Regional associations of white matter hyperintensities and early cortical amyloid pathology
Open accessAbstract
Abstract White matter hyperintensities (WMHs) have a heterogeneous aetiology, associated with both vascular risk factors and amyloidosis due to Alzheimer’s disease. While spatial distribution of both amyloid and WM lesions carry important information for the underlying pathogenic mechanisms, the regional relationship between these two pathologies and their joint contribution to early cognitive deterioration remains largely unexplored. We included 662 non-demented participants from three Amyloid Imaging to Prevent Alzheimer’s disease (AMYPAD)-affiliated cohorts: EPAD-LCS (N = 176), ALFA+ (N = 310), and EMIF-AD PreclinAD Twin60++ (N = 176). Using PET imaging, cortical amyloid burden was assessed regionally within early accumulating regions (medial orbitofrontal, precuneus, and cuneus) and globally, using the Centiloid method. Regional WMH volume was computed using Bayesian Model Selection. Global associations between WMH, amyloid, and cardiovascular risk scores (Framingham and CAIDE) were assessed using linear models. Partial least square (PLS) regression was used to identify regional associations. Models were adjusted for age, sex, and APOE-e4 status. Individual PLS scores were then related to cognitive performance in 4 domains (attention, memory, executive functioning, and language). While no significant global association was found, the PLS model yielded two components of interest. In the first PLS component, a fronto-parietal WMH pattern was associated with medial orbitofrontal–precuneal amyloid, vascular risk, and age. Component 2 showed a posterior WMH pattern associated with precuneus-cuneus amyloid, less related to age or vascular risk. Component 1 was associated with lower performance in all cognitive domains, while component 2 only with worse memory. In a large pre-dementia population, we observed two distinct patterns of regional associations between WMH and amyloid burden, and demonstrated their joint influence on cognitive processes. These two components could reflect the existence of vascular-dependent and -independent manifestations of WMH-amyloid regional association that might be related to distinct primary pathophysiology.
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The relationship between WMHs and Aβ is strongly determined by the spatial distribution of the two pathologies.
“evidence from recent studies has suggested that the relationship between WMHs and Aβ is strongly determined by the spatial distribution of the two pathologies [24]”
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“Additionally, evidence from recent studies has suggested that the relationship between WMHs and Aβ is strongly determined by the spatial distribution of the two pathologies [24].”
Background
- Authors
- Lorenzini, L., Ansems, L. T., Lopes Alves, I., Ingala, S., Vállez García, D., Tomassen, J., Sudre, C., Salvadó, G., Shekari, M., Operto, G., Brugulat-Serrat, A., Sánchez-Benavides, G., ten Kate, M., Tijms, B., Wink, A. M., Mutsaerts, H. J. M. M., den Braber, A., Visser, P. J., van Berckel, B. N. M., Gispert, J. D., Barkhof, F., Collij, L. E., the EPAD consortium for the ALFA cohort, Beteta, A., Brugulat, A., Cacciaglia, R., Cañas, A., Deulofeu, C., Cumplido, I., Dominguez, R., Emilio, M., Fauria, K., Fuentes, S., Hernandez, L., Huesa, G., Huguet, J., Marne, P., Menchón, T., Polo, A., Pradas, S., Rodriguez-Fernandez, B., Sala-Vila, A., Sánchez-Benavides, G., Soteras, A., & Vilanova, M.
- Affiliations
- Amsterdam Neuroscience (NL)
- Dept. of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam Neuroscience , Amsterdam , The Netherlands
- King's College London (GB)
- Pasqual Maragall Foundation (ES)
- Universitat Pompeu Fabra (ES)
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation , Barcelona , Spain
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC , Amsterdam , The Netherlands
- Maastricht University (NL)
- University of California, San Francisco (US)
- Corresponding author
- Lorenzini, Luigi
- ORCID
- Lorenzini, Luigi
- Ingala, Silvia
- Vállez García, David
- Tomassen, Jori
- Sudre, Carole
- Salvadó, Gemma
- Shekari, Mahnaz
- Tijms, Betty
- Wink, Alle Meije
- Mutsaerts, Henk J M M
- Visser, Pieter Jelle
- Gispert, Juan Domingo
- Barkhof, Frederik
- Collij, Lyduine E
- Cacciaglia, Raffaele
- Cañas, Alba
- Fauria, Karine
- Huguet, Jordi
- Soteras, Anna
- Venue
- Brain Communications
- Publisher
- Oxford University Press (OUP)
- Published
- 2022-05-02
- Volume
- 4
- Issue
- 3
- Pages
- fcac150-fcac150
- ISSN
- 2632-1297 (ISSN-L)
- PMC
- PMC9246276
- OpenAlex
- W4282958471
- Cited by
- 36
- References
- 64
- Citations by year
- 2026: 5 · 2025: 14 · 2024: 8 · 2023: 8 · 2022: 1
- FWCI
- 5.05
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Brain Communications (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, cc-by)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion, other-oa)
- CINECA IRIS Institutial Research Information System (University of Genoa) (submittedVersion, other-oa)
- Zenodo (CERN European Organization for Nuclear Research) (submittedVersion, cc-by)
- UCL Discovery (University College London) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- Innovative Medicines Initiative (115952, 115736)
- European Union
- EFPIA
- ALFA
- “la Caixa” Foundation (100010434)
- Alzheimer’s Association
- TriBEKa Imaging Platform
- Universities and Research Secretariat
- Ministry of Business and Knowledge of the Catalan Government
- EPAD
- EU/EFPIA
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Neurology › Cerebrovascular and genetic disorders
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Keywords
- white matter hyperintensities, cortical amyloid, Alzheimer's disease, preclinical Alzheimer's disease, vascular risk factors, cognitive performance, memory, precuneus, cuneus, medial orbitofrontal cortex, centiloid, APOE ε4, non-demented elderly
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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