The Relationship of High-Intensity Signals on Magnetic Resonance Images to Cognitive and Psychiatric State in Alzheimer's Disease

Harrell, Lindy E.; Duvall, Ernest R.; Folks, David G.; Duke, Linda W.; Bartolucci, Alfred A.; Conboy, Thomas J.; Callaway, Ross; Kerns, Donna

doi:10.1001/archneur.1991.00530230044019

Cited by 86 publications

(41 citation statements)

References 20 publications

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“…72 Positive associations between WM changes and psychiatric symptoms have been reported in subjects without dementia. 73,74 Although previous studies have failed to find a relationship between WM changes and neurobehavioral signs in patients with dementia, 14,21,28,30 the present study clearly demonstrated that WM changes were involved in the development of aberrant motor behaviors. Aberrant motor behaviors, including wandering, pacing, and rummaging, belong to repetitive and excessive behaviors, which are likely to be caused by frontal lobe dysfunction.…”

Section: Discussionsupporting

confidence: 53%

Impact of White Matter Changes on Clinical Manifestation of Alzheimer’s Disease

Hirono

Kitagaki

Kazui

et al. 2000

Stroke

176

123

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Background and Purpose-There have been conflicting results involving the clinical significance of white matter changes in patients with Alzheimer's disease (AD). We studied the association between the volume of white matter hyperintensities (WMHs) on T2-weighted images and cognitive, neurological, and neuropsychiatric symptoms. Methods-The subjects were 76 AD patients who had WMHs but no obvious cerebrovascular diseases. We quantified the volume of WMHs by using fast-fluid-attenuated inversion recovery images and whole brain atrophy by using 3D spoiled gradient-echo images. Effects of WMHs and brain atrophy on dementia severity, cognitive function, neuropsychiatric disturbances, and neurological findings were examined. Results-Whole brain atrophy was significantly associated with dementia severity and cognitive disturbances, as well as with grasp reflex and some kinds of neuropsychiatric disturbances. After we controlled for the effects of brain atrophy, duration of symptoms, and demographic factors, we found that WMH volume was not associated with global cognitive disturbances or dementia severity but was significantly associated with urinary incontinence, grasp reflex, and aberrant motor behaviors. Brain atrophy and WMH volume were not significantly correlated either before or after controlling for age, sex, education, and duration of symptoms. WMH volume was associated with hypertension, but brain atrophy was not positively correlated with any vascular risk factors. Conclusions-Our results support the hypothesis that WMHs in AD patients are superimposed phenomena of vascular origin. WMHs contribute to specific neurological and neuropsychiatric manifestations but not to global cognitive impairment, which is more closely associated with brain atrophy. (Stroke. 2000;31:2182-2188.)

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Section: Discussionsupporting

confidence: 53%

Impact of White Matter Changes on Clinical Manifestation of Alzheimer’s Disease

Hirono

Kitagaki

Kazui

et al. 2000

Stroke

176

123

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“…In 2VO rats, we previously found that white matter rarefaction was observed 4 months after the operation. 10,34) Cerebral white matter lesions are a common finding in elderly persons 11,[44][45][46] and a relation between white matter lesions and cognitive impairment is found in aged people, 11,47,48) suggesting that the 2VO rat may be a useful model for cloning the intrinsic factors concerned with dementia. In fact, the factor vof-16 cloned in this study may be a related to the impairment of learning performance.…”

Section: Discussionmentioning

confidence: 99%

Molecular Cloning and Characterization of a Novel Sequence, vof-16, with Enhanced Expression in Permanent Ischemic Rat Brain

