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Cerebral small vessel disease in aging and A lzheimer's disease: a comparative study using MRI and SPECT
Author(s) -
Makedonov I.,
Black S. E.,
MacIntosh B. J.
Publication year - 2013
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/j.1468-1331.2012.03785.x
Subject(s) - perfusion , medicine , white matter , hyperintensity , magnetic resonance imaging , voxel , nuclear medicine , lesion , single photon emission computed tomography , perfusion scanning , cerebral perfusion pressure , cardiology , radiology , pathology
Background White matter hyperintensities ( WMH ) are associated with aging and are prevalent in various brain pathologies. The purpose of the current study was to characterize WMH perfusion in age‐matched elderly controls ( EC s) and patients with A lzheimer's disease ( AD s). Methods Fifty EC s (23 men) and 61 AD s (33 men) underwent magnetic resonance imaging ( MRI ), 99m T c‐ ECD single‐photon emission computed tomography ( SPECT ) and cognitive testing. Brain tissue type was classified on T 1 weighted images, and WMH were identified on interleaved p roton d ensity/ T 2 weighted images. Co‐registered MR images were used to characterize SPECT perfusion patterns. Results WMH perfusion was lower than normal appearing white matter ( NAWM ) perfusion ( P < 0.001) in both EC and AD groups. There was no WMH perfusion difference between groups when considering the mean perfusion from all WMH voxels ( P > 0.43). However, locations that were likely to be considered WMH tended to have lower perfusion in AD s compared with EC s. Perfusion gradients along watershed white matter regions were significantly different between EC and AD groups ( P < 0.05). A relationship was found between the volume of a WMH lesion and its mean perfusion ( P < 0.001) in both EC s and AD s. Conclusion Global WMH were hypoperfused compared with NAWM to the same degree in EC and AD participants, which suggests a common WMH etiology between groups. However, white matter locations that were likely to contain WMH tended to be hypoperfused in AD s compared with healthy aging. This finding is suggestive of AD ‐specific pathology that reduces the perfusion at anatomic locations susceptible to the formation of WMH through either the neurodegenerative process or AD ‐related vasculopathy or both.