Columbia University Medical Center

It’s Not Just Amyloid: White Matter Hyperintensities and Alzheimer’s Disease

New York, NY (February 19, 2013) — 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.

Example brain scans. A, Example of a Pittsburgh Compound B (PIB)–negative scan. B, Example of a PIB-positive scan. Color bar represents mean ptake values. Scans were classified as PIB positive if the mean uptake value of the anterior cingulate, frontal cortex, lateral temporal cortex, parietal lobe, and precuneus was greater than 1.50. The color bar also displays the scale for uptake values.

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.

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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. For more information visit The Taub Institute at http://www.cumc.columbia.edu/dept/taub/.

Columbia University Medical Center provides international leadership in basic, pre-clinical, and clinical research; medical and health sciences education; and patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Established in 1767, Columbia’s College of Physicians and Surgeons was the first institution in the country to grant the MD degree and is among the most selective medical schools in the country. Columbia University Medical Center is home to the largest medical research enterprise in New York City and State and one of the largest in the United States. Its physicians treat patients at multiple locations throughout the tri-state area, including the NewYork-Presbyterian/Columbia campus in Washington Heights, the new ColumbiaDoctors Midtown location at 51 W. 51st St. in Manhattan, and the new ColumbiaDoctors Riverdale practice. For more information, visit www.cumc.columbia.edu or columbiadoctors.org.

 

Media Contact: Karin Eskenazi, ket2116@columbia.edu, 212-342-0508

 

 

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