Small vessel disease more than Alzheimer's disease determines diffusion MRI alterations in memory clinic patients

• Published in: Alzheimer's & dementia Vol. 16; no. 11; pp. 1504 - 1514
• Main Authors: Finsterwalder, Sofia, Vlegels, Naomi, Gesierich, Benno, Araque Caballero, Miguel Á., Weaver, Nick A., Franzmeier, Nicolai, Georgakis, Marios K., Konieczny, Marek J., Koek, Huiberdina L., Karch, Celeste M., Graff‐Radford, Neill R., Salloway, Stephen, Oh, Hwamee, Allegri, Ricardo F., Chhatwal, Jasmeer P., Jessen, Frank, Düzel, Emrah, Dobisch, Laura, Metzger, Coraline, Peters, Oliver, Incesoy, Enise I., Priller, Josef, Spruth, Eike J., Schneider, Anja, Fließbach, Klaus, Buerger, Katharina, Janowitz, Daniel, Teipel, Stefan J., Kilimann, Ingo, Laske, Christoph, Buchmann, Martina, Heneka, Michael T., Brosseron, Frederic, Spottke, Annika, Roy, Nina, Ertl‐Wagner, Birgit, Scheffler, Klaus, Seo, Sang Won, Kim, Yeshin, Na, Duk L., Kim, Hee Jin, Jang, Hyemin, Ewers, Michael, Levin, Johannes, Schmidt, Reinhold, Pasternak, Ofer, Dichgans, Martin, Biessels, Geert Jan, Duering, Marco
• Format: Journal Article
• Language: English
• Published: United States 01.11.2020
• Subjects: Adult; Aged; Alzheimer Disease - diagnostic imaging; Alzheimer Disease - pathology; Alzheimer's disease; biomarker; Brain - diagnostic imaging; Brain - pathology; cerebral small vessel disease; Cerebral Small Vessel Diseases - diagnostic imaging; Cerebral Small Vessel Diseases - pathology; Diffusion Magnetic Resonance Imaging; diffusion tensor imaging; Female; free water imaging; Humans; Male; Middle Aged; white matter; white matter; cerebral small vessel disease; diffusion tensor imaging; free water imaging; biomarker; Alzheimer's disease
• ISSN: 1552-5260; 1552-5279; 1552-5279
• DOI: 10.1002/alz.12150

Introduction Microstructural alterations as assessed by diffusion tensor imaging (DTI) are key findings in both Alzheimer's disease (AD) and small vessel disease (SVD). We determined the contribution of each of these conditions to diffusion alterations. Methods We studied six samples (N = 365 participants) covering the spectrum of AD and SVD, including genetically defined samples. We calculated diffusion measures from DTI and free water imaging. Simple linear, multivariable random forest, and voxel‐based regressions were used to evaluate associations between AD biomarkers (amyloid beta, tau), SVD imaging markers, and diffusion measures. Results SVD markers were strongly associated with diffusion measures and showed a higher contribution than AD biomarkers in multivariable analysis across all memory clinic samples. Voxel‐wise analyses between tau and diffusion measures were not significant. Discussion In memory clinic patients, the effect of SVD on diffusion alterations largely exceeds the effect of AD, supporting the value of diffusion measures as markers of SVD.