White Matter Damage in Alzheimer Disease and Mild Cognitive Impairment: Assessment with Diffusion-Tensor MR Imaging and Parallel Imaging Techniques

Stahl, Robert; Dietrich, Olaf; Teipel, Stefan J.; Hampel, Harald; Reiser, Maximilian; Schoenberg, Stefan O.

doi:10.1148/radiol.2432051714

Cited by 196 publications

(180 citation statements)

References 32 publications

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“…As a major risk factor for dementia, diabetes is reported to be closely associated with the pathological processes of various dementias such as AD and frontotemporal dementia (FTD). AD can be regarded as a cortical disconnection syndrome that affects not only the cortical neurons but also the axons and dendrites in the cerebral WM (18). MCI, the prodromal phase of AD, impairs memory function and disrupts widespread WM tracts (19).…”

Section: Discussionmentioning

confidence: 99%

“…Fractional anisotropy (FA) and mean diffusivity (MD) describe fiber density, axonal diameter, and myelination in WM based on quantitative measure of the degree of diffusion anisotropy (15,16). As reported previously based on the DTI technique, decreased FA or increased MD in varieties of cognitive dysfunction related to Alzheimer disease (AD) (17,18), amnestic mild cognitive impairment (MCI) (19), schizophrenia (20,21), and type 1 diabetes (22), etc. Thus, DTI techniques are important for exploring more sensitive imaging-based biomarkers in prevention and early treatment of cognitive dysfunction induced by T2DM.…”

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confidence: 92%

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White Matter Integrity Disruptions Associated With Cognitive Impairments in Type 2 Diabetic Patients

et al. 2014

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Type 2 diabetes mellitus (T2DM) is associated with a twofold increased risk of dementia and can affect many cognitive abilities, but its underlying cause is still unclear. In this study, we used a combination of a battery of neuropsychological tests and diffusion tensor imaging (DTI) to explore how T2DM affects white matter (WM) integrity and cognition in 38 T2DM patients and 34 age-, sex-, and education-matched normal control subjects. A battery of neuropsychological tests was used to assess a wide range of cognitive functions. Tract-based spatial statistics combined with region of interest-wise (ROI-wise) analysis of mean values of DTI metrics in ROIs was used to compare group differences of DTI metrics on WM skeletons to identify severely disrupted WM tracts in T2DM. We found that T2DM patients showed 1) various cognitive impairments, including executive function, spatial processing, attention, and working memory deficits; 2) widespread WM disruptions, especially in the whole corpus callosum, the left anterior limb of the internal capsule (ALIC.L), and external capsule (EC); and 3) a positive correlation between executive function and WM integrity in the ALIC.L and the left EC.In conclusion, T2DM patients show various cognitive impairments and widespread WM integrity disruptions, which we attribute to demyelination. Moreover, executive dysfunction closely correlates with WM abnormalities.Type 2 diabetes mellitus (T2DM) in the elderly is a major public health problem. In China, .20.4% of the elderly population has diabetes, among which T2DM accounts for ;90% (1). As a risk factor for cognitive decline, T2DM is associated with a twofold increased risk of dementia (2) and can affect a wide range of cognitive abilities (3,4). However, its underlying cause is still unclear.A number of studies were carried out to investigate the mechanisms of T2DM-induced dementia and attributed the cognition decline to cerebral microstructure impairments, which included gray matter (GM) and white matter (WM) destruction (5,6). Despite the importance of GM atrophy in T2DM, WM microstructure abnormalities played a distinct and irreplaceable role in cognition impairments induced by T2DM (7,8). WM has a vital role for transferring information between GM regions, and its efficiency depends on WM microstructural integrity (9). However, the relationship between WM microstructural changes and T2DM is debated and contradictory. Many studies suggested a close correlation between T2DM and WM lesion (WML) severity or progression (5,10), but others did not (11,12). This uncertainty could be partly due to the insufficient sensitivity of conventional MRI modalities in detecting subtle brain WM changes or assessing the severity of WM hyperintensities (WMH) (7).Diffusion tensor imaging (DTI), a new type of MRI, has been developed as a powerful noninvasive technique to investigate WM microstructures and integrity (13,14). Fractional anisotropy (FA) and mean diffusivity (MD)

