal Kantarci  1 , Scott A Przybelski  5 , Robert I Reid  6 , Matthew L Senjem  1   6 , Jeffrey L Gunter  1   6 , Liana G Apostolova  7 , Val J Lowe  1 , Ronald C Petersen  4 , Clifford R Jack  1 , Keith A Josephs  4 , Jennifer L Whitwell  1
Affiliations

Characterizing White Matter Tract Degeneration in Syndromic Variants of Alzheimer's Disease: A Diffusion Tensor Imaging Study

Ajay Madhavan et al. J Alzheimers Dis. 2016.

Abstract

Background: Different clinical syndromes can arise from Alzheimer's disease (AD) neuropathology, including dementia of the Alzheimer's type (DAT), logopenic primary progressive aphasia (lvPPA), and posterior cortical atrophy (PCA).

Objective: To assess similarities and differences in patterns of white matter tract degeneration across these syndromic variants of AD.

Methods: Sixty-four subjects (22 DAT, 24 lvPPA, and 18 PCA) that had diffusion tensor imaging and showed amyloid-β deposition on PET were assessed in this case-control study. A whole-brain voxel-based analysis was performed to assess differences in fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity across groups.

Results: All three groups showed overlapping diffusion abnormalities in a network of tracts, including fornix, corpus callosum, posterior thalamic radiations, superior longitudinal fasciculus, inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, and uncinate fasciculus. Subtle regional differences were also observed across groups, with DAT particularly associated with degeneration of fornix and cingulum, lvPPA with left inferior fronto-occipital fasciculus and uncinate fasciculus, and PCA with posterior thalamic radiations, superior longitudinal fasciculus, posterior cingulate, and splenium of the corpus callosum.

Conclusion: These findings show that while each AD phenotype is associated with degeneration of a specific structural network of white matter tracts, striking spatial overlap exists among the three network patterns that may be related to AD pathology.

Keywords: Alzheimer’s disease; diffusion tensor imaging; logopenic; posterior cortical atrophy; white matter.

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Figures

Fig. 1.
Fig. 1.
Reduced fractional anisotropy (FA) and increased mean diffusivity (MD) in each disease group compared to controls. Results are shown after correction for multiple comparisons using the false discovery rate correction at p < 0.05. The bottom row shows the regions that overlap across all three disease groups when compared to controls. Lat, lateral; med, medial.
Fig. 2.
Fig. 2.
Reduced fractional anisotropy (FA) and increased mean diffusivity (MD) in DAT compared to lvPPA and PCA. Results are shown uncorrected at p < 0.05. Lat, lateral; med, medial.
Fig. 3.
Fig. 3.
Reduced fractional anisotropy (FA) and increased mean diffusivity (MD) in lvPPA compared to DAT and PCA. Results are shown uncorrected at p < 0.05. Lat, lateral; med, medial.
Fig. 4.
Fig. 4.
Reduced fractional anisotropy (FA) and increased mean diffusivity (MD) in PCA compared to DAT and lvPPA. Results are shown uncorrected at p < 0.05. Lat, lateral; med, medial.
See this image and copyright information in PMC

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