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Abstract: Background: Recent autopsy study showed a high incidence of cerebrovascular lesions in alzheimer&rsquo;s disease (AD). To assess the impact of cerebrovascular pathology in AD, we used diffusion tensor imaging (DTI) to study AD patients with and without cerebrovascular lesions. Materials and Methods: Conventional and DTI scans were obtained from 10 patients with probable AD, 10 AD/V patients (probable AD with cerebrovascular lesions) and ten normal controls. Mean diffusivity (D) and fractional anisotropy (FA) values of some structures involved with AD pathology were measured. Results: D value was higher in AD patients than in controls in hippocampus and the cingulate gyrus. In AD/V patients, increased D value was found in the same structures and also in the thalamus and basal ganglia compared to controls. There was a significant difference of D value between AD and AD/V patients. FA value reduced in the white matter of left inferior temporal gyrus and in the bilateral middle cingulate gyrus in patients with AD/V compared with controls. The MMSE (mini-mental state examination) score significantly correlated with FA value in the right hippocampus (r=0.639, P<0.019), in the right anterior cingulate gyrus (r=0.587, P<0.035) and in left parahippocampal gyrus (r=0.559, P<0.047). Conclusion: cerebrovascular pathology had stronger impact on the D value than the AD pathology alone did. Elevated D value in thalamic and basal ganglia may contribute to cognitive decline in AD/V patients. Reduced FA values in AD/V patients may indicate that cerebrovascular pathology induced more severe white matter damage than the AD pathology alone did.

[1] Agüero-Torres, H., Kivipelto, M., von Strauss, E., 2006. Rethinking the dementia diagnoses in a population-based study: what is Alzheimer’s disease and what is vascular dementia? A study from the Kungsholmen Project. Dement. Geriatr. Cogn. Disord., 22(3):244-249.

[2] Basser, P.J., Pierpaoli, C., 1996. Microstructural features measured using diffusion tensor imaging. J. Magn. Reson. B, 111(3):209-219.

[3] Basser, P.J., Mattiello, J., Le Bihan, D., 1994a. MR diffusion tensor spectroscopy and imaging. Biophys. J., 66(1):259-267.

[4] Basser, P.J., Mattiello, J., Le Bihan, D., 1994b. Estimation of the effective self-diffusion tensor from the NMR spin-echo. J. Magn. Reson. B, 103(3):247-254.

[5] Bozzali, M., Falini, A., Franceschi, M., Cercignani, M., Zuffi, M., Scotti, G., Comi, G., Filippi, M., 2002. White matter damage in Alzheimer’s disease assessed in vivo using diffusion tensor magnetic resonance imaging. J. Neurol. Neurosurg. Psychiatry, 72(6):742-746.

[6] Braak, H., Braak, E., 1998. Evolution of neuronal changes in the course of Alzheimer’s disease. J. Neural. Transm. Suppl., 53:127-140.

[7] Fellgiebel, A., Wille, P., Müller, M.J., Winterer, G., Scheurich, A., Vucurevic, G., Schmidt, L.G., Stoeter, P., 2004. Ultrastructural hippocampal and white matter alterations in mild cognitive impairment: a diffusion tensor imaging study. Dement. Geriatr. Cogn. Disord., 18(1):101-108.

[8] Gold, G., Kovari, E., Herrmann, F.R., Canuto, A., Hof, P.R., Michel, J.P., Bouras, C., Giannakopoulos, P., 2005. Cognitive consequences of thalamic, basal ganglia, and deep white matter lacunes in brain aging and dementia. Stroke, 36(6):1184-1188.

[9] Jellinger, K.A., 2002. Alzheimer disease and cerebrovascular pathology: an update. J. Neural. Transm., 109(5-6):813-836.

[10] Jellinger, K.A., Mitter-Ferstl, E., 2003. The impact of cerebrovascular lesions in Alzheimer disease—a comparative autopsy study. J. Neurol., 250(9):1050-1055.

[11] Kantarci, K., Jack, C.R.Jr, Xu, Y.C., Campeau, N.G., O′Brien, P.C., Smith, G.E., Ivnik, R.J., Boeve, B.F., Kokmen, E., Tangalos, E.G., et al., 2001. Mild cognitive impairment and Alzheimer disease: regional diffusivity of water. Radiology, 219(1):101-107.

[12] Muller, M.J., Greverus, D., Dellani, P.R., Weibrich, C., Wille, P.R., Scheurich, A., Stoeter, P., Fellgiebel, A., 2005. Functional implications of hippocampal volume and diffusivity in mild cognitive impairment. Neuroimage, 28(4):1033-1042.

[13] Naggara, O., Oppenheim, C., Rieu, D., Raoux, N., Rodrigo, S., Dalla Barba, G., Meder, J.F., 2006. Diffusion tensor imaging in early Alzheimer’s disease. Psychiatry Res., 146(3):243-249.

[14] Petrella, J.R., Coleman, R.E., Doraiswamy, P.M., 2003. Neuroimaging and early diagnosis of Alzheimer disease: a look to the future. Radiology, 226(2):315-336.

[15] Pierpaoli, C., Jezzard, P., Basser, P.J., Blarnett, A., Di Chiro, G., 1996. Diffusion tensor MR imaging of the human brain. Radiology, 201(3):637-648.

[16] Riekse, R.G., Leverenz, J.B., McCormick, W., Bowen, J.D., Teri, L., Nochlin, D., Simpson, K., Eugenio, C., Larson, E.B., Tsuang, D., 2004. Effect of vascular lesions on cognition in Alzheimer’s disease: a community-based study. J. Am. Geriatr. Soc., 52(9):1442-1448.

[17] Rose, S.E., Chen, F., Chalk, J.B., Zelaya, F.O., Strugnell, W.E., Benson, M., Semple, J., Doddrell, D.M., 2000. Loss of connectivity in Alzheimer’s disease: an evaluation of white matter tract integrity with colour coded MR diffusion tensor imaging. J. Neurol. Neurosurg. Psychiatry, 69(4):528-530.

[18] Takahashi, S., Yonezawa, H., Takahashi, J., Kudo, M., Inoue, T., Tohgi, H., 2002. Selective reduction of diffusion anisotropy in white matter of Alzheimer disease brains measured by 3.0 Tesla magnetic resonance imaging. Neurosci. Lett., 332(1):45-48.

[19] Xie, S., Xiao, J.X., Gong, G.L., Zang, Y.F., Wang, Y.H., Wu, H.K., Jiang, X.X., 2006. Voxel-based detection of white matter abnormalities in mild Alzheimer disease. Neurology, 66(12):1845-1849.