title: Clinical Significance of Cerebrovascular Biomarkers and White Matter Tract Integrity in Alzheimer Disease: Clinical correlations With Neurobehavioral Data in Cross-Sectional and After 18 Months Follow-ups.
abstract: Cerebrovascular risk factors and white matter (WM) damage lead to worse cognitive performance in Alzheimer dementia (AD). This study investigated WM microstructure using diffusion tensor imaging in patients with mild to moderate AD and investigated specific fiber tract involvement with respect to predefined cerebrovascular risk factors and neurobehavioral data prediction cross-sectionally and after 18 months. To identify the primary pathoanatomic relationships of risk biomarkers to fiber tract integrity, we predefined 11 major association tracts and calculated tract specific fractional anisotropy (FA) values. Eighty-five patients with AD underwent neurobehavioral assessments including the minimental state examination (MMSE) and 12-item neuropsychiatric inventory twice with a 1.5-year interval to represent major outcome factors. In the cross-sectional data, total cholesterol, low-density lipoprotein, vitamin B12, and homocysteine levels correlated variably with WM FA values. After entering the biomarkers and WM FA into a regression model to predict neurobehavioral outcomes, only fiber tract FA or homocysteine level predicted the MMSE score, and fiber tract FA or age predicted the neuropsychiatric inventory total scores and subdomains of apathy, disinhibition, and aberrant motor behavior. In the follow-up neurobehavioral data, the mean global FA value predicted the MMSE and aberrant motor behavior subdomain, while age predicted the anxiety and elation subdomains. Cerebrovascular risk biomarkers may modify WM microstructural organization, while the association with fiber integrity showed greater clinical significance to the prediction of neurobehavioral outcomes both cross-sectionally and longitudinally.
authors.affiliation: From the Department of Psychiatry (M-KW, S-FC); Department of Neurology, Cognition and Aging Center, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine (Y-TL, C-WH, N-CC, W-NC, Y-TC, S-FC, C-CC); Department of Health and Beauty, Shu-Zen College of Medicine and Management (P-HL, Chen-Chang Lee); and Department of Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan (Chun-Chung Lui).
authors.forename: Ming-Kung
authors.initials: MK
authors.lastname: Wu
authors.forename: Yan-Ting
authors.initials: YT
authors.lastname: Lu
authors.forename: Chi-Wei
authors.initials: CW
authors.lastname: Huang
authors.forename: Pin-Hsuan
authors.initials: PH
authors.lastname: Lin
authors.forename: Nai-Ching
authors.initials: NC
authors.lastname: Chen
authors.forename: Chun-Chung
authors.initials: CC
authors.lastname: Lui
authors.forename: Wen-Neng
authors.initials: WN
authors.lastname: Chang
authors.forename: Chen-Chang
authors.initials: CC
authors.lastname: Lee
authors.forename: Ya-Ting
authors.initials: YT
authors.lastname: Chang
authors.forename: Sz-Fan
authors.initials: SF
authors.lastname: Chen
authors.forename: Chiung-Chih
authors.initials: CC
authors.lastname: Chang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000097:blood / Q000473:pathology* / Q000523:psychology; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D008297:Male; D012044:Regression Analysis; D066127:White Matter / Q000473:pathology*