Impact of White Matter Hyperintensities on progression in Alzheimer's disease Comparison of Amyloid Biomarkers in Alzheimer's Disease-a Monocentric Study

N Dyremose, M Bruun, K S Frederiksen, L Gjerum, H Rhodius-Meester, M Baroni, G Waldemar, W Van Der Flier, H Soininen, P Mecocci, J Koikkalainen, S G Hasselbalch, T Urhemaa, J Lötjönen, D Carneiro, I Baldeiras, A P Moreira, J Castelhano, M Castelo-Branco, I Santana

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Abstract

Background and aims: Cerebral white matter hyperintensities (WMH) have been suggested to contribute to progression in Alzheimer's disease (AD). Quantification of WMH in patients can be performed both manually, where WMH is categorized according to the Fazekas scale, and automatically using software which calculates WMH based on a FLAIR MRI sequence. The aim of this study was to investigate to which extent the WMH-burden affects progression in a mixed population of clinical AD and prodromal AD. Furthermore, we assessed whether manual rating and automatic segmentation of WMH provide equal information on progression. Methods: Patients with clinical diagnosis of AD and MCI patients suspected of having early AD were included. Evaluation of progression was performed by an experienced clinician at a 12-month follow-up visit. Manual evaluation (Fazekas scale) of WMH was performed by an experienced neuroradiologist and automatic segmentation was performed as previously described (Koikkalainen et al, 2016, Neuroimage). Patients were examined for the association between WMH-burden at baseline and progression in disease after 12 months and stratified by diagnosis of AD without CVD and AD with CVD. Results: There was no significant difference between WMH-burden and progression status in either AD without CVD (p=0.122) or AD with CVD (p=0.159). However, there was a trend for a higher WMH-burden in progressed vs. stable patients diagnosed with AD with CVD. Conclusion: WMH-burden seems to have an impact on progression in AD only when present in large amounts. We are currently investigating the prognostic value of manual and automatic WMH-burden measurements. Background and aims: According to international criteria, amyloid-biomarkers are diagnostic elements for Alzheimer's disease (AD). Controversies about their accuracy for early and differential diagnosis may be explained by distinct pathological processes or by between-center variability in amyloid-markers. We pretended to compare the agreement between amyloid CSF-biomarkers, [11C]-Pittsburgh Compound Positron Emission Tomography (PIB-PET) and Florbetapir (18F) and the accuracy of these biomarkers for AD diagnosis. Methods: 96 patients with at least two amyloid markers were included. The clinical course was considered the diagnostic gold standard. We used locally established cutoffs of amyloid CSF-AD biomarkers-Aβ42
Original languageEnglish
Number of pages187
Volume25
Publication statusPublished - 2018

Publication series

NameEuropean Journal of Neurology
Volume25

Cite this

Dyremose, N., Bruun, M., Frederiksen, K. S., Gjerum, L., Rhodius-Meester, H., Baroni, M., ... Santana, I. (2018). Impact of White Matter Hyperintensities on progression in Alzheimer's disease Comparison of Amyloid Biomarkers in Alzheimer's Disease-a Monocentric Study. (European Journal of Neurology; Vol. 25).