Key result
Amyloid pathology links to posterior white matter hyperintensities while vascular risk correlates with frontal lesions.
Why the study?
White matter hyperintensities are associated with vascular risk and Alzheimer's disease, but their relations to amyloid pathology and vascular risk in different cognitive impairment stages require clarification.
Cross-Sectional (n=339)
p-value: p=0.001
Different topographies of white matter hyperintensities are associated with distinct etiologies, with posterior WMHs linked to amyloid pathology and frontal WMHs linked to vascular risk.
WMH topography may aid etiology assessment in cognitive decline; hypothesis-generating for targeted diagnostics pending longitudinal studies.
White matter hyperintensities (WMHs) are associated with vascular risk and Alzheimer’s disease. In this study, we examined relations between WMH load and distribution, amyloid pathology and vascular risk in 339 controls and cases with either subjective (SCD) or mild cognitive impairment (MCI). Regional deep (DWMH) and periventricular (PWMH) WMH loads were determined using an automated algorithm. We stratified on Aβ1-42 pathology (Aβ+/−) and analyzed group differences, as well as associations with Framingham Risk Score for cardiovascular disease (FRS-CVD) and age. Occipital PWMH ( p = 0.001) and occipital DWMH ( p = 0.003) loads were increased in SCD-Aβ+ compared with Aβ− controls. In MCI-Aβ+ compared with Aβ− controls, there were differences in global WMH ( p = 0.003), as well as occipital DWMH ( p = 0.001) and temporal DWMH ( p = 0.002) loads. FRS-CVD was associated with frontal PWMHs ( p = 0.003) and frontal DWMHs ( p = 0.005), after adjusting for age. There were associations between global and all regional WMH loads and age. In summary, posterior WMH loads were increased in SCD-Aβ+ and MCI-Aβ+ cases, whereas frontal WMHs were associated with vascular risk. The differences in WMH topography support the use of regional WMH load as an early-stage marker of etiology.
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Pålhaugen et al. (2020) conducted a cross-sectional in Subjective cognitive decline (SCD) or mild cognitive impairment (MCI) (n=339). Amyloid pathology (Aβ+) and vascular risk vs. Aβ− controls was evaluated on Regional deep (DWMH) and periventricular (PWMH) white matter hyperintensity loads (p=0.001). Amyloid pathology was associated with increased posterior white matter hyperintensity loads (occipital PWMH p=0.001), whereas vascular risk was associated with frontal white matter hyperintensities.
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