Neuropsychiatric symptoms (NPS), such as apathy, irritability and depression, are frequently encountered in patients with Alzheimer’s disease (AD). Focal grey matter atrophy has been linked to NPS development. Cerebrovascular disease is common among AD patients and can be detected on MRI as white matter hyperintensities (WMH). In this longitudinal study, the relative contribution of WMH burden and GM atrophy to NPS was evaluated in a cohort of mild cognitive impairment (MCI), AD and normal controls. This study included 121 AD, 315 MCI and 225 normal control subjects from the Alzheimer’s Disease Neuroimaging Initiative. NPS were assessed using the Neuropsychiatric Inventory and grouped into hyperactivity, psychosis, affective and apathy subsyndromes. WMH were measured using an automatic segmentation technique and mean deformation-based morphometry (DBM) was used to measure atrophy of grey matter regions. Linear mixed-effects models found focal grey matter atrophy and WMH volume both contributed significantly to NPS subsyndromes in MCI and AD subjects, however, WMH burden played a greater role. This study could provide a better understanding of the pathophysiology of NPS in AD and support the monitoring and control of vascular risk factors.

阿尔茨海默氏病（AD）患者经常遇到神经精神症状（NPS），例如冷漠，烦躁和沮丧。局灶性灰质萎缩与NPS的发展有关。脑血管疾病在AD患者中很常见，可以在MRI上检测为白质高信号（WMH）。在这项纵向研究中，在轻度认知障碍（MCI），AD和正常对照人群中评估了WMH负担和GM萎缩对NPS的相对贡献。这项研究包括来自阿尔茨海默氏病神经影像学计划的121位AD，315位MCI和225位正常对照受试者。NPS使用神经精神病学调查表进行评估，分为活动过度，精神病，情感和冷漠亚综合征。使用自动分割技术测量WMH，并使用基于平均变形的形态计量学（DBM）来测量灰质区域的萎缩。线性混合效应模型发现，局灶性灰质萎缩和WMH量均对MCI和AD受试者的NPS亚综合征有显着影响，但是WMH负担起了更大的作用。这项研究可以更好地了解AD中NPS的病理生理，并支持监测和控制血管危险因素。