Department of Neurology, Medical University of Graz, Graz, Austria.
Department of Neurology and Center for Neurosciences, Imaging of Dementia and Aging Laboratory, University of California at Davis, CA, USA.
J Alzheimers Dis. 2019;68(2):789-796. doi: 10.3233/JAD-180982.
BACKGROUND/OBJECTIVE: Higher white matter hyperintensity (WMH) load has been reported in Alzheimer's disease (AD) patients in different brain regions when compared to controls. We aimed to assess possible differences of WMH spatial distribution between AD patients and age-matched controls by means of lesion probability maps.
The present study included MRI scans of 130 probable AD patients with a mean age of 73.4±8.2 years from the Prospective Dementia Registry Austria Study and 130 age-matched healthy controls (HC) from the Austrian Stroke Prevention Family Study. Risk factors such as hypertension, diabetes mellitus, hypercholesterolemia, coronary artery disease, and smoking were assessed. Manually segmented FLAIR WMH masks were non-linearly registered to a template and voxel-based probability mapping was performed.
There were no significant between-group differences in cardiovascular risk factors and WMH volume. AD patients showed a significantly higher likelihood of having WMH in a bilateral periventricular distribution than controls before and after correcting for age, sex, cardiovascular risk factors, and ventricular volume (p≤0.05; threshold-free cluster enhancement corrected). There was no significant association between the periventricular WMH volume and cognitive decline of AD patients.
In AD, WMH were preferentially found in a periventricular location but the volume of lesions was unrelated to cognitive decline in our study irrespective of lesion location.
背景/目的：与对照组相比，阿尔茨海默病（AD）患者在不同脑区的脑白质高信号（WMH）负荷更高。我们旨在通过病灶概率图评估 AD 患者与年龄匹配的对照组之间 WMH 空间分布的差异。
本研究纳入了来自奥地利前瞻性痴呆登记研究的 130 名可能的 AD 患者和来自奥地利卒中预防家族研究的 130 名年龄匹配的健康对照组（HC）的 MRI 扫描。评估了高血压、糖尿病、高胆固醇血症、冠心病和吸烟等危险因素。手动分割的 FLAIR WMH 掩模通过非线性方法注册到模板，并进行基于体素的概率映射。
AD 患者与对照组之间在心血管危险因素和 WMH 体积方面没有显著差异。AD 患者的 WMH 双侧脑室周围分布的可能性显著高于对照组，无论是否校正年龄、性别、心血管危险因素和脑室体积（p≤0.05；阈值自由聚类增强校正）。脑室周围 WMH 体积与 AD 患者的认知下降之间没有显著相关性。
在 AD 中，WMH 优先出现在脑室周围位置，但在本研究中，无论病灶位置如何，病灶体积与认知下降无关。
