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Frontal lobe white matter hyperintensities and neurofibrillary pathology in the oldest old.
Neurology. 2010 Dec 07; 75(23):2071-8.Neur

Abstract

BACKGROUND

Current studies suggest an interaction between vascular mechanisms and neurodegenerative processes that leads to late-onset Alzheimer disease (AD). We tested whether AD pathology was associated with white matter hyperintensities (WMH) or cerebral infarcts in the oldest old individuals.

METHODS

Brains from 132 subjects over 85 years old, who came to autopsy from the Vantaa 85+ population-based cohort, were scanned by postmortem MRI and examined for neuropathologic changes. Coronal images were analyzed to determine the degree of frontal and parietal periventricular WMH (PVWMH) and deep WMH (DWMH) and cerebral infarcts. Neuropathologic variables included Consortium to Establish a Registry for Alzheimer's Disease scores for neuritic plaques and Braak staging among subjects in 5 groups: normal aging (NA), borderline with insufficient AD pathology, AD, AD plus other pathology, and other primary degenerative diseases.

RESULTS

Frontal DWMH were detected in >50% of the sample. Both frontal PVWMH and DWMH were significantly more extensive in the AD group compared to the NA group or the NA and borderline groups combined. Frontal PVWMH and DWMH were also associated with increased Braak staging (p = 0.03) and the neuritic plaque load (p = 0.01). Further analysis revealed there were a greater number of cerebral infarcts associated with frontal DWMH (p = 0.03) but not with frontal PVWMH.

CONCLUSIONS

Our study showed an association between neurofibrillary pathology and frontal PVWMH and DWMH (rather than parietal), as a surrogate of small vessel disease, particularly in very old community-dwelling individuals.

Authors+Show Affiliations

Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21048201

Citation

Polvikoski, T M., et al. "Frontal Lobe White Matter Hyperintensities and Neurofibrillary Pathology in the Oldest Old." Neurology, vol. 75, no. 23, 2010, pp. 2071-8.
Polvikoski TM, van Straaten EC, Barkhof F, et al. Frontal lobe white matter hyperintensities and neurofibrillary pathology in the oldest old. Neurology. 2010;75(23):2071-8.
Polvikoski, T. M., van Straaten, E. C., Barkhof, F., Sulkava, R., Aronen, H. J., Niinistö, L., Oinas, M., Scheltens, P., Erkinjuntti, T., & Kalaria, R. N. (2010). Frontal lobe white matter hyperintensities and neurofibrillary pathology in the oldest old. Neurology, 75(23), 2071-8. https://doi.org/10.1212/WNL.0b013e318200d6f9
Polvikoski TM, et al. Frontal Lobe White Matter Hyperintensities and Neurofibrillary Pathology in the Oldest Old. Neurology. 2010 Dec 7;75(23):2071-8. PubMed PMID: 21048201.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Frontal lobe white matter hyperintensities and neurofibrillary pathology in the oldest old. AU - Polvikoski,T M, AU - van Straaten,E C W, AU - Barkhof,F, AU - Sulkava,R, AU - Aronen,H J, AU - Niinistö,L, AU - Oinas,M, AU - Scheltens,P, AU - Erkinjuntti,T, AU - Kalaria,R N, Y1 - 2010/11/03/ PY - 2010/11/5/entrez PY - 2010/11/5/pubmed PY - 2011/1/8/medline SP - 2071 EP - 8 JF - Neurology JO - Neurology VL - 75 IS - 23 N2 - BACKGROUND: Current studies suggest an interaction between vascular mechanisms and neurodegenerative processes that leads to late-onset Alzheimer disease (AD). We tested whether AD pathology was associated with white matter hyperintensities (WMH) or cerebral infarcts in the oldest old individuals. METHODS: Brains from 132 subjects over 85 years old, who came to autopsy from the Vantaa 85+ population-based cohort, were scanned by postmortem MRI and examined for neuropathologic changes. Coronal images were analyzed to determine the degree of frontal and parietal periventricular WMH (PVWMH) and deep WMH (DWMH) and cerebral infarcts. Neuropathologic variables included Consortium to Establish a Registry for Alzheimer's Disease scores for neuritic plaques and Braak staging among subjects in 5 groups: normal aging (NA), borderline with insufficient AD pathology, AD, AD plus other pathology, and other primary degenerative diseases. RESULTS: Frontal DWMH were detected in >50% of the sample. Both frontal PVWMH and DWMH were significantly more extensive in the AD group compared to the NA group or the NA and borderline groups combined. Frontal PVWMH and DWMH were also associated with increased Braak staging (p = 0.03) and the neuritic plaque load (p = 0.01). Further analysis revealed there were a greater number of cerebral infarcts associated with frontal DWMH (p = 0.03) but not with frontal PVWMH. CONCLUSIONS: Our study showed an association between neurofibrillary pathology and frontal PVWMH and DWMH (rather than parietal), as a surrogate of small vessel disease, particularly in very old community-dwelling individuals. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/21048201/Frontal_lobe_white_matter_hyperintensities_and_neurofibrillary_pathology_in_the_oldest_old_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&pmid=21048201 DB - PRIME DP - Unbound Medicine ER -