J Clin Neurol.  2016 Apr;12(2):201-208. 10.3988/jcn.2016.12.2.201.

Regional MRI Diffusion, White-Matter Hyperintensities, and Cognitive Function in Alzheimer's Disease and Vascular Dementia

• Altamura C
• Scrascia F
• Quattrocchi CC
• Errante Y
• Gangemi E
• Curcio G
• Ursini F
• Silvestrini M
• Maggio P
• Beomonte Zobel B
• Rossini PM
• Pasqualetti P
• Falsetti L
• Vernieri F

• KMID: 2354141
• DOI: http://doi.org/10.3988/jcn.2016.12.2.201

Abstract

BACKGROUND AND PURPOSE
An increase in brain water diffusivity as measured using magnetic resonance imaging (MRI) has been recently reported in normal-appearing white matter (NAWM) in patients affected by cognitive impairment. However, it remains to be clarified if this reflects an overt neuronal tissue disruption that leads to degenerative or microvascular lesions. This question was addressed by comparing the regional MRI apparent diffusion coefficients (ADCs) of NAWM in patients affected by Alzheimer's disease (AD) or vascular dementia (VaD). The relationships of ADCs with the white-matter hyperintensity (WMH) burden, carotid atherosclerosis, and cognitive performance were also investigated.
METHODS
Forty-nine AD and 31 VaD patients underwent brain MRI to assess the WMH volume and regional NAWM ADCs, neuropsychological evaluations, and carotid ultrasound to assess the plaque severity and intima-media thickness (IMT).
RESULTS
Regional ADCs in NAWM did not differ between VaD and AD patients, while the WMH volume was greater in VaD than in AD patients. The ADC in the anterior corpus callosum was related to the WMH volume, while a greater carotid IMT was positively correlated with the temporal ADC and WMH volume. The memory performance was worse in patients with higher temporal ADCs. Constructional praxis scores were related to ADCs in the frontal, and occipital lobes, in the anterior and posterior corpus callosum as well as to the WMH volume. Abstract reasoning was related to frontal, parietal, and temporal ADCs.
CONCLUSIONS
Our data show that higher regional ADCs in NAWM are associated with microcirculatory impairment, as depicted by the WMH volume. Moreover, regional ADCs in NAWM are differently associated with the neuropsychological performances in memory, constructional praxia, and abstract reasoning domains.

Keyword

Alzheimer's disease; vascular dementia; diffusion magnetic resonance imaging; leukoaraiosis; atherosclerosis

MeSH Terms

Alzheimer Disease*
Atherosclerosis
Brain
Carotid Artery Diseases
Corpus Callosum
Dementia, Vascular*
Diffusion Magnetic Resonance Imaging
Diffusion*
Humans
Leukoaraiosis
Magnetic Resonance Imaging*
Memory
Neurons
Occipital Lobe
Rabeprazole
Ultrasonography
Water
Water

Figure

• 

  Fig. 1 Scatterplot showing the relationship on a logarithmic scale between the ADC in the anterior corpus callosum and the WMH volume in AD (circles) and VaD (squares) patients.

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