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Table of Contents
Vol. 50, No. 4, 2004
Issue release date: July – August
Section title: Debate
Gerontology 2004;50:242–246
(DOI:10.1159/000078353)

Do White Matter Changes Have Clinical Significance in Alzheimer’s Disease?

Kono I.a · Mori S.a · Nakajima K.a · Nakagawa M.a · Watanabe Y.b · Kizu O.c · Yamada K.c · Sakai Y.d
Departments of aNeurology, bEpidemiology for Social Health and Medicine, and cRadiology, Kyoto Prefectural University of Medicine, and dKyoto Geriatric Hospital, Kyoto, Japan

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Article / Publication Details

First-Page Preview
Abstract of Debate

Received: August 14, 2003
Accepted: August 31, 2003
Published online: July 08, 2004
Issue release date: July – August

Number of Print Pages: 5
Number of Figures: 1
Number of Tables: 4

ISSN: 0304-324X (Print)
eISSN: 1423-0003 (Online)

For additional information: http://www.karger.com/GER

Abstract

Background: Although white matter changes visible with MRI are generally considered to result from ischemia, it has become clear that these changes also appear in patients with Alzheimer’s disease (AD). However, their significance in AD is unknown. Objective: We evaluated the clinical significance of white matter changes in AD. Methods: Ninety-six AD patients (79.4 ± 5.92 years old) and 48 age-matched control subjects (80.0 ± 7.03 years old) participated in the study. Three neuroradiologists assessed the degree of periventricular hyperintensities (PVH) and deep white matter hyperintensities (DWMH) using a modified Fazekas’ rating scale. We examined whether there was a difference in the severity and the histogram pattern of the white matter changes, or in vascular factors (hypertension, diabetes mellitus, and ischemic heart disease) between the two groups. We also analyzed the association between the severity of the white matter changes and the degree of dementia (MMSE score and disease duration). Results: There were no differences in the vascular factors between AD and control subjects. The degree of PVH in AD was severe compared with that in the control subjects. In histograms of the number of subjects with each degree of PVH severity, the distribution of AD patients had peaks at both the low and intermediate degrees of PVH, while most of the controls had a low degree of PVH. There was no difference in the degree or the histogram pattern of DWMH between the two groups. The severity of white matter changes was not associated with severity of dementia in AD. Conclusions: Although PVH might have several causative factors, and may have some clinical significance, the change itself does not contribute to the progression of AD.

© 2004 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Debate

Received: August 14, 2003
Accepted: August 31, 2003
Published online: July 08, 2004
Issue release date: July – August

Number of Print Pages: 5
Number of Figures: 1
Number of Tables: 4

ISSN: 0304-324X (Print)
eISSN: 1423-0003 (Online)

For additional information: http://www.karger.com/GER


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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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