Greater abnormalities of brain cerebrospinal fluid volumes in younger than in older patients with Alzheimer's disease
E. V. Sullivan, P. K. Shear, D. H. Mathalon, K. O. Lim, J. A. Yesavage, J. R. Tinklenberg and A. Pfefferbaum
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Calif.
OBJECTIVE--This study used a semiautomated analysis technique to quantify
differences in regional brain cerebrospinal fluid volumes observed with
computed tomography between healthy adults and patients with Alzheimer's
disease (AD). DESIGN--Cross-sectional, between-subject design, using an
age-regression model. SETTING--Palo Alto (Calif) Department of Veterans
Affairs Medical Center. PATIENTS AND OTHER PARTICIPANTS--The 117 patients
with probable or definite AD were recruited from the Geriatric Psychiatry
Research Unit and National Institute of Mental Health Clinical Research
Center of the Palo Alto Department of Veterans Affairs Medical Center. The
114 healthy volunteers were recruited from the local community. MAIN
OUTCOME MEASURES--Cerebrospinal fluid volumes estimated from computed
tomographic scans and neuropsychological test scores. RESULTS--The computed
tomographic estimates of ventricular and sulcal cerebrospinal fluid volumes
increased significantly in all sampled brain regions in normal aging and
were vastly larger in AD than in normal aging. Furthermore, younger
patients with AD had significantly greater cerebrospinal fluid volume
enlargement than did older patients with AD compared with healthy controls
of their age. When the AD group was divided on the basis of reported age at
symptom onset, patients in the early-onset group (onset before age 65
years) were quantitatively more abnormal than and showed a different
pattern of abnormality from the patients in the late-onset group. This
onset difference was also evident in neuropsychological test performance.
CONCLUSIONS--This cross-sectional study revealed a number of converging
findings that suggested greater abnormality in the early-onset than in the
late-onset group of patients with AD. The possibility remains, however,
that the two onset groups represent different stages along a continuum of
pathologic changes.
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Arch Neurol 2005;62:690-690.
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