PDF(Pubmed)
Abstract：
OBJECTIVE: Alzheimer\'s disease (AD) and cerebral small vessel disease (cSVD), the two most common causes of dementia, are characterized by white matter (WM) alterations diverging from the physiological changes occurring in healthy aging. Diffusion tensor imaging (DTI) is a valuable tool to quantify WM integrity non-invasively and identify the determinants of such alterations. Here, we investigated main effects and interactions of AD pathology, APOE-ε4, cSVD, and cardiovascular risk on spatial patterns of WM alterations in non-demented older adults.
METHODS: Within the prospective European Prevention of Alzheimer\'s Dementia study, we selected 606 participants (64.9 ± 7.2 years, 376 females) with baseline cerebrospinal fluid samples of amyloid β1-42 and p-Tau181 and MRI scans, including DTI scans. Longitudinal scans (mean follow-up time = 1.3 ± 0.5 years) were obtained in a subset (n = 223). WM integrity was assessed by extracting fractional anisotropy and mean diffusivity in relevant tracts. To identify the determinants of WM disruption, we performed a multimodel inference to identify the best linear mixed-effects model for each tract.
RESULTS: AD pathology, APOE-ε4, cSVD burden, and cardiovascular risk were all associated with WM integrity within several tracts. While limbic tracts were mainly impacted by AD pathology and APOE-ε4, commissural, associative, and projection tract integrity was more related to cSVD burden and cardiovascular risk. AD pathology and cSVD did not show any significant interaction effect.
CONCLUSIONS: Our results suggest that AD pathology and cSVD exert independent and spatially different effects on WM microstructure, supporting the role of DTI in disease monitoring and suggesting independent targets for preventive medicine approaches.
METHODS: Within the prospective European Prevention of Alzheimer\'s Dementia study, we selected 606 participants (64.9 ± 7.2 years, 376 females) with baseline cerebrospinal fluid samples of amyloid β1-42 and p-Tau181 and MRI scans, including DTI scans. Longitudinal scans (mean follow-up time = 1.3 ± 0.5 years) were obtained in a subset (n = 223). WM integrity was assessed by extracting fractional anisotropy and mean diffusivity in relevant tracts. To identify the determinants of WM disruption, we performed a multimodel inference to identify the best linear mixed-effects model for each tract.
RESULTS: AD pathology, APOE-ε4, cSVD burden, and cardiovascular risk were all associated with WM integrity within several tracts. While limbic tracts were mainly impacted by AD pathology and APOE-ε4, commissural, associative, and projection tract integrity was more related to cSVD burden and cardiovascular risk. AD pathology and cSVD did not show any significant interaction effect.
CONCLUSIONS: Our results suggest that AD pathology and cSVD exert independent and spatially different effects on WM microstructure, supporting the role of DTI in disease monitoring and suggesting independent targets for preventive medicine approaches.
摘要：
目标：阿尔茨海默病（AD）和脑小血管病（cSVD），痴呆症的两个最常见的原因，其特征在于白质（WM）改变与健康衰老中发生的生理变化不同。扩散张量成像（DTI）是一种有价值的工具，可以无创地量化WM完整性并确定此类改变的决定因素。这里,我们调查了AD病理的主要影响和相互作用，APOE-ε4,cSVD,非痴呆老年人WM改变的空间模式和心血管风险。
方法：在前瞻性欧洲预防老年痴呆症研究中，我们选择了606名参与者(64.9±7.2岁，376名女性），使用淀粉样蛋白β1-42和p-Tau181的基线脑脊液样本和MRI扫描，包括DTI扫描。在一个子集（n=223）中获得了纵向扫描（平均随访时间=1.3±0.5年）。通过提取相关区域中的分数各向异性和平均扩散系数来评估WM完整性。为了确定WM中断的决定因素，我们进行了多模型推断,以确定每个管道的最佳线性混合效应模型.
结果：AD病理，APOE-ε4，cSVD负荷，和心血管风险都与WM完整性相关。虽然边缘束主要受AD病理和APOE-ε4的影响，但连合，联想,投射道完整性与cSVD负荷和心血管风险更相关。AD病理与cSVD没有显示任何显著的交互感化。
结论：我们的结果表明，AD病理和cSVD对WM微观结构产生独立且空间不同的影响，支持DTI在疾病监测中的作用，并为预防医学方法提出独立的目标。
方法：在前瞻性欧洲预防老年痴呆症研究中，我们选择了606名参与者(64.9±7.2岁，376名女性），使用淀粉样蛋白β1-42和p-Tau181的基线脑脊液样本和MRI扫描，包括DTI扫描。在一个子集（n=223）中获得了纵向扫描（平均随访时间=1.3±0.5年）。通过提取相关区域中的分数各向异性和平均扩散系数来评估WM完整性。为了确定WM中断的决定因素，我们进行了多模型推断,以确定每个管道的最佳线性混合效应模型.
结果：AD病理，APOE-ε4，cSVD负荷，和心血管风险都与WM完整性相关。虽然边缘束主要受AD病理和APOE-ε4的影响，但连合，联想,投射道完整性与cSVD负荷和心血管风险更相关。AD病理与cSVD没有显示任何显著的交互感化。
结论：我们的结果表明，AD病理和cSVD对WM微观结构产生独立且空间不同的影响，支持DTI在疾病监测中的作用，并为预防医学方法提出独立的目标。
