Quantification of small vessel disease in frontal and parietal white matter, genu and splenium: Human neuropathology/vascular. (7th December 2020)

• Record Type: Journal Article
• Authors: McAleese, Kirsty E.; Dugger, Brittany N.; Mifflin, Kelsey; Attems, Johannes; Jin, Lee‐Way; DeCarli, Charles
• Is Part Of: Alzheimer's & dementia. Volume 16(2020)Supplement 2
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-12-07
• Subjects: Alzheimer's disease -- Periodicals; Alzheimer Disease -- Periodicals; Dementia -- Periodicals; Démence; Maladie d'Alzheimer; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.83
• DOI: 10.1002/alz.043504
• Languages: English
• ISSNs: 1552-5260

Abstract

Abstract: Background: Cerebral small vessel disease (SVD) encompasses progressive fibrosis/hyalinosis of the small arteries (lipohyalinosis) and arterioles (arteriolosclerosis) of the white matter (WM) resulting in ischemic WM damage. SVD is commonly assessed using a broad semi‐quantitative (SQ) criterion. We implemented sclerotic index (SI) assessment to quantitatively assess vessel wall thickness in small arteries and arterioles separately in four regions known to exhibit WM changes. Method: The cohort consisted of 75 cases from the University of California Davis Alzheimer's Disease Centre Biorepository, neuropathological diagnosed as controls (n=18), intermediate Alzheimer's disease neuropathologic change (n=13), definite Alzheimer's disease (n=33), or cerebrovascular disease (n=11). H&E sections that included frontal and parietal WM, genu, or splenium were SQ assessed for SVD and images of small arteries (150‐800μm diameter) and arterioles (40‐150μm diameter) were captured. SI assessment was performed, and mean SI scores were calculated for arteries, arterioles, and an overall total. Result: Age was not associated with any SQ or SI measure in any region (p>0.106). SI and SQ scores of both arteries and arterioles were highly correlated in all regions (rho >0.551, p<0.0001) validating the SI method. Arteriole‐SI was significantly higher than artery‐SI in both WM regions (p<0.0001) and this was consistent cross controls and disease groups (all p<0.03). Regarding the whole cohort, frontal and parietal WM total‐SI was significantly higher than artery‐SI (P<0.0001) and significantly lower than arteriole‐SI (P<0.0001). Intragroup comparisons between frontal and parietal WM revealed no differences in artery‐ or arteriole‐SI scores (overall cohort p>0.76; subgroups p>0.112), and comparisons between genu and splenium also revealed no difference in arteriole‐SI (overall cohort p>0.41; subgroups p>0.34). Conclusion: SVD‐associated vessel fibrosis is uniform between the anterior and posterior WM. Separate assessment of arteries and arterioles should be considered given arteriolosclerosis results in more severe vessel occlusion and maybe clinically relevant to ischemic WM changes. A combined SVD assessment may lead to under‐ or overestimation of disease severity.