Regional Quantification of White Matter Hyperintensity in Normal Aging, Mild Cognitive Impairment, and Alzheimer’s Disease

Abstract

Background/Aims: A quantitative method was applied to measure the volume of white matter hyperintensity (WMH) in different brain regions of subjects with Alzheimer’s disease (AD), mild cognitive impairment (MCI) and normal healthy age-matched controls, and the relationship between regional WMH and age and cognitive function was investigated. Methods: Fifty-six subjects were included in this study, 27 AD, 15 MCI and 14 normal age-matched controls. A user-friendly software was developed for WMH quantification in frontal, temporal, and parieto-occipital lobes. Mini-Mental State Examination and cognitive scores in performing naming, language fluency, and memory tasks were obtained for correlation analysis. Results: AD patients had the greatest total WMH volume, followed by MCI, then controls. However, there was a large variation within each group, and the difference did not reach a significant level. There was a positive linear correlation between the total WMH (p = 0.031) and the frontal WMH (p = 0.006) vs. age. After age correction the Boston Naming Test scores were negatively correlated with the total WMH volume in the AD (p = 0.03) and the control (p = 0.03) groups, and with the frontal WMH in controls (p = 0.01). Conclusion: We demonstrated a quantitative analysis method to measure regional WMH. Although WMH was not strongly associated with disease severity or cognition, it may provide a characteristic neuroimaging parameter in the study of AD development.

Spatial Distribution of White-Matter Hyperintensities in Alzheimer Disease, Cerebral Amyloid Angiopathy, and Healthy Aging

“…Although global WMH volumes were considerably greater in CAA and AD/MCI than in HA subjects, we found a common spatial pattern of hyperintensities, consistent with the recent finding of similar distributions in regionbased approaches in HA and AD. 6,7 We further demonstrated, using an atlas of normal cerebral perfusion patterns, that WMHs in all disease groups show a predilection for regions of WM that normally have lower relative perfusion. We believe that this is the first study to examine how the normal regional variability in WM perfusion influences the distribution of WMHs.…”

“…2,4 Greater WMH burdens have been found in neurologic syndromes such as vascular dementia, cerebral amyloid angiopathy (CAA), and Alzheimer disease (AD) and mild cognitive impairment (MCI). [5][6][7][8] It is unclear whether the increased volume of WMHs in these disorders is related to a shared etiology of the primary disease, an incidental secondary pathogenic process, or rather the superimposition of different types of WM damage exhibiting a common appearance on MRI.…”

Executive dysfunction and periventricular diffusion tensor changes in amnesic mild cognitive impairment and early Alzheimer's disease

“…The volume was calculated using outlined area multiplied by slice thickness. This analysis was performed separately in the frontal, temporal, and parieto-occipital lobes of either hemisphere (Chen et al, 2006 …”

Current and future uses of neuroimaging for cognitively impaired patients

“…39 Subcortical white-matter hyperintensity has been observed on MRI scans both in AD and normal ageing and is not strongly associated with disease severity. 40 Older people with severe white-matter changes are at greater risk for rapid global functional decline than those with mild changes. 41 The extent and spatial location of these lesions seem to determine their influence on cognition.…”