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. 2017 Jul 28;17(1):144.
doi: 10.1186/s12883-017-0911-5.

Comparison of neuropsychiatric symptoms and diffusion tensor imaging correlates among patients with subcortical ischemic vascular disease and Alzheimer's disease

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Comparison of neuropsychiatric symptoms and diffusion tensor imaging correlates among patients with subcortical ischemic vascular disease and Alzheimer's disease

Min-Chien Tu et al. BMC Neurol. .

Erratum in

Abstract

Background: The causes of behavioral and psychological symptoms of dementia (BPSD) vary according to the dementia subtype and associated neuropathology. The present study aimed to (i) compare BPSD between patients with subcortical ischemic vascular disease (SIVD) and Alzheimer's disease (AD) across stages, and (ii) explore the associations with diffusion tensor imaging (DTI) in the corpus callosum (CC) and other major fibers.

Methods: Twenty-four patients with SIVD and 32 with AD were recruited. Four domains of the Neuropsychiatric Inventory (NPI) (hyperactivity, psychosis, affective, and apathy) and two DTI parameters [fractional anisotropy (FA) and mean diffusivity (MD)] within the genu, body (BCC), and splenium (SCC) of the CC and other major fibers were assessed.

Results: Overall, the patients with clinical dementia rating (CDR) 1 ~ 2 had higher scores in apathy domain than those with CDR0.5. Among those with CDR1 ~ 2, SIVD had higher scores in apathy domain than AD. MD values in the BCC/SCC were positively correlated with total NPI score and psychosis, hyperactivity, and apathy domains. FA values in the SCC were inversely correlated with total NPI score and psychosis domain. The correlations were modified by age, the CASI, and CDR scores. Stepwise linear regression models suggested that FA value within the left superior longitudinal fasciculus predicted the hyperactivity domain. MD value within the SCC/left uncinate fasciculus and FA value within the GCC/left forceps major predicted the psychosis domain. MD value within the right superior longitudinal fasciculus and CDR predicted the apathy domain. Further analysis suggested distinct patterns of regression models between SIVD and AD patients.

Conclusion: White matter integrity within the BCC/SCC had associations with multi-domains of BPSD. Our study also identified important roles of regions other than the CC to individual domain of BPSD, including the left superior longitudinal fasciculus to the hyperactivity domain, the left uncinate fasciculus/forceps major to the psychosis domain, and the right superior longitudinal fasciculus to the apathy domain. The neuronal substrates in predicting BPSD were different between SIVD and AD patients. Of note, apathy, which was more profound in SIVD, was associated with corresponding fiber disconnection in line with dementia severity and global cognition decline.

Keywords: Alzheimer’s disease; Apathy; Behavioral and psychological symptoms of dementia; Corpus callosum; Diffusion tensor imaging; Neuropsychiatric inventory; Psychosis; Subcortical ischemic vascular disease.

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Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the Institutional Review Board of our hospital (REC 103–14). All participants and caregivers provided their written informed consent to participate in this study.

Consent for publication

Not applicable [The data contain no information of individual identity].

Competing interests

The authors declare that they have no competing interests.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Template for regions of interest in diffusion tensor imaging parameters measurement (1: the genu of the corpus callosum; 2: the body of the corpus callosum; 3: the splenium of the corpus callosum; 4/5: the right/left superior longitudinal fasciculus; 6/7: the right/left anterior thalamic radiation; 8/9: the right/left forceps minor; 10/11: the right/left forceps major; 12/13:the right/left uncinate fasciculus; 14/15: the right/left inferior longitudinal fasciculus)

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