RT Journal Article
SR Electronic
T1 Age-associated leukoaraiosis and cortical cholinergic deafferentation
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 1411
OP 1416
DO 10.1212/WNL.0b013e3181a187c6
VO 72
IS 16
A1 Bohnen, N. I.
A1 Müller, M. L.T.M.
A1 Kuwabara, H.
A1 Constantine, G. M.
A1 Studenski, S. A.
YR 2009
UL http://n.neurology.org/content/72/16/1411.abstract
AB Objective: To investigate the relationship between age-associated MRI leukoaraiosis or white matter hyperintensities (WMH) and cortical acetylcholinesterase (AChE) activity. Background: One possible mechanism of cognitive decline in elderly individuals with leukoaraiosis is disruption of cholinergic fibers by strategically located white matter lesions. Periventricular lesions may have a higher chance of disrupting cholinergic projections compared with more superficial nonperiventricular white matter lesions because of anatomic proximity to the major cholinergic axonal projection bundles that originate from the basal forebrain. Methods: Community-dwelling, middle-aged and elderly subjects without dementia (mean age 71.0 ± 9.2 years; 55–84 years; n = 18) underwent brain MRI and AChE PET imaging. The severity of periventricular and nonperiventricular WMH on fluid-attenuated inversion recovery MRI images was scored using the semiquantitative rating scale of Scheltens et al. [11C]methyl-4-piperidinyl propionate AChE PET imaging was used to assess cortical AChE activity. Age-corrected Spearman partial rank correlation coefficients were calculated. Results: The severity of periventricular (R = −0.52, p = 0.04) but not nonperiventricular (R = −0.20, not significant) WMH was inversely related to global cortical AChE activity. Regional cortical cholinergic effects of periventricular WMH were most significant for the occipital lobe (R = −0.58, p = 0.02). Conclusions: The presence of periventricular but not nonperiventricular white matter hyperintensities (WMH) is significantly associated with lower cortical cholinergic activity. These findings support a regionally specific disruption of cholinergic projection fibers by WMH. AChE=acetylcholinesterase; AD=Alzheimer disease; CADASIL=cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy; CPT-RT=Conners continuous performance test reaction time; CPT-SE=Conners continuous performance test standard error; FLAIR=fluid-attenuated inversion recovery; FWHM=full-width at half-maximum; MMSE=Mini-Mental State Examination; nbM=nucleus basalis of Meynert; NEX=number of excitations; NS=not significant; [11C]PMP=[11C]methyl-4-piperidinyl propionate; SPGR=spoiled gradient recall; TAC=time–radioactivity curve; TE=echo time; TMT-BA=Trail Making Test B minus A; TR=repetition time; VOI=volume of interest; WMH=white matter hyperintensities.