Association between white matter lesions and Alzheimer's disease and dementia among the elderly
Hong Wenjuan1, Huang Jie1, Wang Congguo1, Ma Jingjing1, Li Jingping1, Li Xiaoxiong1, Zhou Huadong1,2
1Department of Neurology, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China; 2Department of Neurology, Army Medical Center of PLA, Chongqing 400010, China
Abstract：Objective This study aims to explore the relationship between white matter lesions (WML) and Alzheimer's disease (AD) and dementia among the elderly. Methods The clinical and imaging data of 981 inpatients (472 males and 509 females, 75-89 years old) in the Neurology Department of the Army Medical Center of PLA from August 2018 to July 2020 were collected and analyzed retrospectively. The patients underwent head magnetic resonance (MR) examination to verify the presence of WML. Neuropsychological scale was used to evaluate cognitive impairment. According to the results of clinical diagnosis, the patients were divided into a normal cognitive function group (743 cases) and an AD and dementia group (238 cases). Among them, 23 patients in the normal cognitive function group and 48 patients in the AD and dementia group received MR-DTI examination. The clinical characteristics of the two groups were compared, and the risk factors of AD and dementia were analyzed by logistic regression analysis. The distribution and grading of WML were compared between the two groups. The MR-diffusion tensor imaging(DTI)of the patients' brain was analyzed, and the differences in fractional anisotropy(FA) values and apparent diffusion coefficient(ADC) values in frontal lobe, temporal lobe, parietal lobe, occipital lobe and hemioval region were compared between the two groups. Results Multivariate logistic regression analysis revealed that age; gender (female); low education level; widowhood; having hypertension, diabetes, and hypercholesterolemia; engaging in smoking; and moderate and severe WML were risk factors of AD and dementia(all P values＜0.05). In the AD and dementia group, paraventricular WML (71.0%) was more extensive than subcortical WML (29.0%). Subcortical WML (29.0%) was more extensive in the AD and dementia group than that in the control group (19.4%). Moreover, moderate and severe paraventricular and subcortical WML in the AD and dementia group were more significantly extensive than that in the control group (all P values＜0.05). MR-DTI analysis showed that there were significant differences in FA value and ADC value of frontal lobe, semioval area, and FA value of parietal lobe between the two groups(all P values＜0.05); there were no significant difference in FA value and ADC value of temporal lobe, occipital lobe and the ADC value of the parietal lobe between the two groups(all P values＞0.05). Conclusions This study found a significant correlation between moderate and severe WML and the risk of AD. Moreover, this study established that paraventricular and subcortical WML is associated with AD and dementia.
洪文娟, 黄洁, 王从过, 马晶晶, 李金平, 李小雄, 周华东. 老年脑白质病变与阿尔茨海默病痴呆的关联研究[J]. 中华解剖与临床杂志, 2021, 26(2): 197-203.
Hong Wenjuan, Huang Jie, Wang Congguo, Ma Jingjing, Li Jingping, Li Xiaoxiong, Zhou Huadong. Association between white matter lesions and Alzheimer's disease and dementia among the elderly. Chinese Journal of Anatomy and Clinics, 2021, 26(2): 197-203.
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