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J. Clin. Med. 2019, 8(2), 167; https://doi.org/10.3390/jcm8020167

White Matter Changes in Patients with Alzheimer’s Disease and Associated Factors

1
Department of Neurology, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin 640, Taiwan
2
Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung City 801, Taiwan
3
Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City 807, Taiwan
4
Graduate Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung City 807, Taiwan
5
Department of Neurology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung City 812, Taiwan
6
Department of and Master’s Program in Neurology, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung City 807, Taiwan
7
Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung City 807, Taiwan
*
Author to whom correspondence should be addressed.
Received: 31 December 2018 / Revised: 20 January 2019 / Accepted: 26 January 2019 / Published: 1 February 2019
(This article belongs to the Section Neuroscience)
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Abstract

Alzheimer’s disease (AD) is traditionally thought of as a neurodegenerative disease. Recent evidence shows that beta amyloid-independent vascular changes and beta amyloid-dependent neuronal dysfunction both equally influence the disease, leading to loss of structural and functional connectivity. White matter changes (WMCs) in the brain are commonly observed in dementia patients. The effect of vascular factors on WMCs and the relationship between WMCs and severity of AD in patients remain to be clarified. We recruited 501 clinically diagnosed probable AD patients with a series of comprehensive neuropsychological tests and brain imaging. The WMCs in cerebral CT or MRI were rated using both the modified Fazekas scale and the combined CT-MRI age related WMC (ARWMC) rating scale. Periventricular WMCs were observed in 79.4% of the patients and deep WMCs were also seen in 48.7% of the patients. WMC scores were significantly higher in the advanced dementia stage in periventricular WMCs (p = 0.001) and total ARWMCs (p < 0.001). Age and disease severity were both independently associated with WMCs score, particularly in the total, frontal and parieto-occipital areas. Vascular factors including hypertension, diabetes mellitus, and gender were not significantly associated with WMCs. In conclusion, both age and severity of dementia were significantly associated with WMCs in AD patients. These associations highlight future research targets. View Full-Text
Keywords: Alzheimer’s Disease; age; diabetes mellitus; hypertension; Leukoaraiosis; white matter changes; vascular risk factor Alzheimer’s Disease; age; diabetes mellitus; hypertension; Leukoaraiosis; white matter changes; vascular risk factor
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Kao, Y.-H.; Chou, M.-C.; Chen, C.-H.; Yang, Y.-H. White Matter Changes in Patients with Alzheimer’s Disease and Associated Factors. J. Clin. Med. 2019, 8, 167.

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