title: Diffusion tensor imaging of white matter degeneration in Alzheimer's disease and mild cognitive impairment.
abstract: Alzheimer's disease (AD) has traditionally been regarded as a disease of the gray matter (GM). However, the advent of diffusion tensor imaging (DTI) has contributed to new knowledge about how changes in white matter (WM) microstructure in vivo may be directly related to the pathophysiology of AD. It is now evident that WM is heavily affected in AD, even at early stages. Still, our knowledge about WM degeneration in AD is poor compared to what we know about GM atrophy. For instance, it has not been clear if WM can be directly affected in AD independently of GM degeneration, or whether WM changes mainly represent secondary effects of GM atrophy, e.g. through Wallerian degeneration. In this paper, we review recent studies using DTI to study WM alterations in AD. These studies suggest that microstructural WM affection at pre-AD stages cannot completely be accounted for by concomitant GM atrophy. Further, recent research has demonstrated relationships between increased cerebrospinal fluid levels of Tau proteins and changes in WM microstructure indexed by DTI, which could indicate that WM degeneration in pre-AD stages is related to ongoing axonal damage. We conclude that DTI is a promising biomarker for AD, with the potential also to identify subgroups of patients with especially high degree of WM affection, thereby contributing to more differentiated pre-AD diagnoses. However, more research and validation studies are needed before it is realistic to use this information in clinical practice with individual patients.
authors.affiliation: Research Group for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo, Norway. Electronic address: inge.amlien@psykologi.uio.no.
authors.forename: I K
authors.initials: IK
authors.lastname: Amlien
authors.affiliation: Research Group for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo, Norway.
authors.forename: A M
authors.initials: AM
authors.lastname: Fjell
mesh_terms: D000544:Alzheimer Disease / Q000473:pathology*; D000818:Animals; D001369:Axons / Q000473:pathology*; D015415:Biomarkers; D060825:Cognitive Dysfunction / Q000473:pathology*; D056324:Diffusion Tensor Imaging; D018450:Disease Progression; D066128:Gray Matter / Q000473:pathology; D006801:Humans; D009410:Nerve Degeneration; D014855:Wallerian Degeneration; D066127:White Matter / Q000473:pathology*; D016875:tau Proteins / Q000134:cerebrospinal fluid
chemical_list: D015415:Biomarkers; D016875:tau Proteins
keywords: Alzheimer’s disease; CSF biomarkers; Tau proteins; diffusion tensor imaging; mild cognitive impairment; white matter