White Matter Damage in Alzheimer Disease and Mild Cognitive Impairment: Assessment with Diffusion-Tensor MR Imaging and Parallel Imaging Techniques

Purpose: To prospectively determine regional differences in fiber tract integrity between elderly patients with Alzheimer disease (AD), those with mild cognitive impairment (MCI), and healthy elderly subjects by using diffusion-tensor imaging with parallel imaging techniques and a new eight-element receiving coil.

Materials and Methods: Institutional review board approval and informed consent were obtained. Fifteen patients with AD (seven men, eight women; mean age; 68.8 years), 16 patients with MCI (nine men, seven women; mean age, 68.9 years) and 19 healthy control subjects (eight men, 11 women; mean age, 63.9 years) underwent diffusion-tensor imaging performed with a 1.5-T magnetic resonance system. An echo-planar imaging diffusion sequence was used with an integrated parallel acquisition technique (PAT) and an eight-element head coil. The mean apparent diffusion coefficient (ADC), fractional anisotropy (FA), and relative anisotropy (RA) values of several white matter (WM) regions were determined. The Kruskal-Wallis test was used initially to test for overall equality of median values in each data group. Single posttest comparisons were performed with the Mann-Whitney U test, with an overall statistical significance level of .05.

Results: FA and RA values were significantly (P < .05) decreased, whereas ADC values in the splenium of the corpus callosum were higher in patients with AD than in patients with MCI. Evidence of higher ADC values in the WM of the temporal lobe was observed in patients with AD compared with the ADC values in patients with MCI and in control subjects. ADC values in the parietal WM were significantly (P < .05) elevated in patients with MCI compared with those in control subjects. The images obtained with integrated PAT showed fewer susceptibility artifacts and were less distorted than images acquired without parallel imaging techniques.

Conclusion: Reduced FA and RA values in patients with AD suggest that diffusion-tensor imaging of the brain can be used to confirm clinical manifestation of AD but is less applicable in the detection of MCI.

