INTRODUCTION: Cognitive decline in Alzheimers disease is associated with amyloid-β accumulation, neurodegeneration and cerebral small vessel disease, but the temporal relationships between these factors is not well established. METHODS: Data included white matter hyperintensity (WMH) load, grey matter (GM) atrophy and Alzheimers Disease Assessment Scale-Cognitive-Plus (ADAS13) scores for 720 participants and cerebrospinal fluid amyloid (Aβ1-42) for 461 participants from the Alzheimers Disease Neuroimaging Initiative. Linear regressions were used to assess the relationships between baseline WMH, GM, and Aβ1-42 to changes in WMH, GM, Aβ1-42, and cognition at one-year follow-up. RESULTS: Baseline WMHs and A-β predicted WMH increase and GM atrophy. Baseline WMHs, GM, and A-beta1-42 predicted worsening cognition. Only baseline A-beta predicted change in A-β. DISCUSSION: Baseline WMHs lead to greater future GM atrophy and cognitive decline, suggesting that WM damage precedes neurodegeneration and cognitive decline. Baseline A-β1-42 predicted WMH increase, suggesting a potential role of amyloid in WM damage.

中文翻译：

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白质过高，神经退行性病变，淀粉样β蛋白与认知之间的时间关系

简介：阿尔茨海默氏病的认知能力下降与淀粉样β积累，神经变性和脑小血管疾病有关，但这些因素之间的时间关系尚不明确。方法：数据包括720名参与者的白质高强度（WMH）负荷，灰质（GM）萎缩和阿尔茨海默氏病评估量表-认知加分（ADAS13）得分，以及461名阿尔茨海默氏病参与者的脑脊液淀粉样蛋白（Aβ1-42）神经影像倡议。在一年的随访中，使用线性回归评估基线WMH，GM和Aβ1-42与WMH，GM，Aβ1-42和认知变化之间的关系。结果：基线WMH和A-β预测WMH增加和GM萎缩。基线WMH，GM和A-beta1-42预测认知能力恶化。只有基线A-β可以预测A-β的变化。讨论：基线WMH导致未来更大的GM萎缩和认知能力下降，提示WM损害先于神经变性和认知能力下降。基线A-β1-42预测WMH升高，提示淀粉样蛋白在WM损伤中具有潜在作用。