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Section: Discussionmentioning

confidence: 99%

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confidence: 92%

White Matter Integrity Disruptions Associated With Cognitive Impairments in Type 2 Diabetic Patients

et al. 2014

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“…It is very difficult to summarize the general picture of these results because other studies on AD "all stages" [23,37,40,75] reported no significant differences in MD or FA in the anterior and posterior CC when the patient group was compared with HC. Stahl and coworkers [40] also measured ADC and relative anisotropy and found no differences between AD patients and HC. Furthermore, the findings of studies on more homogeneous patients, such as those with mild AD, are discrepant.…”

Section: Diffusion-weighted Imaging and Diffusion Tensor Imaging Studiesmentioning

confidence: 95%

“…At present, the DTI study results on MCI patients can be divided into two groups: 1) DTI studies on both amnesic and MCI "all subtypes" [23,40,41,84,85,88] that found no differences in MD and/or in FA in the CC compared with HC; and 2) the most recent studies [83,86,[89][90][91], which reported differences. One study on MCI "all subtypes" [89] found a significant change in MD and FA in the genu and the splenium of the CC in patients compared with HC.…”

Section: Diffusion-weighted Imaging and Diffusion Tensor Imaging Studiesmentioning

confidence: 99%

“…In fact, the main result mentioned above, that is atrophy mainly in the callosal anterior and posterior subregions, comes from studies of AD groups that included patients in different illness stages, ranging from mild to severe dementia [7,8,[10][11][12][14][15][16][17][18][19][23][24][25][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] and sometimes selected using different diagnostic criteria [10,14].…”

Section: Introductionmentioning

confidence: 99%

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In Vivo Structural Neuroanatomy of Corpus Callosum in Alzheimer's Disease and Mild Cognitive Impairment Using Different MRI Techniques: A Review

Paola

Spalletta

Caltagirone

2010

JAD

128

103

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Abstract. The corpus callosum (CC), which connects the two cerebral hemispheres, is the largest white matter fiber bundle in the human brain. This structure presents a peculiar myelination pattern: it has small diameter fibers, located in the genu, which myelinate much later in normal development, and large diameter fibers of the splenium, which myelinate early in development. Although the pathology of AD mainly involves the cerebral gray matter structure, there is evidence that white matter may also be involved. To illustrate callosal white matter changes in AD pathology, in this review we summarize in vivo imaging studies in humans, focusing on region of interest, voxel-based morphometry, diffusion-weighted imaging, and diffusion tensor imaging techniques. Our aims were to identify where in the CC, when in the different stages of AD, and how callosal changes can be detected with different MRI techniques. Results showed that changes in the anterior (genu and anterior body) as well as in the posterior (isthmus and splenum) portions of the CC might already be present in the early stages of AD. These findings support the hypothesis that two mechanisms, Wallerian degeneration and myelin breakdown, might be responsible for the region-specific changes detected in AD patients. Wallerian degeneration affects the posterior CC subregion, which receives axons directly from those brain areas (temporo-parietal lobe regions) primarily affected by the AD pathology. Instead, the myelin breakdown process affects the later-myelinating CC subregion and explains the earlier involvement of the genu in CC atrophy.

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Diffusion Tensor Imaging of Vascular Parkinsonism

Wang¹,

Hsu

Leemans

2012

Arch Neurol

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To investigate the white matter (WM) microstructure using diffusion tensor imaging in patients with vascular parkinsonism (VP) and specific fiber tract involvement with respect to clinical severity. Design: Diffusion measures (fractional anisotropy and mean diffusivity) were calculated from diffusion tensor images of patients with VP and control subjects. We performed global-, voxel-, and tract-based analyses to compare WM microstructural properties between groups. We further correlated findings with Unified Parkinson's Disease Rating Scale scores and modified postural instability gait difficulty (PIGD) scores to identify most relevant tract involvement.

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White Matter Damage in Alzheimer Disease and Mild Cognitive Impairment: Assessment with Diffusion-Tensor MR Imaging and Parallel Imaging Techniques

Abstract: Reduced FA and RA values in patients with AD suggest that diffusion-tensor imaging of the brain can be used to confirm clinical manifestation of AD but is less applicable in the detection of MCI.

Cited by 196 publications

References 32 publications

White Matter Integrity Disruptions Associated With Cognitive Impairments in Type 2 Diabetic Patients

White Matter Integrity Disruptions Associated With Cognitive Impairments in Type 2 Diabetic Patients

In Vivo Structural Neuroanatomy of Corpus Callosum in Alzheimer's Disease and Mild Cognitive Impairment Using Different MRI Techniques: A Review

Diffusion Tensor Imaging of Vascular Parkinsonism

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