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White Matter Intensities in Alzheimer Disease

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White Matter Intensities in Alzheimer Disease


This is the Medscape Neurology Minute. I am Dr. Alan Jacobs. Most current approaches to Alzheimer's disease focus on the accumulation of amyloid plaque in the brain. Now, researchers at the Taub Institute for Research on Alzheimer's Disease and Aging at Columbia University in New York City have examined the additional contribution of small-vessel cerebrovascular disease which they visualized as white matter hyperintensities. The study included 20 patients with clinically defined Alzheimer's disease, 59 patients with mild cognitive impairment, and 21 normal control individuals. Using data from the Alzheimer's Disease Neuroimaging Initiative public database, the researchers found that amyloid and white matter hyperintensities were equally associated with an Alzheimer's diagnosis. Amyloid and white matter hyperintensities were also equally predictive of which patients with mild cognitive impairment would go on to develop Alzheimer's. Among those with significant amyloid, white matter hyperintensities were more prevalent in those with Alzheimer's than in normal control individuals. The investigators concluded that along with amyloid deposits, white matter hyperintensities may be a second necessary factor for the development of Alzheimer's disease, and that because risk factors for white matter disease, which are mainly vascular, can be controlled, this finding suggests potential ways to prevent the development of Alzheimer's in those with amyloid deposits.

This has been the Medscape Neurology Minute. I'm Dr. Alan Jacobs.

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