title: Decreasing myelin density reflected increasing white matter pathology in Alzheimer's disease--a neuropathological study.
abstract: BACKGROUND
  White matter disease (WMD) is frequently seen in Alzheimer's disease (AD) at neuropathological examination. It is defined as a subtotal tissue loss with a reduction of myelin, axons and oligodendrocytes as well as astrocytosis. Studies quantitatively defining the myelin loss in AD are scarce. The aim was to develop a method that could provide numerical values of myelin density in AD. The purpose was to compare the myelin contents in increasing grades of pathology of WMD, with age and cortical AD pathology as well as in different regions of the brain in AD.
  
  
  METHODS
  Sixteen cases with AD and concomitant WMD were investigated with an in-house developed image analysis technique to determine the myelin attenuation with optical density (OD) in frontoparietal, parietal, temporal and occipital white matter on whole brain coronal sections stained for myelin with Luxol Fast Blue (LFB). The OD values in LFB were compared grouped according to Haematoxylin/Eosin (HE) evaluated mild, moderate and severe WMD or normal tissue. The OD values were also correlated with age and cortical AD pathology and compared between the different studied white matter regions.
  
  
  RESULTS
  Increasing severity of WMD was associated with a statistically significant OD reduction. No correlation was seen between age and OD or overall cortical AD pathology. The OD values were significantly lower in frontoparietal-compared to occipital white matter.
  
  
  CONCLUSIONS
  Myelin loss in AD with WMD is a marked morphologic component of the disease and it is possible to determine the reduction objectively in neuropathological specimens with quantitative measures. This may be of use for clinical diagnostics including brain imaging.
authors.affiliation: Department of Pathology, Division of Neuropathology, University Hospital, Lund, Sweden. martin.sjobeck@med.lu.se
authors.forename: Martin
authors.initials: M
authors.lastname: Sjöbeck
authors.forename: Mattias
authors.initials: M
authors.lastname: Haglund
authors.forename: Elisabet
authors.initials: E
authors.lastname: Englund
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000473:pathology*; D001921:Brain / Q000473:pathology*; D002540:Cerebral Cortex / Q000473:pathology; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D009186:Myelin Sheath / Q000473:pathology*; D010781:Photography / Q000379:methods; D012720:Severity of Illness Index