title: Demyelination of superficial white matter in early Alzheimer's disease: a magnetization transfer imaging study.
abstract: Assuming selective vulnerability of short association U-fibers in early Alzheimer's disease (AD), we quantified demyelination of the surface white matter (dSWM) with magnetization transfer ratio (MTR) in 15 patients (Clinical Dementia Rating Scale [CDR] 0.5-1; Functional Assessment Staging [FAST]: 3-4) compared with 15 controls. MTRs were computed for 39 areas in each hemisphere. We found a bilateral MTR decrease in the temporal, cingulate, parietal, and prefrontal areas. With linear discriminant analysis, we successfully classified all the participants with 3 variates including the cuneus, parahippocampal, and superior temporal regions of the left hemisphere. The pattern of dSWM changed with the age of AD onset. In early onset patients, we found bilateral posterior demyelination spreading to the temporal areas in the left hemisphere. The late onset patients showed a distributed bilateral pattern with the temporal and cingulate areas strongly affected. A correlation with Mini Mental State Examination (MMSE), Lexis, and memory tests revealed the dSWM impact on cognition. A specific landscape of dSWM in early AD shows the potential of MTR imaging as an in vivo biomarker superior to currently used techniques.
authors.affiliation: Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland. Eleonora.Fornari@chuv.ch
authors.forename: Eleonora
authors.initials: E
authors.lastname: Fornari
authors.forename: Philippe
authors.initials: P
authors.lastname: Maeder
authors.forename: Reto
authors.initials: R
authors.lastname: Meuli
authors.forename: Joseph
authors.initials: J
authors.lastname: Ghika
authors.forename: Maria G
authors.initials: MG
authors.lastname: Knyazeva
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000150:complications* / Q000473:pathology*; D003711:Demyelinating Diseases / Q000150:complications* / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity