title: White matter lesions are associated with cortical atrophy more than entorhinal and hippocampal atrophy.
abstract: The goal of this study was to examine the relationship between subcortical vascular disease and brain atrophy in patients with Alzheimer's disease (AD) and mixed dementia (i.e., AD and subcortical vascular disease together). MRI was performed on 77 cognitively normal (CN) subjects, 50 AD and 13 mixed dementia patients. Subcortical vascular disease was determined by white matter hyperintensities (WMH) volume and presence of subcortical lacunes. Brain atrophy was measured using total brain cortical gray matter (CGM), entorhinal cortex (ERC) and hippocampal volumes. CGM volume, but not ERC or hippocampal volume was inversely related to WMH volume in patients and controls. In contrast, no relationship was detected between CGM, ERC, or hippocampal volumes and subcortical lacunes. Furthermore, no interaction was found between WMH and diagnosis on cortical atrophy, implying that WMH affect cortical atrophy indifferently of group. These results suggest that subcortical vascular disease, manifested as WMH, may affect cortical atrophy more than ERC and hippocampal atrophy. Further, AD pathology and subcortical vascular disease may independently affect cortical atrophy.
authors.affiliation: Magnetic Resonance Unit (114M), Department of Veterans Affairs Medical Center, 4150, Clement Street, San Francisco, CA 94121, USA.
authors.forename: An-Tao
authors.initials: AT
authors.lastname: Du
authors.forename: Norbert
authors.initials: N
authors.lastname: Schuff
authors.forename: Linda L
authors.initials: LL
authors.lastname: Chao
authors.forename: John
authors.initials: J
authors.lastname: Kornak
authors.forename: Frank
authors.initials: F
authors.lastname: Ezekiel
authors.forename: William J
authors.initials: WJ
authors.lastname: Jagust
authors.forename: Joel H
authors.initials: JH
authors.lastname: Kramer
authors.forename: Bruce R
authors.initials: BR
authors.lastname: Reed
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Miller
authors.forename: David
authors.initials: D
authors.lastname: Norman
authors.forename: Helena C
authors.initials: HC
authors.lastname: Chui
authors.forename: Michael W
authors.initials: MW
authors.lastname: Weiner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000473:pathology*; D001284:Atrophy / Q000473:pathology; D002540:Cerebral Cortex / Q000473:pathology*; D003072:Cognition Disorders / Q000209:etiology / Q000473:pathology; D015140:Dementia, Vascular / Q000209:etiology / Q000473:pathology*; D018728:Entorhinal Cortex / Q000473:pathology*; D005260:Female; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests