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Interaction of medial temporal lobe atrophy and white matter hyperintensities in AD

From the Department of Neurology (Drs. van der Flier, Middelkoop and Bollen), Section of Gerontology and Geriatrics of the Department of General Internal Medicine (Drs. Weverling-Rijnsburger and Westendorp), Section of Image Processing (LKEB) of the Department of Radiology (Dr. Admiraal-Behloul), and Department of Radiology (Drs. Spilt and van Buchem), Leiden University Medical Center, The Netherlands.

Address correspondence and reprint requests to W.M. van der Flier, Department of Neurology J3R, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands; e-mail: wm.vdflier{at}vumc.nl

The authors investigated the interaction between medial temporal lobe (MTL) atrophy and white matter hyperintensities (WMH) in Alzheimer disease (AD). They measured the MTL and WMH on MRI in 58 AD patients and 28 controls. MTL atrophy was associated with an increased risk of AD (OR = 6.2), but there was no significant association between WMH and AD. Moreover, there was an interaction between MTL and WMH (p = 0.045). These results suggest that vascular and Alzheimer-type pathology act in synergy in the clinical syndrome of AD.

Received July 1, 2003. Accepted in final form January 19, 2004.

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