title: Dynamic Progression of White Matter Hyperintensities in Alzheimer's Disease and Normal Aging: Results from the Sunnybrook Dementia Study.
abstract: Although white matter hyperintensities (WMH), markers of cerebral small vessel disease (SVD), are believed to generally increase over time, some studies have shown sharp decreases after therapeutic intervention, suggesting that WMH progression may be more dynamic than previously thought. Our primary goal was to examine dynamic progression of WMH in a real-world sample of Alzheimer's disease (AD) patients and normal elderly (NC), with varying degrees of SVD. WMH volumes from serial magnetic resonance imaging (MRI; mean = 1.8 years) were measured from NC (n = 44) and AD patients (n = 113) with high and low SVD burden. Dynamic progression for each individual was measured using spatial overlap images to assess shrinkage, growth, and stable WMH volumes. Significant group differences were found for shrinkage (p < 0.001), growth (p < 0.001) and stable (p < 0.001) WMH, where the AD high SVD group showed the largest changes relative to low SVD and NC. Our results suggest spatial progression measured at the individual patient level may be more sensitive to the dynamic nature of WMH.
authors.affiliation: LC Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Research Program, Sunnybrook Research InstituteToronto, ON, Canada; Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Health Sciences CentreToronto, ON, Canada.
authors.forename: Joel
authors.initials: J
authors.lastname: Ramirez
authors.affiliation: LC Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Research Program, Sunnybrook Research InstituteToronto, ON, Canada; Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Health Sciences CentreToronto, ON, Canada.
authors.forename: Alicia A
authors.initials: AA
authors.lastname: McNeely
authors.affiliation: LC Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Research Program, Sunnybrook Research InstituteToronto, ON, Canada; Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Health Sciences CentreToronto, ON, Canada; Graduate Department of Psychological Clinical Science, University of Toronto ScarboroughToronto, ON, Canada.
authors.forename: Courtney
authors.initials: C
authors.lastname: Berezuk
authors.affiliation: LC Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Research Program, Sunnybrook Research InstituteToronto, ON, Canada; Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Health Sciences CentreToronto, ON, Canada.
authors.forename: Fuqiang
authors.initials: F
authors.lastname: Gao
authors.affiliation: LC Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Research Program, Sunnybrook Research InstituteToronto, ON, Canada; Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Health Sciences CentreToronto, ON, Canada; Graduate Department of Psychological Clinical Science, University of Toronto ScarboroughToronto, ON, Canada; Faculty of Medicine, School of Graduate Studies, University of TorontoToronto, ON, Canada; Department of Medicine, Neurology, University of Toronto and Sunnybrook Health Sciences CentreToronto, ON, Canada.
authors.forename: Sandra E
authors.initials: SE
authors.lastname: Black
keywords: Alzheimer’s disease; aging; dementia; longitudinal progression; small vessel disease; white matter hyperintensities