Relationship between White Matter Lesions and Progression of Cognitive Decline in Alzheimer's Disease

Abstract

Background: This study examined the relationship between baseline white matter lesions (WMLs) and the progression of cognitive decline in patients with late-onset Alzheimer's disease (AD). Methods: Fifty-six patients with AD were included in the study (23 men, 33 women; mean age, 77.8 years). All subjects were treated with acetylcholinesterase inhibitors and followed up for approximately 1 year. The Mini-Mental State Examination (MMSE) score was assessed at least twice to evaluate the progressive cognitive impairment. All subjects underwent brain MRI at baseline and were divided into WMLs(-), mild WMLs(+), and moderate WMLs(+) groups based on WML severity. Changes in MMSE scores between baseline and follow-up were analyzed using the Wilcoxon signed-rank test. Results: MMSE scores at baseline did not differ significantly among the three groups (p = 0.1658), whereas MMSE scores at the follow-up evaluation were significantly lower in the moderate WMLs(+) group than in the WMLs(-) group (p = 0.0257). The mean MMSE scores remained above baseline values during the approximately 1-year follow-up in the WMLs(-) group, whereas they were decreased in the mild and moderate WMLs(+) groups. Moreover, the frequency of improvement in patients from the WMLs(-) group tended to be higher than that in patients from the WMLs(+) groups. Conclusion: Baseline WMLs may be associated with the heterogeneous progression of cognitive decline in patients with AD.

Hypertensive Disorders of Pregnancy Appear Not to Be Associated with Alzheimer's Disease Later in Life

“…Subjective cognitive complaints can be the first sign of AD in elderly whose objective cognitive performance is normal [ 29 ]. Furthermore, white matter lesions on cerebral magnetic resonance imaging (MRI) correlate with subjective cognitive failure [ 30 ], and the severity of white matter lesions has been shown to predict the rate of cognitive decline over time [ 31 , 32 ]. These white matter lesions are suggested to play an important role in the pathogenesis of dementia [ 33 , 34 , 35 ].…”

“…These white matter lesions are suggested to play an important role in the pathogenesis of dementia [ 33 , 34 , 35 ]. The frequency of white matter lesions in women with AD varies [ 32 , 36 ]. Although the etiology of AD is still not completely elucidated, it is now known that the presence of cerebral white matter lesions, vascular risk factors and endothelial dysfunction contribute to its development [ 37 , 38 , 39 , 40 ].…”

Relationship between white matter lesions and regional cerebral blood flow changes during longitudinal follow up in Alzheimer's disease

“…The effects of WML on cognitive function in AD patients are controversial, however, because of differences in the study samples or methods used to assess cognitive function . We previously evaluated the effect of WML on cognitive function and cerebral perfusion at baseline in AD patients . AD patients with WML had significantly decreased regional cerebral blood flow (rCBF) in regions associated with memory and learning, and a rapid progression of cognitive decline during the 1‐year follow up compared with those without WML.…”

Induction of Genes Expressed in Endothelial Cells of the Corpus Callosum in the Chronic Cerebral Hypoperfusion Rat Model

“…Cerebral white matter lesions (WMLs), characterized by hyperintense signals on T2-weighted magnetic resonance images, are observed in healthy elderly people and patients with subcortical vascular dementia [1,2,3,4,5]. These WMLs are thought to be associated with cognitive impairment [2,6].…”

“…These WMLs are thought to be associated with cognitive impairment [2,6]. Neuropathologic changes of WMLs are characterized by rarefaction, demyelination, gliosis, microglial activation, and axonal loss [7,8,9,10].…”