The Correlation Between White Matter Hyperintensity Burden and Regional Brain Volumetry in Patients With Alzheimer's Disease

Abstract

BackgroundWhite matter hyperintensities (WMHs) and regional brain lobe atrophy coexist in the brain of patients with Alzheimer's disease (AD), but the association between them in patients with AD still lacks comprehensive investigation and solid imaging data support.ObjectiveWe explored whether WMHs can promote the pathological process of AD by aggravating atrophy in specific brain regions and tried to explain the regional specificity of these relationships.MethodsA sample of 240 adults including 180 normal controls (NCs) and 80 cases with AD were drawn from the ADNI database. T1-weighted magnetic resonance imaging (MRI) and T2-weighted fluid-attenuated MRI of the participants were downloaded and were analyzed using AccuBrain® to generate the quantitative ratio of WMHs (WMHr, WMH volumes corrected by intracranial volume) and regional brain atrophy. We also divided WMHr into periventricular WMHr (PVWMHr) and deep WMHr (DWMHr) for the purpose of this study. The Cholinergic Pathways Hyperintensities Scale (CHIPS) scores were conducted by two evaluators. Independent t-test, Mann–Whitney U test, or χ2 test were used to compare the demographic characteristics, and Spearman correlation coefficient values were used to determine the association between WMHs and different regions of brain atrophy.ResultsPositive association between WMHr and quantitative medial temporal lobe atrophy (QMTA) (rs = 0.281, p = 0.011), temporal lobe atrophy (rs = 0.285, p = 0.011), and insular atrophy (rs = 0.406, p < 0.001) was found in the AD group before Bonferroni correction. PVWMHr contributed to these correlations. By separately analyzing the relationship between PVWMHr and brain atrophy, we found that there were still positive correlations after correction in QMTA (rs = 0.325, p = 0.003), temporal lobe atrophy (rs = 0.298, p = 0.007), and insular atrophy (rs = 0.429, p < 0.001) in AD group.ConclusionWMH severity tends to be associated with regional brain atrophy in patients with AD, especially with medial temporal lobe, temporal lobe, and insular lobe atrophy. PVWMHs were devoted to these correlations.

Cerebrovascular pathology mediates associations between hypoxemia during rapid eye movement sleep and medial temporal lobe structure and function in older adults

“…The findings presented identify cerebrovascular pathology as a candidate mechanism driving MTL degeneration associated with OSA-related hypoxemia. Prior studies also support this possibility, suggesting a strong link between WMH burden and MTL atrophy 143–146 which the present findings extend by implicating hypoxic burden during REM sleep as a contributor to this link. AD patients with periventricular WMH had a significantly increased risk of progression of MTL atrophy compared to those without baseline periventricular WMH 144 .…”

The role of magnetic resonance imaging in the diagnosis and prognosis of dementia

“…The whole scale considers DWMHs to a greater extent, whereas the first two grades of PWMHs are almost considered normal in the whole WM form of the Fazekas scale. Research has found that DWMHs have greater and more correlative diagnostic value to clinical presentation value (see: White matter hyperintensities); however, specific guidelines on which scale to use have not yet been established, and in both scales, there is a possibility to underdiagnose or overdiagnose patients [ 59 ].…”

Cerebrovascular lesion loads and accelerated brain aging: insights into the cognitive spectrum

“…The prevalence of WMH is 10–20% for people in their 60 s, reaching 100% in people over the age of 90 (Smith et al, 2017 ). In the aging population, WMHs can contribute to a higher rate of brain atrophy in beyond-normal brain aging, particularly in regions related to AD (Habes et al, 2016 ), such as the medial temporal lobe, insular lobe, and temporal lobe (Cao et al, 2022 ).…”