Korean Journal of Biological Psychiatry

Objects : To investigate the relationship between the age of onset with the atrophy and the white matter hyperintensities observed in the brain MRI of Alzheimer patients.

Methods : The authors measured volumetrically cartical and ventricular brain atrophy and rated semiquantitatively white matter signal hyperintensities in nine presenile and 18 senile Alzheimer patients, who were matched for dementia severity, according to NINCDS-ADRDA criteria and in age-matched 10 presenile and 11 senile control subjects.

Results : Presenile Alzheimer patients showed significantly greater cortical and ventricular atrophy indices(p<0.05) but no difference in white matter hyperintensity scores compared to the age-matched control group. On the contrary, senile Alzheimer patients showed significantly greater white matter hyperintensity scores(p<0.05) but no difference in cortical and ventircular atrophy indices compared to the age-matched control group. 

Conclusion : An earlier onset was related to marked brain atrophy with less white matter lesions and a later onset is related to marked white matter lesions with less brain atrophy in Alzheimer's disease. Our results suggested the possible difference in the pathophysiology between the presenile- and the senile-onset Alzheimer's disease.

Keywords Dementia of the Alzheimer type;Age of onset;Brain atrophy;White matter hyperintensities;Magnetic resonance.