CSF β-amyloid and white matter damage: a new perspective on Alzheimer's disease

被引:42
作者
Pietroboni, Anna M. [1 ]
Scarioni, Marta [1 ]
Carandini, Tiziana [1 ]
Basilico, Paola [1 ]
Cadioli, Marcello [2 ]
Giulietti, Giovanni [3 ]
Arighi, Andrea [1 ]
Caprioli, Michela [1 ]
Serra, Laura [3 ]
Sina, Clara [2 ]
Fenoglio, Chiara [1 ]
Ghezzi, Laura [1 ]
Fumagalli, Giorgio G. [1 ]
De Riz, Milena A. [1 ]
Calvi, Alberto [1 ]
Triulzi, Fabio [2 ]
Bozzali, Marco [3 ,4 ]
Scarpini, Elio [1 ]
Galimberti, Daniela [1 ]
机构
[1] Univ Milan, Dept Pathophysiol & Transplantat, Neurodegenerat Dis Unit, Ctr Dino Ferrari,Fdn Ca Granda,IRCCS,Osped Maggio, Milan, Italy
[2] Univ Milan, Dept Pathophysiol & Transplantat, Neuroradiol Unit, Fdn Ca Granda,IRCCS,Osped Maggiore Policlin, Milan, Italy
[3] Santa Lucia Fdn, IRCCS, Neuroimaging Lab, Rome, Italy
[4] Univ Sussex, Brighton & Sussex Med Sch, Dept Neurosci, Brighton, E Sussex, England
关键词
VASCULAR COGNITIVE IMPAIRMENT; MR SIGNAL ABNORMALITIES; FRONTOTEMPORAL DEMENTIA; HYPERINTENSITIES; PATHOPHYSIOLOGY; HETEROGENEITY; PROGRANULIN; MUTATION; LESIONS; MEMORY;
D O I
10.1136/jnnp-2017-316603
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective To assess the connection between amyloid pathology and white matter (WM) macrostructural and microstructural damage in demented patients compared with controls. Methods Eighty-five participants were recruited: 65 with newly diagnosed Alzheimer's disease (AD), non-AD dementia or mild cognitive impairment and 20 age-matched and sex-matched healthy controls. beta-amyloid 1-42 (A beta) levels were determined in cerebrospinal fluid (CSF) samples from all patients and five controls. Among patients, 42 had pathological CSF A beta levels (A beta(+)), while 23 had normal CSF A beta levels (A beta(-)). All participants underwent neurological examination, neuropsychological testing and brain MRI. We used T2-weighted scans to quantify WM lesion loads (LLs) and diffusion-weighted images to assess their microstructural substrate. Non-parametric statistical tests were used for between-group comparisons and multiple regression analyses. Results We found an increased WM-LL in A beta(+) compared with both, healthy controls (p=0.003) and A beta(-) patients (p=0.02). Interestingly, CSF A beta concentration was the best predictor of patients' WM-LL (r=-0.30, p<0.05) when using age as a covariate. Lesion apparent diffusion coefficient value was higher in all patients than in controls (p=0.0001) and correlated with WM-LL (r=0.41, p=0.001). In A beta(+), WM-LL correlated with WM microstructural damage in the left peritrigonal WM (p<0.0001). Conclusions WM damage is crucial in AD pathogenesis. The correlation between CSF A beta levels and WM-LL suggests a direct link between amyloid pathology and WM macrostructural and microstructural damage.
引用
收藏
页码:352 / 357
页数:6
相关论文
共 40 条
[1]   White Matter Damage in Frontotemporal Lobar Degeneration Spectrum [J].
Agosta, F. ;
Scola, E. ;
Canu, E. ;
Marcone, A. ;
Magnani, G. ;
Sarro, L. ;
Copetti, M. ;
Caso, F. ;
Cerami, C. ;
Comi, G. ;
Cappa, S. F. ;
Falini, A. ;
Filippi, M. .
CEREBRAL CORTEX, 2012, 22 (12) :2705-2714
[2]   Unified segmentation [J].
Ashburner, J ;
Friston, KJ .
NEUROIMAGE, 2005, 26 (03) :839-851
[3]   Why voxel-based morphometry should be used [J].
Ashburner, J ;
Friston, KJ .
NEUROIMAGE, 2001, 14 (06) :1238-1243
[4]   A reproducible evaluation of ANTs similarity metric performance in brain image registration [J].
Avants, Brian B. ;
Tustison, Nicholas J. ;
Song, Gang ;
Cook, Philip A. ;
Klein, Arno ;
Gee, James C. .
NEUROIMAGE, 2011, 54 (03) :2033-2044
[5]   White matter lesions on magnetic resonance imaging in dementia with Lewy bodies, Alzheimer's disease, vascular dementia, and normal aging [J].
Barber, R ;
Scheltens, F ;
Gholkar, A ;
Ballard, C ;
McKeith, I ;
Ince, P ;
Perry, R ;
O'Brien, J .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1999, 67 (01) :66-72
[6]   Alzheimer's disease as homeostatic responses to age-related myelin breakdown [J].
Bartzokis, George .
NEUROBIOLOGY OF AGING, 2011, 32 (08) :1341-1371
[7]   MR SIGNAL ABNORMALITIES IN MEMORY DISORDER AND DEMENTIA [J].
BOWEN, BC ;
BARKER, WW ;
LOEWENSTEIN, DA ;
SHELDON, J ;
DUARA, R .
AMERICAN JOURNAL OF ROENTGENOLOGY, 1990, 154 (06) :1285-1292
[8]   Quantitative MRI to understand Alzheimer's disease pathophysiology [J].
Bozzali, Marco ;
Serra, Laura ;
Cercignani, Mara .
CURRENT OPINION IN NEUROLOGY, 2016, 29 (04) :437-444
[9]   Cerebral autoregulation, beta amyloid, and white matter hyperintensities are interrelated [J].
Brickman, Adam M. ;
Guzman, Vanessa A. ;
Gonzalez-Castellon, Miguel ;
Razlighi, Qolamreza ;
Gu, Yian ;
Narkhede, Atul ;
Janicki, Sarah ;
Ichise, Masanori ;
Stern, Yaakov ;
Manly, Jennifer J. ;
Schupf, Nicole ;
Marshall, Randolph S. .
NEUROSCIENCE LETTERS, 2015, 592 :54-58
[10]   Contemplating Alzheimer's Disease and the Contribution of White Matter Hyperintensities [J].
Brickman, Adam M. .
CURRENT NEUROLOGY AND NEUROSCIENCE REPORTS, 2013, 13 (12)