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Ottoy, Julie; Ozzoude, Miracle; Zukotynski, Katherine; Adamo, Sabrina; Scott, Christopher; Gaudet, Vincent; Ramirez, Joel; Swardfager, Walter; Cogo‐Moreira, Hugo; Lam, Benjamin; Bhan, Aparna; Mojiri, Parisa; Kang, Min Su; Rabin, Jennifer S.; Kiss, Alex; Strother, Stephen; Bocti, Christian; Borrie, Michael; Chertkow, Howard; Frayne, Richard; Hsiung, Robin; Laforce, Robert Jr; Noseworthy, Michael D.; Prato, Frank S.; Sahlas, Demetrios J.; Smith, Eric E.; Kuo, Phillip H.; Sossi, Vesna; Thiel, Alexander; Soucy, Jean‐Paul; Tardif, Jean‐Claude; Black, Sandra E.; Goubran, Maged
Alzheimer's & dementia, April 2023, 2023-04-00, Letnik: 19, Številka: 4Journal Article
It remains unclear to what extent cerebrovascular burden relates to amyloid beta (Aβ) deposition, neurodegeneration, and cognitive dysfunction in mixed disease populations with small vessel disease and Alzheimer's disease (AD) pathology. In 120 subjects, we investigated the association of vascular burden (white matter hyperintensity WMH volumes) with cognition. Using mediation analyses, we tested the indirect effects of WMH on cognition via Aβ deposition (18F‐AV45 positron emission tomography PET) and neurodegeneration (cortical thickness or 18F fluorodeoxyglucose PET) in AD signature regions. We observed that increased total WMH volume was associated with poorer performance in all tested cognitive domains, with the strongest effects observed for semantic fluency. These relationships were mediated mainly via cortical thinning, particularly of the temporal lobe, and to a lesser extent serially mediated via Aβ and cortical thinning of AD signature regions. WMH volumes differentially impacted cognition depending on lobar location and Aβ status. In summary, our study suggests mainly an amyloid‐independent pathway in which vascular burden affects cognitive function via localized neurodegeneration. Highlights Alzheimer's disease often co‐exists with vascular pathology. We studied a unique cohort enriched for high white matter hyperintensities (WMH). High WMH related to cognitive impairment of semantic fluency and executive function. This relationship was mediated via temporo‐parietal atrophy rather than metabolism. This relationship was, to lesser extent, serially mediated via amyloid beta and atrophy.
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in: SICRIS
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