Central European Institute of Technology (CEITEC), Brain and Mind Research Program, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic.
First Department of Neurology, St. Anne's Hospital, School of Medicine, Masaryk University, Pekařská, 602 00, Brno, Czech Republic.
J Neural Transm (Vienna). 2022 Aug;129(8):1023-1030. doi: 10.1007/s00702-022-02519-z. Epub 2022 Jul 11.
White Matter Lesions (WML) are a radiological finding common in aged subjects. We explored the impact of WML on underlying neurodegenerative processes. We focused on the impact of WML on two neurodegenerative diseases with different pathology. In this cross-sectional study of 137 subjects (78 female, 59 men, mean age 67.2; 43-87 years), we compared WML in healthy controls (HC; n = 55), patients with Alzheimer's disease and amnestic Mild Cognitive Impairment (aMCI), and Parkinson's disease patients with normal cognition and with MCI. Subjects with AD and aMCI were treated as one group (n = 40), subjects with PD and PDMCI were another group (n = 42). MRI T2_FLAIR sequences were analyzed. WML were divided into periventricular (pWML) or subcortical (sWML) depending on their distance from the ventricles. Subjects from the AD + aMCI group, had a significantly greater volume of WML than both HC and the PD + PDMCI group. The volume of WML was greater in the PD + PDMCI than in HC but the difference was not significant. In AD + aMCI subjects, sWML and not pWML were related to a decrease in global cognitive functioning despite greater volume of pWML. In PD + PDMCI, pWML correlate with decline in executive functions and working memory. In HC, pWML correlated with the multidomain decrease corresponding with the aging. This points to a difference between normal aging and pathological aging due to AD and PD brain pathology. The WML location together with underlying disease related neurodegeneration may play a role in determining the effect of WML on cognition. Our results suggest that the impact of WML is not uniform in all patients; rather, their volume, location and cognitive effect may be disease-specific.
脑白质病变（WML）是老年人群中常见的影像学表现。我们探讨了 WML 对潜在神经退行性过程的影响。我们专注于 WML 对两种具有不同病理学的神经退行性疾病的影响。在这项对 137 名受试者（78 名女性，59 名男性，平均年龄 67.2 岁；43-87 岁）的横断面研究中，我们比较了健康对照组（HC；n=55）、阿尔茨海默病和遗忘型轻度认知障碍（aMCI）患者以及认知正常和 MCI 的帕金森病患者的 WML。AD 和 aMCI 患者被视为一组（n=40），PD 和 PDMCI 患者为另一组（n=42）。分析 MRI T2_FLAIR 序列。根据与脑室的距离，将 WML 分为脑室周围（pWML）或皮质下（sWML）。AD+aMCI 组的受试者 WML 体积明显大于 HC 和 PD+PDMCI 组。PD+PDMCI 组的 WML 体积大于 HC，但差异无统计学意义。在 AD+aMCI 受试者中，尽管 pWML 体积较大，但 sWML 而不是 pWML 与全球认知功能下降有关。在 PD+PDMCI 中，pWML 与执行功能和工作记忆的下降相关。在 HC 中，pWML 与与衰老相关的多领域下降相关。这表明 AD 和 PD 脑病理学导致的正常衰老和病理性衰老之间存在差异。WML 的位置以及潜在的疾病相关神经退行性变可能在确定 WML 对认知的影响方面发挥作用。我们的结果表明，WML 的影响在所有患者中并不均匀；相反，它们的体积、位置和认知效果可能是特定于疾病的。
