White-matter lesions on CT in Alzheimer patients: relation to clinical symptomatology and vascular factors

Abstract

Fifty-four patients with Alzheimer's disease (AD) were examined for whitematter lesions (WMLs) using computerized tomography. WMLs were more frequent in late-onset AD (LAD) (26/34 - 76%) than in early-onset AD (EAD) (5/20 - 25%) (p < 0.0001), in AD without parietal predominance (10/11 - 91%) (p < 0.005) than in AD with parietal predominance (5/15 - 33%), and in AD with confusional symptoms (11/12 - 92%) than in AD without confusional symptoms (4/14 - 29%) (p < 0.001). The supine systolic blood pressure was higher in AD with WMLs (151 ± 20) than in AD without WML (139 ± 22) (p < 0.05). AD patients with WMLs, but not those without WMLs, had a higher mean albumin ratio (7.5 ± 2.7) than healthy controls (5.7 ± 2.1) (p ± 0.005). The finding of less focal (= less parietal) symptomatology in AD with WMLs than without WMLs suggests clinical significance of WMLs in AD, while the relations between blood pressure, BBB function and WMLs support the hypothesis of a vascular pathogenesis.