It’s not just amyloid: White matter hyperintensities and Alzheimer’s disease
New findings by Columbia researchers suggest that along with amyloid deposits, white matter hyperintensities (WMHs) may be a second necessary factor for the development of Alzheimer’s disease.
Most current approaches to Alzheimer’s disease focus on the accumulation of amyloid plaque in the brain. The researchers at the Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, led by Adam M. Brickman, PhD, assistant professor of neuropsychology, examined the additional contribution of small-vessel cerebrovascular disease, which they visualized as white matter hyperintensities (WMHs).
The study included 20 subjects with clinically defined Alzheimer’s disease, 59 subjects with mild cognitive impairment, and 21 normal control subjects. Using data from the Alzheimer’s Disease Neuroimaging Initiative public database, the researchers found that amyloid and WHMs were equally associated with an Alzheimer’s diagnosis. Amyloid and WMHs were also equally predictive of which subjects with mildcognitive impairment would go on to develop Alzheimer’s. Among those with significant amyloid, WMHs were more prevalent in those with Alzheimer’s than in normal control subjects.
Because the risk factors for WMHs – which are mainly vascular – can be controlled, the findings suggest potential ways to prevent the development of Alzheimer’s in those with amyloid deposits.
“White Matter Hyperintensities and Cerebral Amyloidosis” was published online today in JAMA Neurology.
The other authors are Frank A. Provenzano, MS (CUMC and Fu Foundation School of Engineering and Applied Sciences); Jordan Muraskin, MS (CUMC and Fu Foundation School of Engineering and Applied Sciences); Guiseppe Tosto, MD (CUMC); Atul Narkhede, MS (CUMC); Ben T. Wasserman, AB (CUMC); Erica Y Griffith, BS (CUMC); Vanessa A. Guzman, BA (CUMC); Irene B. Meier, MSc (CUMC); and Molly E. Zimmerman, PhD (Albert Einstein College of Medicine, NY, NY).
The research was supported by NIH (U01 AG024904, P30 AG010129, K01 AG030514, AG029949, and AG034189).
The authors report no financial or other conflict of interest.
The Taub Institute for Research on Alzheimer’s Disease and the Aging Brain at Columbia University Medical Center is a multidisciplinary group that has forged links between researchers and clinicians to uncover the causes of Alzheimer’s, Parkinson’s and other age-related brain diseases and discover ways to prevent and cure these diseases. It has partnered with the Gertrude H. Sergievsky Center at Columbia University Medical Center, which was established by an endowment in 1977 to focus on diseases of the nervous system, and with the Departments of Pathology & Cell Biology and of Neurology to allow the seamless integration of genetic analysis, molecular and cellular studies and clinical investigation to explore all phases of diseases of the nervous system.
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