White matter hyperintensities in Alzheimer's disease: Beyond vascular contribution

Antoine Garnier‐Crussard; François Cotton; Pierre Krolak‐Salmon; Gael Chételat

doi:10.1002/alz.13057

journal article Open Access Apr 07, 2023

White matter hyperintensities in Alzheimer's disease: Beyond vascular contribution

Antoine Garnier‐Crussard

François Cotton

Pierre Krolak‐Salmon Gael Chételat

Alzheimer's & Dementia Vol. 19 No. 8 pp. 3738-3748 · Wiley

View at Publisher Save 10.1002/alz.13057

Abstract

AbstractWhite matter hyperintensities (WMH), frequently seen in older adults, are usually considered vascular lesions, and participate in the vascular contribution to cognitive impairment and dementia. However, emerging evidence highlights the heterogeneity of WMH pathophysiology, suggesting that non‐vascular mechanisms could also be involved, notably in Alzheimer's disease (AD). This led to the alternative hypothesis that in AD, part of WMH may be secondary to AD‐related processes. The current perspective brings together the arguments from different fields of research, including neuropathology, neuroimaging and fluid biomarkers, and genetics, in favor of this alternative hypothesis. Possible underlying mechanisms leading to AD‐related WMH, such as AD‐related neurodegeneration or neuroinflammation, are discussed, as well as implications for diagnostic criteria and management of AD. We finally discuss ways to test this hypothesis and remaining challenges. Acknowledging the heterogeneity of WMH and the existence of AD‐related WMH may improve personalized diagnosis and care of patients.

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Metrics

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Details

Published: Apr 07, 2023
Vol/Issue: 19(8)
Pages: 3738-3748
License: View

Authors

A

Antoine Garnier‐Crussard

Normandie Univ, UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,” Neuropresage Team, Cyceron Caen France; Clinical and Research Memory Center of Lyon Lyon Institute For Aging Hospices Civils de Lyon Villeurbanne France; Eduwell team, Lyon Neuroscience Research Center (CRNL), INSERM U1028 CNRS UMR5292 UCBL1 Lyon France

F

François Cotton

Radiology Department Centre Hospitalier Lyon‐Sud Hospices Civils de Lyon Pierre‐Bénite France; CREATIS, INSERM U1044, CNRS UMR 5220 UCBL1 Villeurbanne France

P

Pierre Krolak‐Salmon

Clinical and Research Memory Center of Lyon Lyon Institute For Aging Hospices Civils de Lyon Villeurbanne France; Eduwell team, Lyon Neuroscience Research Center (CRNL), INSERM U1028 CNRS UMR5292 UCBL1 Lyon France

G

Gael Chételat

Normandie Univ, UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,” Neuropresage Team, Cyceron Caen France

Cite This Article

Antoine Garnier‐Crussard, François Cotton, Pierre Krolak‐Salmon, et al. (2023). White matter hyperintensities in Alzheimer's disease: Beyond vascular contribution. Alzheimer's & Dementia, 19(8), 3738-3748. https://doi.org/10.1002/alz.13057

White matter hyperintensities in Alzheimer's disease: Beyond vascular contribution

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