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Open Access Publications from the University of California

The Aging Brain: Are two pathologies worse than one? White matter hyperintensities, beta-amyloid, and cognition in normal elderly


White matter hyperintensities (WMH)—areas of increased signal on T2 and Fluid Attenuated Inversion Recovery (FLAIR) MRI images—and beta-amyloid (ABeta) plaques—an Alzheimer’s disease pathology—are commonly found in the brains of cognitively normal elderly people. Although previous studies have looked at these pathologies, the interaction between them remains unclear. This study investigated the potential of WMH and ABeta burden in predicting cognition in normal elderly. FLAIRs of 45 local elderly participants were used to quantify WMH volumes to determine WMH load; and a Pittsburg Compound B (PIB) index obtained with positron emission tomography (PET) was used as a measure of ABeta burden. Hierarchical regressions of WMH volume and PIB group predicting executive function, working memory, and episodic memory were done. Results showed a trend towards a WMH and PIB interaction with episodic memory, suggesting that WMH and ABeta burden together may cause worse episodic memory than either of those pathologies by itself. Additionally, we found that education may be modulating the effects of WMH on executive function.

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