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Front. Neurosci. | doi: 10.3389/fnins.2018.00274

Specific patterns of white matter alterations help distinguishing Alzheimer’s and Vascular Dementia

  • 1Department of Physics, University of Pavia, Italy
  • 2Brain Connectivity Center, Fondazione Istituto Neurologico Nazionale Casimiro Mondino (IRCCS), Italy
  • 3Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Italy
  • 4Neuroradiology Unit, Fondazione Istituto Neurologico Nazionale Casimiro Mondino (IRCCS), Italy
  • 5Brain MRI 3T Mondino Research Center, Fondazione Istituto Neurologico Nazionale Casimiro Mondino (IRCCS), Italy
  • 6Department of Brain and Behavioral Sciences, University of Pavia, Italy
  • 7Alzheimer's Disease Assessment Unit, Laboratory of Neuropsychology, Fondazione Istituto Neurologico Nazionale Casimiro Mondino (IRCCS), Italy
  • 8San Raffaele Scientific Institute (IRCCS), Italy
  • 9Department of Emergency Neurology, Fondazione Istituto Neurologico Nazionale Casimiro Mondino (IRCCS), Italy
  • 10Queen Square MS Centre, Faculty of Brain Sciences, Institute of Neurology, University College London, United Kingdom

Alzheimer disease (AD) and vascular dementia (VaD) together represent the majority of dementia cases. Since their neuropsychological profiles often overlap and white matter lesions are observed in elderly subjects including AD, differentiating between VaD and AD can be difficult. Characterization of these different forms of dementia would benefit by identification of quantitative imaging biomarkers specifically sensitive to AD or VaD. Parameters of microstructural abnormalities derived from diffusion tensor imaging (DTI) have been reported to be helpful in differentiating between dementias, but only few studies have used them to compare AD and VaD with a voxelwise approach. Therefore, in this study a whole brain statistical analysis was performed on DTI data of 93 subjects (31 AD, 27 VaD and 35 healthy controls - HC) to identify specific white matter patterns of alteration in patients affected by VaD and AD with respect to HC. Parahippocampal tracts were found to be mainly affected in AD, while VaD showed more spread white matter damages associated with thalamic radiations involvement. The genu of the corpus callosum was predominantly affected in VaD, while the splenium was predominantly affected in AD revealing the existence of specific patterns of alteration useful in distinguishing between VaD and AD. Therefore, DTI parameters of these regions could be informative to understand the pathogenesis and support the etiological diagnosis of dementia. Further studies on larger cohorts of subjects, characterized for brain amyloidosis, will allow to confirm and to integrate the present findings and, furthermore, to elucidate the mechanisms of mixed dementia. These steps will be essential to translate these advances to clinical practice.

Keywords: Alzheimer’s disease, Vascular Dementia, DTI, Splenium of corpus callosum, genu of corpus callosum, parahippocampal gyri, thalamic radiations

Received: 16 Jan 2018; Accepted: 09 Apr 2018.

Edited by:

Stephen C. Strother, Baycrest Hospital, Canada

Reviewed by:

Jodie R. Gawryluk, University of Victoria, Canada
Frithjof Kruggel, University of California, Irvine, United States  

Copyright: © 2018 Palesi, De Rinaldis, Vitali, Castellazzi, Casiraghi, Germani, Bernini, Anzalone, Cotta Ramusino, Denaro, Sinforiani, Costa, Magenes, D‘Angelo, Gandini Wheeler-Kingshott and Micieli. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: PhD. Fulvia Palesi, University of Pavia, Department of Physics, Pavia, Italy,