Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
Department of Neurology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
J Magn Reson Imaging. 2024 Jul;60(1):268-278. doi: 10.1002/jmri.29022. Epub 2023 Sep 22.
White matter (WM) degeneration is a key feature of Alzheimer's disease (AD). However, the underlying mechanism remains unclear.
To investigate how amyloid-β (Aβ), tau, and small vascular disease (SVD) jointly affect WM degeneration in subjects along AD continuum.
Retrospective.
152 non-demented participants (age: 55.8-91.6, male/female: 66/86) from the ADNI database were included, classified into three groups using the A (Aβ)/T (tau)/N pathological scheme (Group 1: A-T-; Group 2: A+T-; Group 3: A+T+) based on positron emission tomography data.
FIELD STRENGTH/SEQUENCE: 3T; T1-weighted images, T2-weighted fluid-attenuated inversion recovery images, T2*-weighted images, diffusion-weighted spin-echo echo-planar imaging sequence (54 diffusion directions).
Free-water diffusion model (generated parameters: free water, FW; tissue fractional anisotropy, FAt; tissue mean diffusivity, MDt); SVD total score; Neuropsychological tests.
Linear regression analysis was performed to investigate the independent contribution of AD (Aβ and tau) and SVD pathologies to diffusion parameters in each fiber tract, first in the entire population and then in each subgroup. We also investigated associations between diffusion parameters and cognitive functions. The level of statistical significance was set at p < 0.05 (false discovery rate corrected).
In the entire population, we found that: 1) Increased FW was significantly associated with SVD and tau, while FAt and MDt were significantly associated with Aβ and tau; 2) The spatial pattern of fiber tracts related to a certain pathological marker is consistent with the known distribution of that pathology; 3) Subgroup analysis showed that Group 2 and 3 had more alterations of FAt and MDt associated with Aβ and tau; 4) Diffusion imaging indices showed significant associations with cognitive score in all domains except memory.
WM microstructural injury was associated with both AD and SVD pathologies, showing compartment-specific, tract-specific, and stage-specific WM patterns.
1 TECHNICAL EFFICACY: Stage 3.
脑白质（WM）退化是阿尔茨海默病（AD）的一个关键特征。然而，其潜在机制尚不清楚。
探讨淀粉样蛋白-β（Aβ）、tau 和小血管疾病（SVD）如何共同影响 AD 连续体中 WM 退化的情况。
回顾性。
来自 ADNI 数据库的 152 名非痴呆参与者（年龄：55.8-91.6，男/女：66/86），根据正电子发射断层扫描数据，采用 A（Aβ）/T（tau）/N 病理方案（A-T-组、A+T-组、A+T+组）进行分类。
磁场强度/序列：3T；T1 加权图像、T2 加权液体衰减反转恢复图像、T2*-加权图像、扩散加权自旋回波回波平面成像序列（54 个扩散方向）。
自由水扩散模型（生成参数：自由水、FW；组织各向异性分数、FAt；组织平均扩散率、MDt）；SVD 总分；神经心理学测试。
采用线性回归分析，首先在整个人群中，然后在每个亚组中，研究 AD（Aβ 和 tau）和 SVD 病理学对各纤维束扩散参数的独立贡献。我们还研究了扩散参数与认知功能之间的相关性。统计学显著性水平设定为 p<0.05（错误发现率校正）。
在整个人群中，我们发现：1）FW 的增加与 SVD 和 tau 显著相关，而 FAt 和 MDt 与 Aβ 和 tau 显著相关；2）与特定病理标志物相关的纤维束的空间模式与该病理的已知分布一致；3）亚组分析显示，Aβ 和 tau 与 Group 2 和 3 的 FAt 和 MDt 改变更为相关；4）除了记忆之外，扩散成像指标与所有认知领域的认知评分均显著相关。
WM 微观结构损伤与 AD 和 SVD 病理学均相关，显示出具有特定隔室、特定束和特定阶段的 WM 模式。
1 技术功效：3 级。
