Introduction: Alzheimer’s disease (AD) and cerebral small vessel disease (CVSD) both contribute to age-related cognitive decline but can be difficult to clinically distinguish at early stages. At mild cognitive impairment (MCI), we investigated brain MRI volumetric differences in white matter hyperintensities (WMH), frontal and temporal lobe volumes between neuropathologically defined groups of cerebral arteriolosclerosis alone (pARTE), AD alone (pAD), and mixed (ADARTE). Methods: From the National Alzheimer’s Coordinating Center, we defined neuropathology groups of pARTE (n = 18), pAD (n = 36), and ADARTE (n = 55) who had MRI brain volumetrics within 1 year of clinical evaluation with Clinical Dementia Rating score of 0.5, corresponding to MCI. We included moderate-to-severe arteriolosclerosis and/or ABC score 2–3 for AD, after excluding other major neuropathologies. We compared WMH and frontal and temporal lobe volumes between neuropathology groups using regression analysis. Results: Adjusted regression models show AD-related groups associated with less WMH when compared to pARTE (pAD adjusted odds ratio (aOR) (95% confidence interval [CI]): 0.94 (0.90–0.98); ADARTE aOR (95% CI): 0.96 (0.93–0.99)). The mixed pathology group, but not pAD, had smaller right temporal lobe volumes than pARTE (pAD aOR [95% CI]: 0.86 [0.74–1.00]; ADARTE aOR [95% CI]: 0.83 [0.72–0.96]). There were no differences in frontal lobe volumes. Discussion/Conclusions: Findings from this neuropathologically confirmed cohort suggest volumetric differences in WMH and temporal lobe volumes between AD- and CVSD-related MCI. Moreover, our results suggest a differential atrophy susceptibility of the right versus left temporal lobe to the additive effect of AD and vascular pathologies.
Dement Geriatr Cogn Disord Extra 2022;12:69–75

中文翻译：

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尸检证实的阿尔茨海默病、脑小血管病和混合病理之间白质高信号和颞叶体积的早期 MRI 体积差异

简介：阿尔茨海默氏病 (AD) 和脑小血管病 (CVSD) 都会导致与年龄相关的认知能力下降，但在早期阶段很难在临床上加以区分。在轻度认知障碍 (MCI) 时，我们研究了神经病理学定义的单独脑动脉硬化 (pARTE)、单独 AD (pAD) 和混合 (ADARTE) 组之间白质高信号 (WMH)、额叶和颞叶体积的脑部 MRI 体积差异. 方法：从国家阿尔茨海默病协调中心，我们将神经病理学组定义为 pARTE ( n = 18)、pAD ( n = 36) 和 ADARTE ( n= 55) 在临床评估后 1 年内进行 MRI 脑容积测量，临床痴呆评分为 0.5，对应于 MCI。在排除其他主要神经病变后，我们将中度至重度动脉硬化和/或 ABC 评分 2-3 纳入 AD。我们使用回归分析比较了神经病理学组之间的 WMH 和额叶和颞叶体积。结果：调整后的回归模型显示，与 pARTE 相比，AD 相关组与较少的 WMH 相关（pAD 调整后的比值比 (aOR)（95% 置信区间 [CI]）：0.94 (0.90–0.98)；ADARTE aOR (95% CI)：0.96 （0.93–0.99））。混合病理学组（但不是 pAD）的右颞叶体积小于 pARTE（pAD aOR [95% CI]：0.86 [0.74–1.00]；ADARTE aOR [95% CI]：0.83 [0.72–0.96]）。额叶体积没有差异。讨论/结论：这个神经病理学证实队列的发现表明 AD 和 CVSD 相关 MCI 之间 WMH 和颞叶体积的体积差异。此外，我们的结果表明右颞叶和左颞叶对 AD 和血管病变的累加效应的不同萎缩易感性。
Dement Geriatr Cogn Disord Extra 2022；12:69–75