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Behavioural and psychological symptoms are not related to white matter hyperintensities and medial temporal lobe atrophy in Alzheimer's disease.
Int J Geriatr Psychiatry. 2008 Apr; 23(4):387-92.IJ

Abstract

BACKGROUND

The neuropathology of behavioural and psychological symptoms is much less understood than the neuropathology of cognitive impairment in AD. On MRI, medial temporal lobe atrophy (MTA) is presumed to reflect Alzheimer- type pathology. White matter hyperintensities (WMH) are considered markers of vascular pathology.

AIM

We investigated differences in prevalence of behavioural and psychological symptoms in AD according to the presence of MTA and WMH on MRI.

METHODS

Behavioural and psychological symptoms of 111 consecutive AD patients were assessed using the Neuropsychatric Inventory (NPI). Symptoms were considered present when the score was > or =1. On MRI, MTA was rated using the five-point Scheltens-scale and WMH using the four-point Fazekas-scale. Both MRI measures were dichotomised (MTA: absent 0/1, present 2-4; WMH absent 0/1, present 2/3).

RESULTS

Of the 111 AD patients, 60(55%) had MTA, and 32(29%) had WMH. The presence of MTA was associated with the presence of WMH (chi (2) = 11.8, p < 0.001). The prevalence of behavioural and psychological symptoms--defined as a NPI score of > or =1 on at least one symptom--was 74%.The median NPI score of the total study population was 6(0-41). There was no difference in prevalence according to MTA (p = 0.53) or WMH (p = 0.18). On inspection of individual NPI items, neither MTA, nor WMH was related to any of the symptoms.

CONCLUSIONS

There were no differences in prevalence of behavioural and psychological symptoms according to MTA or WMH, as rated on MRI. This suggests that the occurrence of those symptoms depends on other determinants, such as coping style or genetic make-up.

Authors+Show Affiliations

Alzheimer Centre and Department of Neurology, Vrije Universiteit Medical Centre, Amsterdam, the Netherlands. s.staekenborg@vumc.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17907266

Citation

Staekenborg, Salka S., et al. "Behavioural and Psychological Symptoms Are Not Related to White Matter Hyperintensities and Medial Temporal Lobe Atrophy in Alzheimer's Disease." International Journal of Geriatric Psychiatry, vol. 23, no. 4, 2008, pp. 387-92.
Staekenborg SS, Gillissen F, Romkes R, et al. Behavioural and psychological symptoms are not related to white matter hyperintensities and medial temporal lobe atrophy in Alzheimer's disease. Int J Geriatr Psychiatry. 2008;23(4):387-92.
Staekenborg, S. S., Gillissen, F., Romkes, R., Pijnenburg, Y. A., Barkhof, F., Scheltens, P., & van der Flier, W. M. (2008). Behavioural and psychological symptoms are not related to white matter hyperintensities and medial temporal lobe atrophy in Alzheimer's disease. International Journal of Geriatric Psychiatry, 23(4), 387-92.
Staekenborg SS, et al. Behavioural and Psychological Symptoms Are Not Related to White Matter Hyperintensities and Medial Temporal Lobe Atrophy in Alzheimer's Disease. Int J Geriatr Psychiatry. 2008;23(4):387-92. PubMed PMID: 17907266.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Behavioural and psychological symptoms are not related to white matter hyperintensities and medial temporal lobe atrophy in Alzheimer's disease. AU - Staekenborg,Salka S, AU - Gillissen,Freek, AU - Romkes,Rolinka, AU - Pijnenburg,Yolande A L, AU - Barkhof,Frederik, AU - Scheltens,Philip, AU - van der Flier,Wiesje M, PY - 2007/10/2/pubmed PY - 2008/12/17/medline PY - 2007/10/2/entrez SP - 387 EP - 92 JF - International journal of geriatric psychiatry JO - Int J Geriatr Psychiatry VL - 23 IS - 4 N2 - BACKGROUND: The neuropathology of behavioural and psychological symptoms is much less understood than the neuropathology of cognitive impairment in AD. On MRI, medial temporal lobe atrophy (MTA) is presumed to reflect Alzheimer- type pathology. White matter hyperintensities (WMH) are considered markers of vascular pathology. AIM: We investigated differences in prevalence of behavioural and psychological symptoms in AD according to the presence of MTA and WMH on MRI. METHODS: Behavioural and psychological symptoms of 111 consecutive AD patients were assessed using the Neuropsychatric Inventory (NPI). Symptoms were considered present when the score was > or =1. On MRI, MTA was rated using the five-point Scheltens-scale and WMH using the four-point Fazekas-scale. Both MRI measures were dichotomised (MTA: absent 0/1, present 2-4; WMH absent 0/1, present 2/3). RESULTS: Of the 111 AD patients, 60(55%) had MTA, and 32(29%) had WMH. The presence of MTA was associated with the presence of WMH (chi (2) = 11.8, p < 0.001). The prevalence of behavioural and psychological symptoms--defined as a NPI score of > or =1 on at least one symptom--was 74%.The median NPI score of the total study population was 6(0-41). There was no difference in prevalence according to MTA (p = 0.53) or WMH (p = 0.18). On inspection of individual NPI items, neither MTA, nor WMH was related to any of the symptoms. CONCLUSIONS: There were no differences in prevalence of behavioural and psychological symptoms according to MTA or WMH, as rated on MRI. This suggests that the occurrence of those symptoms depends on other determinants, such as coping style or genetic make-up. SN - 0885-6230 UR - https://www.unboundmedicine.com/medline/citation/17907266/Behavioural_and_psychological_symptoms_are_not_related_to_white_matter_hyperintensities_and_medial_temporal_lobe_atrophy_in_Alzheimer's_disease_ L2 - https://doi.org/10.1002/gps.1891 DB - PRIME DP - Unbound Medicine ER -