Abstract Details

Title Regional White Matter Hyperintensities and Relation to Cognition in Posterior Cortical Atrophy and Logopenic Progressive Aphasia

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) P1 - Poster Session 1 (9:00 AM-5:00 PM)

Poster/Presentation
Number 026

Objective To examine whether regional patterns of white matter hyperintensities (WMH) differ between logopenic progressive aphasia (LPA) and posterior cortical atrophy (PCA), and whether WMH burden correlates with cognition or beta-amyloid burden.

Background WMHs are markers of small vessel disease and have been associated with age, cognitive decline, beta-amyloid deposition, and higher risk of Alzheimer’s disease (AD). However, little is known about the frequency and regional distribution of WMHs in atypical variants of AD, such as LPA and PCA, or whether WMHs are related to cognition or beta-amyloid burden in these syndromes.

Design/Methods

Seventy-five LPA and 39 PCA patients were recruited by the Neurodegenerative Research Group and underwent fluid-attenuated inversion recovery MRI and Pittsburgh Compound B (PiB) PET. All patients were PiB-positive. Periventricular and subcortical WMHs were segmented with total and regional burden adjusted by total intracranial volume. Adjusted WMH burdens were compared between LPA and PCA, and associations were assessed between WMH and age, global PiB standard uptake value ratios (SUVRs), and cognition.

Results

Total WMH burden did not differ between groups. However, PCA had greater subcortical WMH burden in right occipital, parietal, and temporal lobes compared to LPA. Conversely, LPA had higher WMH burden in left deep grey and white and greater subcortical burden in left parietal lobe compared to PCA. Total WMH burden was related to age, with greater burden observed with older age in both groups but was not related to global PiB SUVR. Greater total WMH burden was associated with visuoperceptual performance before correction for atrophy in the LPA cohort, whereas a trend was observed after correction.

Conclusions

Regional distribution of WMHs differ across clinical variants of atypical AD and correlate with cognitive outcomes. Further work will be needed to determine whether WMHs in atypical AD reflects underlying cerebrovascular disease or regionally specific neurodegenerative changes.

Authors/Disclosures
Nha Trang Thu Pham (Mayo Clinic) PRESENTER	Nha Trang Thu Pham has received personal compensation for serving as an employee of Mayo Clinic.
Jonathan Graff-Radford, MD, FAAN	Dr. Graff-Radford has received personal compensation for serving as an employee of Mayo Clinic. Dr. Graff-Radford has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NINDS/NIH. Dr. Graff-Radford has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. Dr. Graff-Radford has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Open evidence . The institution of Dr. Graff-Radford has received research support from NIH. The institution of Dr. Graff-Radford has received research support from Eisai. The institution of Dr. Graff-Radford has received research support from Cognition therapeutics. Dr. Graff-Radford has received personal compensation in the range of $5,000-$9,999 for serving as a Faculty Member with IMPACT AD .
Mary M. Machulda, PhD (Mayo Clinic)	The institution of Dr. Machulda has received research support from NIH.
	No disclosure on file
Christopher Schwarz	The institution of Christopher Schwarz has received research support from NIH.
Matthew Senjem (Mayo Clinic)	Matthew Senjem has received stock or an ownership interest from Align Technology, Inc.. Matthew Senjem has received stock or an ownership interest from Inovio Biomedical Corp.. Matthew Senjem has received stock or an ownership interest from Johnson & Johnson. Matthew Senjem has received stock or an ownership interest from Mesa Laboratories, Inc.. Matthew Senjem has received stock or an ownership interest from Nvidia Inc.. Matthew Senjem has received stock or an ownership interest from LHC Group, Inc.. Matthew Senjem has received stock or an ownership interest from Natus Medical Incorporated. Matthew Senjem has received stock or an ownership interest from Varex Imaging Corporation. Matthew Senjem has received personal compensation in the range of $100,000-$499,999 for serving as a IT Technical Specialist II with Mayo Clinic.
Val J. Lowe, MD (Mayo Clinic)	Dr. Lowe has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for AVID Radiopharmaceutical. Dr. Lowe has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai Inc. The institution of Dr. Lowe has received research support from AVID Radiopharmaceuticals.
Clifford R. Jack, Jr., MD (Mayo Clinic)	The institution of Dr. Jack has received research support from NIH. The institution of Dr. Jack has received research support from Alexander Family Alzheimer's Disease Research Professorship of the Mayo Clinic.
Keith A. Josephs, Jr., MD, FAAN (Mayo Clinic)	Dr. Josephs has nothing to disclose.
Jennifer Whitwell, PhD (Mayo Clinic)	The institution of Dr. Whitwell has received research support from NIH.

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