Cited by 23Dementia and Cognitive Impairment ResearchCerebrovascular and genetic disordersAlzheimer's disease research and treatments

Regional White Matter Hyperintensities and Alzheimer’s Disease Biomarkers Among Older Adults with Normal Cognition and Mild Cognitive Impairment

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Newton, Princess, the BIOCARD Research Team, Tchounguen, Jonathan, Pettigrew, Corinne, Lim, Chantelle, Lin, Zixuan, Lu, Hanzhang, Moghekar, Abhay +2 more·2023·Journal of Alzheimer's Disease

Abstract

Background: Alzheimer’s disease (AD) frequently co-occurs with other brain pathologies. Recent studies suggest there may be a mechanistic link between AD and small vessel cerebrovascular disease (CVD), as opposed to simply the overlap of two disorders. Objective: We investigated the cross-sectional relationship between white matter hyperintensity (WMH) volumes (markers of CVD) and cerebrospinal fluid (CSF) biomarkers of AD. Methods: WMH volumes were assessed globally and regionally (i.e., frontal, parietal, temporal, occipital, and limbic). CSF AD biomarkers (i.e., Aβ 40, Aβ 42, Aβ 42/Aβ 40 ratio, phosphorylated tau-181 [p-tau181], and total tau [t-tau]) were measured among 152 non-demented individuals (134 cognitively unimpaired and 18 with mild cognitive impairment (MCI)). Results: Linear regression models showed that among all subjects, higher temporal WHM volumes were associated with AD biomarkers (higher levels of p-tau181, t-tau, and Aβ 40), particularly among APOE ɛ 4 carriers (independent of Aβ 42 levels). Higher vascular risk scores were associated with greater parietal and frontal WMH volumes (independent of CSF AD biomarker levels). Among subjects with MCI only, parietal WMH volumes were associated with a lower level of Aβ 42/Aβ 40. In addition, there was an association between higher global WMH volumes and higher CSF t-tau levels among younger participants versus older ones (∼<65 versus 65+ years), independent of Aβ 42/Aβ 40 and p-tau181. Conclusion: These findings suggest that although WMH are primarily related to systemic vascular risk and neurodegeneration (i.e., t-tau), AD-specific pathways may contribute to the formation of WMH in a regionally-specific manner, with neurofibrillary tangles (i.e., p-tau) playing a role in temporal WMHs and amyloid (i.e., Aβ 42/Aβ 40) in parietal WMHs.

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  • The spatial distribution of WMH is differentially associated with amyloid pathology, vascular risks, and specific cognitive domains.

    “The spatial distribution of WMH was found to be differentially associated with amyloid pathology, vascular risks, and specific cognitive domains. 18 , 19 , 64”

    From White matter hyperintensity modulates the amyloid‐tau‐cognition association and anti‐amyloid treatment efficacy in asymptomatic older adults (2025) · cites this paper as [19]

    The Discussion’s “Regional WMH: Distinct etiologies and risk factor associations” section links parietal or posterior WMH with amyloid and frontal WMH with vascular risk factors. The paper does not report associations between WMH distribution and specific cognitive domains; it examines cognitive status (normal cognition versus MCI) instead. Page numbers were not provided in our copy. (LLM, conf=0.88)

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Authors
Newton, P., the BIOCARD Research Team, Tchounguen, J., Pettigrew, C., Lim, C., Lin, Z., Lu, H., Moghekar, A., Albert, M., & Soldan, A.
Affiliations
Johns Hopkins University (US)
Corresponding author
Soldan, Anja
Venue
Journal of Alzheimer's Disease
Published
2023-03-07
Volume
92
Issue
1
Pages
323-339
ISSN
  • 1387-2877 (ISSN-L)
  • 1875-8908
OpenAlex
W4318701093
Cited by
23
References
78
Citations by year
2026: 8 · 2025: 9 · 2024: 5 · 2023: 1
FWCI
4.66
Type
journal article
Language
en
Open access
Locations
  • Journal of Alzheimer s Disease (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (P30AG005146, EB031771)
  • National Institute on Aging (P30-AG005146, U19AG033655, P50AG005146, P30AG066507)
  • National Institute of Mental Health
  • National Institute of Biomedical Imaging and Bioengineering (P41EB031771)
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, Alzheimer's disease
MeSH terms
Aged, Alzheimer Disease, Cognition, Humans, Magnetic Resonance Imaging, Biomarkers, Amyloid beta-Peptides, tau Proteins, Cerebral Small Vessel Diseases, Cognitive Dysfunction, White Matter

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