Regional pattern of white matter microstructural changes in normal aging, MCI, and AD.

Abstract:

OBJECTIVE:To cross-sectionally compare the regional white matter fractional anisotropy (FA) of cognitively normal (CN) older individuals and patients with mild cognitive impairment (MCI) and Alzheimer disease (AD), separately focusing on the normal-appearing white matter (NAWM) and white matter hyperintensities (WMH), and to test the independent effects of presumed degenerative and vascular process on FA differences. METHODS:Forty-seven patients with AD, 73 patients with MCI, and 95 CN subjects received diffusion tensor imaging and vascular risk evaluation. To properly control normal regional variability of FA, we divided cerebral white matter into 4 strata as measured from a series of young healthy individuals (H1 = highest; H2 = intermediate high; H3 = intermediate low; H4 = lowest anisotropy stratum). RESULTS:For overall cerebral white matter, patients with AD had significantly lower FA than CN individuals or patients with MCI in the regions with higher baseline anisotropy (H1, H2, and H3), corresponding to long corticocortical association fibers, but not in H4, which mostly includes heterogeneously oriented fibers. Vascular risk showed significant independent effects on FA in all strata except H1, which corresponds to the genu and splenium of the corpus callosum. Similar results were found within NAWM. FA in WMH was significantly lower than NAWM across all strata but was not associated with diagnosis or vascular risk. CONCLUSIONS:Both vascular and Alzheimer disease degenerative process contribute to microstructural injury of cerebral white matter across the spectrum of cognitive ability and have different region-specific injury patterns.

journal_name

Neurology

journal_title

Neurology

authors

Lee DY,Fletcher E,Martinez O,Ortega M,Zozulya N,Kim J,Tran J,Buonocore M,Carmichael O,DeCarli C

doi

10.1212/WNL.0b013e3181c33afb

subject

Has Abstract

pub_date

2009-11-24 00:00:00

pages

1722-8

issue

21

eissn

0028-3878

issn

1526-632X

pii

WNL.0b013e3181c33afb

journal_volume

73

pub_type

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