White Matter Hyperintensities 'Core Feature' in Dementia, Alzheimer's Disease

A magnetic resonance imaging study published in Neurology suggests white matter hyperintensities (WMH) "are partly independent of vascular pathology and associated with the neurodegenerative process" in behavioral-variant frontotemporal dementia (bvFTD) and Alzheimer's disease (AD), reports Healio . The authors looked at 129 patients, including 64 with bvFTD, 65 with AD, and 66 controls. Genetic screening was conducted in 124 participants, including 54 with bvFTD, 44 with AD, and 26 controls. The researchers also had access to postmortem pathology in 18 cases, including 13 with bvFTD and five with AD. They saw no significant differences in age, sex, years of education, and vascular risk across all groups, and no differences in lifetime rates of hypertension, hypercholesterolemia, diabetes and smoking, or disease duration. More individuals with bvFTD had a strong family history of neurodegenerative disease versus patients with AD and controls. Total WMH volumes were greater in patients with bvFTD compared with those with AD and controls, and WMH volumes correlated with disease severity but not vascular risk in bvFTD carriers. "WMH should be viewed as a core feature of bvFTD and AD that can contribute to cognitive deficits, not simply a marker of small vessel disease," the researchers concluded.