Tohda

Watanabe

2004

Biological & Pharmaceutical Bulletin

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Studies are underway to clarify the molecular mechanisms of dementia. Especially in the case of Alzheimer's disease, 1) some kinds of related molecules have been isolated: amyloid precursor protein, 2) presenilin 1/2, 3,4) tau 5,6) and others. The disease-generating mechanisms involving these molecules are under vigorous investigation, and it has been found that some kinds of mutations and phosphorylations of these moleculues stimulate formation of neurofibrillary tangles, resulting in Alzheimer's disease. In the case of cerebrovascular dementia, causal mechanisms have also been studied, especially with respect to apoptosis. Although many molecules which are involved in apoptosis have been identified, 7) there is no evidence yet about which factors are specifically involved in vascular dementia. Furthermore, the moleculues involved in non-diathetic dementia with normal aging still remain to be identified.We previously demonstrated that chronic hypoperfusion induced by permanent occlusion of the bilateral common carotid arteries (2VO) in rats caused progressive and longlasting cognitive deficits, 8,9) dysfunction of new information learning in the early stage, and memory loss in the late stage, suggesting that those deficits are due to impairment of memory retention and/or the memory recall process. We also found progressive neuronal damage in the hippocampus and the white matter: neuronal cell loss in the CA1 subfield appeared 4 months but not 1 month after permanent 2VO, and rarefaction of the white matter was observed 1 month after permanent 2VO and markedly increased 4 months after the operation.10) White matter lesions are common findings in elderly persons and in patients with cognitive impairment. 11)These lesions also appear in vascular dementia 11) and Alzheimer's disease patients, 12) suggesting that this 2VO model is useful for investigating molecular mechanisms of the generation of dementia. We have also reported that a decrease of microtubule-associated protein 2 (MAP-2) and an increase of glial fibrillary acidic protein (GFAP) immunoreactivity are observed at an early stage of 2VO treatment. 13)Since it has been reported that MAP-2 is preferentially associated with dendritic processes as a marker for detection of early ischemic damage 14,15) and an increase of GFAP-positive cells accompanies reactive changes in astroglia after cerebral ischemia, 16) some kinds of molecular changes appear to occur in this 2VO model. In the present study, we tried to isolate genes related to this neuronal damage using the differential display reverse transcription-polymerase chain reaction (RT-PCR) method, and obtained more than 20 clones which had different expression levels in 2VO-and sham-operated rats. One of these clones, which we called vof-16, has a novel sequence of which the expression is markedly enhanced by 2VO treatment, and may be related to the cognitive impairment after chronic ischemia induced by 2VO. Here, the sequence of vof-16, and its distributions and characteristics are presented. We previously r...

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“…Scheltens et al Awad et al [40] 1986 no no +++ NS Zimmerman et al [41] 1986 yes no ++ NS Gerard and Weisberg [43] 1986 yes yes ++ NS Erkinjuntti et al [25] 1987 no 3 areas +++ NS Fazekas et al [44] 1987 yes no ++ poor to good 2 Kertesz et al [48] 1988 yes no +++ good Hunt et al [50] 1989 yes 5 areas ++ NS Van Swieten et al [29] 1990 no anterior vs. posterior +++ good Shimada et al [52] 1990 yes no +++ NS Herholz et al [51] 1990 no L/R + NS Wahlund et al [53] 1990 no no ++ NS Harrel et al [55] 1991 yes 3 areas ++ NS Figiel et al [56] 1991 no no ++ good Mirsen et al [57] 1991 yes L/R +++ moderate Coffey et al [69] 1991 yes basal ganglia + NS 3 Liu et al [58] 1992 yes 4 regions ++ NS Davis et al [59] 1992 ? ?…”

Section: The Scale Of Gerard and Weisbergmentioning

confidence: 99%

“…The Scale of Harrel et al [55] The number of white matter lesions is assessed in cortical, subcortical and brain stem regions by counting any signal greater than 2 mm. Periventricular signals are categorized in the following manner: 1 = absent; 2 = punctate lesions; 3 = thin bands; 4 = smooth caps and lines less than 2 mm along the lateral ventricles; 5 = same as 4 but with lines greater than 2 mm; 6 = thick irregular caps and thick irregular lines.…”

Section: The Scale Of Van Swieten Et Al [29]mentioning

confidence: 99%

White Matter Changes on CT and MRI: An Overview of Visual Rating Scales

et al. 1998

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Since the recognition of white matter changes on CT (leukoaraiosis), rating scales for the location and severity of white matter changes have been developed, mainly for research purposes, to investigate factors such as the relation with cognition, risk factors, and pathology. The main purpose of rating scales is to provide scores that can be used in statistical analyses. The development of the NINDS-AIREN criteria for vascular dementia have introduced a new application for these rating scales in investigating and delineating the amount of white matter changes on CT/MRI sufficient to fulfill the criteria. Furthermore, in Alzheimer’s disease, recognition of white matter changes may serve to delineate homogeneous groups and help to identify patients with different symptomatology. We reviewed the existing rating scales for CT and MRI and judged their properties and reliability. The ideal rating scale does not yet exist, but different rating scales may serve different purposes, for which some recommendations are made.

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The Relationship of High-Intensity Signals on Magnetic Resonance Images to Cognitive and Psychiatric State in Alzheimer's Disease

Cited by 86 publications

References 20 publications

Impact of White Matter Changes on Clinical Manifestation of Alzheimer’s Disease

Impact of White Matter Changes on Clinical Manifestation of Alzheimer’s Disease

Molecular Cloning and Characterization of a Novel Sequence, vof-16, with Enhanced Expression in Permanent Ischemic Rat Brain

White Matter Changes on CT and MRI: An Overview of Visual Rating Scales

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