MRI volumetric correlates of white matter lesions in dementia with lewy bodies and Alzheimer's disease

Abstract

The aim of the study was to examine the relationship between white matter changes on magnetic resonance imaging (MRI), brain atrophy and ventricular dilation in late‐life dementias. T1‐weighted, T2‐weighted, and proton density MRI scans were acquired in subjects with Alzheimer's disease (AD, N=25) and dementia with Lewy bodies (DLB, N=27). Total brain and ventricular volumes were measured and white matter lesions rated using a semi‐quantitative scale. Periventricular hyperintensities (PVH) were found to independently correlate with advancing age and increasing ventricular dilatation in all subjects. In contrast, deep white matter hyperintensities (DWMH) did not correlate with measures of brain atrophy, ventricular dilatation or age, but were associated with a history of hypertension. These findings support the hypothesis that PVH and DWMH are pathologically diverse and that white matter change in AD and DLB may be determined by similar processes. In particular, PVH appear to be linked to atrophic processes involving ventricular enlargement and DWMH to ischaemic risk factors. Copyright © 2000 John Wiley & Sons, Ltd.

MRI confirms mild cognitive impairments prodromal for Alzheimer's, vascular and Parkinson-Lewy body dementias

“…Relatively few studies were devoted to structural MRI abnormalities among subjects with cognitive impairment due to PD or LBD, particularly in MCI stages [33][34][35][36][37][38][39][40][41][42][43][44]. The present study revealed marked cerebral structural changes in PLB-MCI, which are not only different from cognitively normals, but also distinct from other major MCI subtypes studied.…”

“…However, the few available studies reported conflicting results when addressing neuroimaging characteristics for MCI subjects prodromal for other dementia subtypes, including VaD, PDD and LBD [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44]. The present study compared MRI abnormalities among different subtypes of MCI prodromal for DAT, VaD and Parkinson-Lewy body dementia (PLBD).…”

MRI confirms mild cognitive impairments prodromal for Alzheimer's, vascular and Parkinson-Lewy body dementias

“…Relatively few studies were devoted to structural MRI abnormalities among subjects with cognitive impairment due to PD or LBD, particularly in MCI stages [33][34][35][36][37][38][39][40][41][42][43][44]. The present study revealed marked cerebral structural changes in PLB-MCI, which are not only different from cognitively normals, but also distinct from other major MCI subtypes studied.…”

“…However, the few available studies reported conflicting results when addressing neuroimaging characteristics for MCI subjects prodromal for other dementia subtypes, including VaD, PDD and LBD [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44]. The present study compared MRI abnormalities among different subtypes of MCI prodromal for DAT, VaD and Parkinson-Lewy body dementia (PLBD).…”

Update on dementia with lewy bodies

“…Occipital hypoperfusion may be noted on single photon emission computed tomography (SPECT) and hypometabolism on positron emission tomography [19,20]. Other features, such as the degree of generalized atrophy, rate of progressive brain atrophy, and severity of white matter lesions, do not aid in the differential diagnosis of DLB from other dementia subtypes [21,22].…”

The influence of cerebrovascular disease in dementia with Lewy bodies and Parkinson's disease dementia

“…There was a similar prevalence and severity of MRI WMHs in DLB and AD in the periventricular [37,40,41,[58][59][60] and deep white matter [37,40,41,58,59], with the posterior periventricular and occipital regions being more affected in DLB compared to AD [36].…”

MRI confirms mild cognitive impairments prodromal for Alzheimer's, vascular and Parkinson-Lewy body dementias

“…Relatively few studies were devoted to structural MRI abnormalities among subjects with cognitive impairment due to PD or LBD, particularly in MCI stages [33][34][35][36][37][38][39][40][41][42][43][44]. The present study revealed marked cerebral structural changes in PLB-MCI, which are not only different from cognitively normals, but also distinct from other major MCI subtypes studied.…”

“…However, the few available studies reported conflicting results when addressing neuroimaging characteristics for MCI subjects prodromal for other dementia subtypes, including VaD, PDD and LBD [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44]. The present study compared MRI abnormalities among different subtypes of MCI prodromal for DAT, VaD and Parkinson-Lewy body dementia (PLBD).…”

Update on dementia with lewy bodies

“…Occipital hypoperfusion may be noted on single photon emission computed tomography (SPECT) and hypometabolism on positron emission tomography [19,20]. Other features, such as the degree of generalized atrophy, rate of progressive brain atrophy, and severity of white matter lesions, do not aid in the differential diagnosis of DLB from other dementia subtypes [21,22].…”

The influence of cerebrovascular disease in dementia with Lewy bodies and Parkinson's disease dementia

“…There was a similar prevalence and severity of MRI WMHs in DLB and AD in the periventricular [37,40,41,[58][59][60] and deep white matter [37,40,41,58,59], with the posterior periventricular and occipital regions being more affected in DLB compared to AD [36].…”

MRI confirms mild cognitive impairments prodromal for Alzheimer's, vascular and Parkinson-Lewy body dementias

“…Relatively few studies were devoted to structural MRI abnormalities among subjects with cognitive impairment due to PD or LBD, particularly in MCI stages [33][34][35][36][37][38][39][40][41][42][43][44]. The present study revealed marked cerebral structural changes in PLB-MCI, which are not only different from cognitively normals, but also distinct from other major MCI subtypes studied.…”

“…However, the few available studies reported conflicting results when addressing neuroimaging characteristics for MCI subjects prodromal for other dementia subtypes, including VaD, PDD and LBD [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44]. The present study compared MRI abnormalities among different subtypes of MCI prodromal for DAT, VaD and Parkinson-Lewy body dementia (PLBD).…”

Update on dementia with lewy bodies

“…Occipital hypoperfusion may be noted on single photon emission computed tomography (SPECT) and hypometabolism on positron emission tomography [19,20]. Other features, such as the degree of generalized atrophy, rate of progressive brain atrophy, and severity of white matter lesions, do not aid in the differential diagnosis of DLB from other dementia subtypes [21,22].…”

The influence of cerebrovascular disease in dementia with Lewy bodies and Parkinson's disease dementia

“…There was a similar prevalence and severity of MRI WMHs in DLB and AD in the periventricular [37,40,41,[58][59][60] and deep white matter [37,40,41,58,59], with the posterior periventricular and occipital regions being more affected in DLB compared to AD [36].…”