© RSNA, 2007

References

  • 1 Delbeuck X, Van der Linden M, Collette F. Alzheimer's disease as a disconnection syndrome? Neuropsychol Rev 2003; 13: 79–92. Crossref, MedlineGoogle Scholar
  • 2 Fox NC, Scahill RI, Crum WR, Rossor MN. Correlation between rates of brain atrophy and cognitive decline in AD. Neurology 1999; 52: 1687–1689. Crossref, MedlineGoogle Scholar
  • 3 Smith AD. Imaging the progression of Alzheimer pathology through the brain. Proc Natl Acad Sci U S A 2002; 99: 4135–4137. Crossref, MedlineGoogle Scholar
  • 4 Brun A, Englund E. A white matter disorder in dementia of the Alzheimer type: a pathoanatomical study. Ann Neurol 1986; 19: 253–262. Crossref, MedlineGoogle Scholar
  • 5 Braak E, Griffing K, Arai K, Bohl J, Bratzke H, Braak H. Neuropathology of Alzheimer's disease: what is new since A Alzheimer? Eur Arch Psychiatry Clin Neurosci 1999; 249: 14–22. Google Scholar
  • 6 Collie A, Maruff P. The neuropsychology of preclinical Alzheimer's disease and mild cognitive impairment. Neurosci Biobehav Rev 2000; 24: 365–374. Crossref, MedlineGoogle Scholar
  • 7 Larrieu S, Letenneur L, Orgogozo JM, et al. Incidence and outcome of mild cognitive impairment in a population-based prospective cohort. Neurology 2002; 59: 1594–1599. Crossref, MedlineGoogle Scholar
  • 8 Wolf H, Grunwald M, Ecke GM, et al. The prognosis of mild cognitive impairment in the elderly. J Neural Transm Suppl 1998; 54: 31–50. Crossref, MedlineGoogle Scholar
  • 9 Taylor WD, Hsu E, Krishnan KR, MacFall JR. Diffusion tensor imaging: background, potential, and utility in psychiatric research. Biol Psychiatry 2004; 55: 201–207. Crossref, MedlineGoogle Scholar
  • 10 Rose SE, Chen F, Chalk JB, et al. Loss of connectivity in Alzheimer's disease: an evaluation of white matter tract integrity with colour coded MR diffusion tensor imaging. J Neurol Neurosurg Psychiatry 2000; 69: 528–530. Crossref, MedlineGoogle Scholar
  • 11 Bozzali M, Falini A, Franceschi M, et al. White matter damage in Alzheimer's disease assessed in vivo using diffusion tensor magnetic resonance imaging. J Neurol Neurosurg Psychiatry 2002; 72: 742–746. Crossref, MedlineGoogle Scholar
  • 12 Fellgiebel A, Wille P, Muller MJ, et al. Ultrastructural hippocampal and white matter alterations in mild cognitive impairment: a diffusion tensor imaging study. Dement Geriatr Cogn Disord 2004; 18: 101–108. Crossref, MedlineGoogle Scholar
  • 13 Le Bihan D, Mangin JF, Poupon C, et al. Diffusion tensor imaging: concepts and applications. J Magn Reson Imaging 2001; 13: 534–546. Crossref, MedlineGoogle Scholar
  • 14 McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology 1984; 34: 939–944. Crossref, MedlineGoogle Scholar
  • 15 Petersen RC, Doody R, Kurz A, et al. Current concepts in mild cognitive impairment. Arch Neurol 2001; 58: 1985–1992. Crossref, MedlineGoogle Scholar
  • 16 Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E. Mild cognitive impairment: clinical characterization and outcome. Arch Neurol 1999; 56: 303–308. Crossref, MedlineGoogle Scholar
  • 17 Folstein MF, Folstein SE, McHugh PR. “Mini-mental state:” a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189–198. Crossref, MedlineGoogle Scholar
  • 18 Morris JC, Heyman A, Mohs RC, et al. The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). I. Clinical and neuropsychological assessment of Alzheimer's disease. Neurology 1989; 39: 1159–1165. Google Scholar
  • 19 Basser PJ, Pierpaoli C. A simplified method to measure the diffusion tensor from seven MR images. Magn Reson Med 1998; 39: 928–934. Crossref, MedlineGoogle Scholar
  • 20 Firbank MJ, Coulthard A, Harrison RM, Williams ED. A comparison of two methods for measuring the signal to noise ratio on MR images. Phys Med Biol 1999; 44(suppl 12): N261–N264. Crossref, MedlineGoogle Scholar
  • 21 Pruessmann KP, Weiger M, Scheidegger MB, Boesiger P. SENSE: sensitivity encoding for fast MRI. Magn Reson Med 1999; 42: 952–962. Crossref, MedlineGoogle Scholar
  • 22 Griswold MA, Jakob PM, Heidemann RM, et al. Generalized autocalibrating partially parallel acquisitions (GRAPPA). Magn Reson Med 2002; 47: 1202–1210. Crossref, MedlineGoogle Scholar
  • 23 Griswold MA, Jakob PM, Chen Q, et al. Resolution enhancement in single-shot imaging using simultaneous acquisition of spatial harmonics (SMASH). Magn Reson Med 1999; 41: 1236–1245. Crossref, MedlineGoogle Scholar
  • 24 Kantarci K, Jack CR Jr, Xu YC, et al. Mild cognitive impairment and Alzheimer disease: regional diffusivity of water. Radiology 2001; 219: 101–107. LinkGoogle Scholar
  • 25 Englund E. Neuropathology of white matter changes in Alzheimer's disease and vascular dementia. Dement Geriatr Cogn Disord 1998; 9: 6–12. Crossref, MedlineGoogle Scholar
  • 26 Bartzokis G. Age-related myelin breakdown: a developmental model of cognitive decline and Alzheimer's disease. Neurobiol Aging 2004; 25: 5–18. Crossref, MedlineGoogle Scholar
  • 27 Bartzokis G, Sultzer D, Lu PH, Nuechterlein KH, Mintz J, Cummings JL. Heterogeneous age-related breakdown of white matter structural integrity: implications for cortical “disconnection” in aging and Alzheimer's disease. Neurobiol Aging 2004; 25: 843–851. Crossref, MedlineGoogle Scholar
  • 28 Bozzao A, Floris R, Baviera ME, Apruzzese A, Simonetti G. Diffusion and perfusion MR imaging in cases of Alzheimer's disease: correlations with cortical atrophy and lesion load. AJNR Am J Neuroradiol 2001; 22: 1030–1036. MedlineGoogle Scholar
  • 29 Hanyu H, Asano T, Sakurai H, et al. Diffusion-weighted and magnetization transfer imaging of the corpus callosum in Alzheimer's disease. J Neurol Sci 1999; 167: 37–44. Crossref, MedlineGoogle Scholar
  • 30 Hanyu H, Sakurai H, Iwamoto T, Takasaki M, Shindo H, Abe K. Diffusion-weighted MR imaging of the hippocampus and temporal white matter in Alzheimer's disease. J Neurol Sci 1998; 156: 195–200. Crossref, MedlineGoogle Scholar
  • 31 Takahashi S, Yonezawa H, Takahashi J, Kudo M, Inoue T, Tohgi H. Selective reduction of diffusion anisotropy in white matter of Alzheimer disease brains measured by 3.0 Tesla magnetic resonance imaging. Neurosci Lett 2002; 332: 45–48. Crossref, MedlineGoogle Scholar
  • 32 Yoshiura T, Mihara F, Ogomori K, Tanaka A, Kaneko K, Masuda K. Diffusion tensor in posterior cingulate gyrus: correlation with cognitive decline in Alzheimer's disease. Neuroreport 2002; 13: 2299–2302. Crossref, MedlineGoogle Scholar
  • 33 de Leon MJ, Convit A, DeSanti S, et al. Contribution of structural neuroimaging to the early diagnosis of Alzheimer's disease. Int Psychogeriatr 1997; 9: 183–190. Google Scholar

Article History

Published in print: 2007