title: Subcortical whiter matter hyperintensities within the cholinergic pathways of patients with dementia and parkinsonism.
abstract: OBJECTIVE
  White matter hyperintensities (WMHs) in the cholinergic pathways are associated with cognitive performance in Alzheimer's disease (AD) and Parkinson disease dementia (PDD). This study aimed to evaluate the relationship between loss of white matter cholinergic pathways and cognitive function in patients with AD, diffuse Lewy body disease (DLB), and PDD.
  
  
  METHODS
  The subjects included 20 patients with AD, 17 with DLB, 21 with PDD, and 20 healthy controls. The extent of WMHs within cholinergic pathways was assessed using the Cholinergic Pathways Hyperintensities Scale (CHIPS) and was compared among the different diseases.
  
  
  RESULTS
  The mean CHIPS scores were similar among the three dementia groups (AD vs. DLB vs. PDD = 34.6 ± 17.9 vs. 32.4 ± 14.1 vs. 31.8 ± 14.5, p = 0.781 by ANCOVA) and higher than those of controls (11.5 ± 7.6, p = 0.001 by ANCOVA).
  
  
  CONCLUSIONS
  Losses of cholinergic pathways were similar among AD, DLB, and PDD groups, and more severe cognitive dysfunction was associated with elevated WMHs. These findings suggest that interruption of acetylcholine pathways may be related to cognitive dysfunction in these three diseases, even though they have different pathological mechanisms.
authors.affiliation: Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Hyung-Eun
authors.initials: HE
authors.lastname: Park
authors.affiliation: Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: In-Seok
authors.initials: IS
authors.lastname: Park
authors.affiliation: Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Yoon-Sang
authors.initials: YS
authors.lastname: Oh
authors.affiliation: Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Dong-Won
authors.initials: DW
authors.lastname: Yang
authors.affiliation: Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Kwang-Soo
authors.initials: KS
authors.lastname: Lee
authors.affiliation: Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Hyun-Seok
authors.initials: HS
authors.lastname: Choi
authors.affiliation: Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Kook-Jin
authors.initials: KJ
authors.lastname: Ahn
authors.affiliation: Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, South Korea. Electronic address: neuronet@catholic.ac.kr.
authors.forename: Joong-Seok
authors.initials: JS
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D018678:Cholinergic Agents / Q000378:metabolism*; D003704:Dementia / Q000473:pathology*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D020961:Lewy Body Disease / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D009434:Neural Pathways / Q000378:metabolism* / Q000473:pathology; D009483:Neuropsychological Tests; D020734:Parkinsonian Disorders / Q000473:pathology*; D066127:White Matter / Q000378:metabolism* / Q000473:pathology*
chemical_list: D018678:Cholinergic Agents
keywords: Alzheimer's disease (AD); Cholinergic Pathways Hyperintensities Scale (CHIPS); Cognition; Diffuse Lewy body disease (DLB); Magnetic resonance imaging; Parkinson disease dementia (PDD)