Abstract
Background
Brain images of patients with Alzheimer's disease (AD) on magnetic resonance imaging
(MRI) show white matter lesions (WML), which are attributed to degenerative changes
of small vessels. These lesions are supposed to be among the factors supporting the
diagnosis of probable AD; however their correlation with the severity of dementia
requires further studies.
Methods
We examined four groups of patients with cognitive impairment: Ten patients with amnestic-MCI
(Mild Cognitive Impairment), 11 with mild AD (21–24 points in MMSE), 17 with moderate
AD (11–20 points in MMSE) and 15 with severe AD (3–10 points in MMSE). The T2 and
FLAIR MRI sequences of the brain of each patient were assessed using the White Matter
Lesions Semiquantitive Rating Scale, taking into consideration the amount, size and
distribution of WML.
Results
WML of the brain were seen in almost all patients with AD and MCI on T2 and FLAIR
sequences. The positive correlation between the patients' age and the amount and size
of WML, in subcortical (T2: p<0.01, r=0.39; FLAIR: p<0.05, r=0.31) and in the periventricular region (T2: p<0.05, r=0.28; FLAIR: p<0.05, r=0.35) has been shown on both sequences. There was no correlation between the size
or distribution of lesions and either hypertension or homocysteine blood level. The
analysis revealed also that in both sequences, the severity of lesions in the periventricular
region increased with the progression of the disease (T2: p=0.038; FLAIR: p=0.02).
Conclusions
A significant factor correlating with the location of WML in patients with MCI and
AD is the age of patient. The amount and size of WML in the periventricular and subcortical
regions of the brain correlates with the severity of dementia. Hypertension and hyperhomocysteinemia
have no influence on the presence of described lesions.
Keywords
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Article info
Publication history
Published online: March 09, 2009
Identification
Copyright
© 2009 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
