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

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

ALZHEIMERS & DEMENTIA

ELSEVIER SCIENCE INC

Año: 2020

1552-5260

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.