Document Detail


Neuropathological basis of magnetic resonance images in aging and dementia.
MedLine Citation:
PMID:  18157909     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Magnetic resonance (MR) imaging is used widely for assessment of patients with cognitive impairment, but the pathological correlates are unclear, especially when multiple pathologies are present.
METHODS: This report includes 93 subjects from a longitudinally followed cohort recruited for the study of Alzheimer's disease (AD) and subcortical cerebrovascular disease (CVD). MR images were analyzed to quantify cortical gray matter volume, hippocampal volume, white matter hyperintensities, and lacunes. Neuropathological examination quantified CVD parenchymal pathology, AD pathology (defined as Consortium to Establish a Registry for Alzheimer's Disease scores and Braak and Braak stage), and hippocampal sclerosis. Subjects were pathologically classified as 12 healthy control subjects, 46 AD, 14 CVD, 9 mixed AD/CVD, and 12 cognitively impaired patients without significant AD/CVD pathology. Multivariate models tested associations between magnetic resonance and pathological findings across the entire sample.
RESULTS: Pathological correlates of cortical gray matter volume were AD, subcortical vascular pathology, and arteriosclerosis. Hippocampal volume was related to AD pathology and hippocampal sclerosis, and the effects of hippocampal sclerosis were greater for subjects with low levels of AD pathology. White matter hyperintensities were related to age and to white matter pathology. Number of MRI lacunes was related to subcortical vascular pathology.
INTERPRETATION: In this clinical setting, the presence of lacunes and white matter changes provide a good signal for vascular disease. The neuropathological basis of MR defined cerebral cortical and hippocampal atrophy in aging and dementia is complex, with several pathological processes converging on similar brain structures that mediate cognitive decline.
Authors:
William J Jagust; Ling Zheng; Danielle J Harvey; Wendy J Mack; Harry V Vinters; Michael W Weiner; William G Ellis; Chris Zarow; Dan Mungas; Bruce R Reed; Joel H Kramer; Norbert Schuff; Charles DeCarli; Helena C Chui
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Annals of neurology     Volume:  63     ISSN:  1531-8249     ISO Abbreviation:  Ann. Neurol.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-02-04     Completed Date:  2008-03-12     Revised Date:  2011-08-05    
Medline Journal Info:
Nlm Unique ID:  7707449     Medline TA:  Ann Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  72-80     Citation Subset:  IM    
Affiliation:
School of Public Health and Helen Wills Neuroscience Institute, University of California, Berkeley, CA 94720-3190, USA. jagust@berkeley.edu
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Aged, 80 and over
Aging / pathology*
Alzheimer Disease / pathology*,  physiopathology
Arteriosclerosis / pathology
Atrophy / pathology,  physiopathology
Brain / blood supply,  pathology*,  physiopathology
Brain Infarction / pathology,  physiopathology
Cerebral Cortex / blood supply,  pathology,  physiopathology
Cohort Studies
Dementia, Vascular / pathology*,  physiopathology
Diagnosis, Differential
Female
Hippocampus / blood supply,  pathology,  physiopathology
Humans
Longitudinal Studies
Magnetic Resonance Imaging / statistics & numerical data*
Male
Nerve Fibers, Myelinated / pathology
Predictive Value of Tests
Grant Support
ID/Acronym/Agency:
AG05142/AG/NIA NIH HHS; AG10129/AG/NIA NIH HHS; AG12435/AG/NIA NIH HHS; AG16570/AG/NIA NIH HHS; P01 AG012435-129001/AG/NIA NIH HHS; P01 AG012435-130002/AG/NIA NIH HHS; P01 AG019724-050002/AG/NIA NIH HHS; P30 AG010129-17/AG/NIA NIH HHS
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