Department of Radiology, Mayo Clinic, Rochester, MN, USA.
Department of Neurology, Mayo Clinic, Rochester, MN, USA.
Neurobiol Aging. 2022 Nov;119:46-55. doi: 10.1016/j.neurobiolaging.2022.07.008. Epub 2022 Jul 28.
White matter hyperintensities (WMH) are markers of cerebral small vessel disease and are associated with higher risk of typical amnestic Alzheimer's disease (tAD). Little is known about the frequency and distribution of WMH in atypical variants of AD, including logopenic progressive aphasia (LPA) and posterior cortical atrophy (PCA). We investigated WMHs in 75 LPA, 39 PCA, and 50 tAD patients and associations with age, beta-amyloid PET burden, and cognition. PCA had greater subcortical WMHs in right occipital, parietal, and temporal lobes compared to LPA, and greater parieto-occipital subcortical and occipital periventricular WMHs than tAD. LPA had greater subcortical WMHs in left parietal lobe and deep white matter WMHs than PCA, and greater fronto-occipital subcortical and occipital periventricular WMHs than tAD. Total WMH increased with increasing age but was not related to beta-amyloid burden. Greater WMH was associated with visuoperceptual performance in LPA and PCA after correcting for atrophy. WMH topography differs across AD variants. Further work is needed to determine whether they reflect cerebrovascular disease or regionally specific neurodegenerative changes.
脑白质高信号（WMH）是脑小血管疾病的标志物，与典型遗忘型阿尔茨海默病（tAD）的更高风险相关。关于阿尔茨海默病非典型变异（包括失语法性进展性失语症（LPA）和后部皮质萎缩症（PCA））中 WMH 的频率和分布知之甚少。我们研究了 75 例 LPA、39 例 PCA 和 50 例 tAD 患者的 WMH，并探讨了其与年龄、β-淀粉样蛋白 PET 负荷和认知的关系。与 LPA 相比，PCA 右侧枕叶、顶叶和颞叶的皮质下 WMH 更多，而与 tAD 相比，PCA 的顶枕叶皮质下和枕周脑室周围 WMH 更多。与 PCA 相比，LPA 左侧顶叶和深部白质的皮质下 WMH 更多，与 tAD 相比，LPA 的额枕叶皮质下和枕周脑室周围 WMH 更多。总 WMH 随年龄增加而增加，但与β-淀粉样蛋白负荷无关。在纠正萎缩后，更大的 WMH 与 LPA 和 PCA 的视觉感知表现相关。AD 变异体的 WMH 分布不同。还需要进一步的工作来确定它们是否反映了脑血管疾病或区域特异性的神经退行性变化。
