Association of dementia severity with cortical gray matter and abnormal white matter volumes in dementia of the Alzheimer type
J. C. Stout, T. L. Jernigan, S. L. Archibald and D. P. Salmon
Alzheimer's Disease Research Center, University of California, San Diego, USA.
OBJECTIVE: To examine associations between dementia severity and
quantitative magnetic resonance imaging measures of cortical gray matter
volume and abnormal white matter volume in 52 patients diagnosed with
probable Alzheimer disease. DESIGN: Analysis of the relationship between
magnetic resonance imaging volume measures and dementia severity using
multiple regression and Pearson correlations. SETTING: Alzheimer's Disease
Research Center, University of California, San Diego. PARTICIPANTS:
Twenty-three men and 29 women with probable Alzheimer disease (average age,
71.7 years; average education, 13.3 years). MAIN OUTCOME MEASURES: The
Mattis Dementia Rating Scale (MDRS) and the Mini-Mental State Examination.
RESULTS: Using simultaneous multiple regression, magnetic resonance imaging
volumetric measures of cortical gray matter and abnormal white matter were
independently associated with dementia severity measured by either the MDRS
or the Mini-Mental State Examination. Cortical gray matter volume and
abnormal white matter volume also made independent contributions to
performance in 4 of 5 cognitive domains assessed by the MDRS. Regional
analysis indicated that limbic cortical gray matter volume and nonlimbic
cortical gray matter volume were also correlated with the MDRS score;
however, in the regression analysis the individual gray matter measures
were not independently associated with MDRS performance. A similar analysis
revealed statistically independent relationships of limbic gray matter
volume and abnormal white matter volume, but not nonlimbic cortical gray
matter volume, to Mini-Mental State Examination performance. CONCLUSIONS:
Quantitative magnetic resonance methods provided strong evidence that
cortical gray matter volume, which may reflect atrophy, and abnormal white
matter volume are independently related to dementia severity in probable
Alzheimer disease: lower gray matter and higher abnormal white matter
volumes are associated with more severe dementia.
Heterogeneity of white matter hyperintensities in Alzheimer's disease: post-mortem quantitative MRI and neuropathology
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Hsu et al.
J Geriatr Psychiatry Neurol 2001;14:145-166.
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Gilman
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