White matter hyperintensities and cholinergic degeneration as Lewy body disease
Abstract Objective Although basal forebrain (BF) cholinergic degeneration and white matter hyperintensities (WMHs) are important in neurodegeneration in Alzheimer's disease (AD) and dementia with Lewy bodies (DLB), their relationships with dopaminergic degeneration and clinical manifestations r...
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Wiley
2025-01-01
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| Series: | Annals of Clinical and Translational Neurology |
| Online Access: | https://doi.org/10.1002/acn3.52257 |
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| author | Sungwoo Kang Seun Jeon Yeoju Kim Su‐Hee Jeon Minsun Choi Young‐gun Lee Mijin Yun Byoung Seok Ye |
| author_facet | Sungwoo Kang Seun Jeon Yeoju Kim Su‐Hee Jeon Minsun Choi Young‐gun Lee Mijin Yun Byoung Seok Ye |
| author_sort | Sungwoo Kang |
| collection | DOAJ |
| description | Abstract Objective Although basal forebrain (BF) cholinergic degeneration and white matter hyperintensities (WMHs) are important in neurodegeneration in Alzheimer's disease (AD) and dementia with Lewy bodies (DLB), their relationships with dopaminergic degeneration and clinical manifestations remain unclear. Methods A total of 407 patients with cognitive impairment meeting the diagnostic criteria for AD, DLB, or both (AD+DLB) were assessed. All participants underwent 3T MRI, dopamine transporter (DAT) positron emission tomography, neuropsychological tests, and assessments for parkinsonism, cognitive fluctuation, visual hallucination, and rapid eye movement sleep behavior disorder (RBD). General linear and logistic regression models were used to investigate the relationships among BF volume, DAT uptake in the anterior caudate (DAT‐AC), WMH volumes in anterior, posterior, periventricular, and deep regions, and clinical manifestations. Results DAT‐AC was positively associated with BF volume and negatively associated with anterior periventricular WMH volume, but not with deep WMHs. Both deep and periventricular WMHs volumes were associated with hypertension and the number of microbleeds and lacunae. Lower BF volume and DAT‐AC were independently associated with increased risk of cognitive fluctuation and visual hallucination, whereas lower DAT‐AC was additionally associated with increased risk of RBD and greater parkinsonian severity. Both lower BF volume and DAT‐AC were independently associated with widespread cognitive impairment, whereas higher anterior periventricular WMH volume was associated with executive dysfunction. Interpretation BF cholinergic degeneration and anterior periventricular WMHs are closely associated with dopaminergic degeneration. Anterior periventricular WMHs may represent axonal alterations caused by the interplay between Lewy body‐related degeneration and vascular pathologies. |
| format | Article |
| id | doaj-art-9bc3200a287644b2acbb5a4d5a3baeff |
| institution | Kabale University |
| issn | 2328-9503 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
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| series | Annals of Clinical and Translational Neurology |
| spelling | doaj-art-9bc3200a287644b2acbb5a4d5a3baeff2025-01-21T05:41:42ZengWileyAnnals of Clinical and Translational Neurology2328-95032025-01-011219710910.1002/acn3.52257White matter hyperintensities and cholinergic degeneration as Lewy body diseaseSungwoo Kang0Seun Jeon1Yeoju Kim2Su‐Hee Jeon3Minsun Choi4Young‐gun Lee5Mijin Yun6Byoung Seok Ye7Department of Neurology Yonsei University College of Medicine Seoul 03722 Republic of KoreaMetabolism‐Dementia Research Institute Yonsei University College of Medicine Seoul 03722 Republic of KoreaMetabolism‐Dementia Research Institute Yonsei University College of Medicine Seoul 03722 Republic of KoreaMetabolism‐Dementia Research Institute Yonsei University College of Medicine Seoul 03722 Republic of KoreaMetabolism‐Dementia Research Institute Yonsei University College of Medicine Seoul 03722 Republic of KoreaDepartment of Neurology, Ilsan Paik Hospital Inje University College of Medicine Goyang 10380 Republic of KoreaDepartment of Nuclear Medicine Yonsei University College of Medicine Seoul 03722 Republic of KoreaDepartment of Neurology Yonsei University College of Medicine Seoul 03722 Republic of KoreaAbstract Objective Although basal forebrain (BF) cholinergic degeneration and white matter hyperintensities (WMHs) are important in neurodegeneration in Alzheimer's disease (AD) and dementia with Lewy bodies (DLB), their relationships with dopaminergic degeneration and clinical manifestations remain unclear. Methods A total of 407 patients with cognitive impairment meeting the diagnostic criteria for AD, DLB, or both (AD+DLB) were assessed. All participants underwent 3T MRI, dopamine transporter (DAT) positron emission tomography, neuropsychological tests, and assessments for parkinsonism, cognitive fluctuation, visual hallucination, and rapid eye movement sleep behavior disorder (RBD). General linear and logistic regression models were used to investigate the relationships among BF volume, DAT uptake in the anterior caudate (DAT‐AC), WMH volumes in anterior, posterior, periventricular, and deep regions, and clinical manifestations. Results DAT‐AC was positively associated with BF volume and negatively associated with anterior periventricular WMH volume, but not with deep WMHs. Both deep and periventricular WMHs volumes were associated with hypertension and the number of microbleeds and lacunae. Lower BF volume and DAT‐AC were independently associated with increased risk of cognitive fluctuation and visual hallucination, whereas lower DAT‐AC was additionally associated with increased risk of RBD and greater parkinsonian severity. Both lower BF volume and DAT‐AC were independently associated with widespread cognitive impairment, whereas higher anterior periventricular WMH volume was associated with executive dysfunction. Interpretation BF cholinergic degeneration and anterior periventricular WMHs are closely associated with dopaminergic degeneration. Anterior periventricular WMHs may represent axonal alterations caused by the interplay between Lewy body‐related degeneration and vascular pathologies.https://doi.org/10.1002/acn3.52257 |
| spellingShingle | Sungwoo Kang Seun Jeon Yeoju Kim Su‐Hee Jeon Minsun Choi Young‐gun Lee Mijin Yun Byoung Seok Ye White matter hyperintensities and cholinergic degeneration as Lewy body disease Annals of Clinical and Translational Neurology |
| title | White matter hyperintensities and cholinergic degeneration as Lewy body disease |
| title_full | White matter hyperintensities and cholinergic degeneration as Lewy body disease |
| title_fullStr | White matter hyperintensities and cholinergic degeneration as Lewy body disease |
| title_full_unstemmed | White matter hyperintensities and cholinergic degeneration as Lewy body disease |
| title_short | White matter hyperintensities and cholinergic degeneration as Lewy body disease |
| title_sort | white matter hyperintensities and cholinergic degeneration as lewy body disease |
| url | https://doi.org/10.1002/acn3.52257 |
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