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The Review of Age-Related White Matter Changes in Alzheimer’s Disease Trials
Dewen Yang1

1ICON Clinical Research, North Wales, PA, United States

Synopsis

Age-related white matter changes (ARWMC) are prevalent brain imaging findings and important substrates for cognitive impairment in the elderly. The true pathogenesis of ARWMC is not well understood. Previous studies verified that ARWMC also associate with cognitive decline. In Alzheimer’s disease, ARWMC is also common findings on MRI images. The clinical importance of ARWMC in AD trials is reviewed.

Purpose

Age-related white matter changes (ARWMC) are prevalent brain imaging findings and important substrates for cognitive impairment in the elderly. Although ARWMC are considered to be cerebral small vessel disease related, the true pathogenesis of ARWMC is not well understood. Previous studies verified that ARWMC also associate with cognitive decline. In Alzheimer’s disease (AD), ARWMC is also common findings on MRI images1-2. The clinical importance of ARWMC in AD trials is reviewed here.

Outline of content

Clinical importance of ARWMC

  1. Review pathology and physiology
  2. ARWMC are not static lesions
  3. ARWMC is associate with cognitive impairment
  4. Treatment of ARWMC

MRI features

  1. Classifications of ARWMC
  2. ARWMC scale3
  3. Associated brain atrophy

ARWMC in AD trials

  1. Cortical tau load is associate with ARWMC
  2. ARWMC scales can be used as exclusion criteria
  3. Should ARWMC scales be applied for patient stratification?

Summary

ARWMC are common findings in elderly, which associated with poor clinical outcomes. Incorporate the ARWMC scales into AD trials as exclusion criteria or stratification should be carefully evaluated and considered.

Acknowledgements

No acknowledgement found.

References

1. de Leeuw FE, et al. White matter lesions and hippocampal atrophy in Alzheimer’s disease. Neurology. 2004; 62:310–312.

2. Targosz-Gajniak M, et al. Cerebral white matter lesions in patients with dementia from MCI to severe Alzheimer’s disease. Journal of the Neurological Sciences. 2009; 283:79–82.

3. Wahlund LO, et al. A new rating scale for age-related white matter changes applicable to MRI and CT. Stroke. 2001; 32:1318-1322.

Figures

Figure1. Examples of the ARWMC rating scores 1, 2, and 3 from A through C

Proc. Intl. Soc. Mag. Reson. Med. 25 (2017)
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