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NEUROLOGY 2006;67:830-833
© 2006 American Academy of Neurology

Associations between white matter lesions, cerebrovascular risk factors, and low CSF Aß42

V. Stenset, MD, L. Johnsen, MSc, D. Kocot, MD, A. Negaard, MD, A. Skinningsrud, MD, P. Gulbrandsen, MD, PhD, A. Wallin, MD, PhD and T. Fladby, MD, PhD

From the Department of Neurology (T.F.), Faculty Division Akershus University Hospital and the Helse Øst Health Services Research Centre (P.G.), Akershus University Hospital, University of Oslo, Oslo, Norway; Departments of Neurology (V.S., T.F., L.J.), Radiology (D.K., A.N.), and Clinical Chemistry (A.S.), Akershus University Hospital, Lørenskog, Norway; and the Institute of Clinical Neuroscience (A.W.), Sahlgrenska University Hospital, Gøteborg, Sweden.

Address correspondence and reprint requests to Dr. Vidar Stenset, Department of Neurology, Akershus University Hospital, Sykehusveien 27, NO-1478 Lørenskog, Norway; e-mail: vidar.stenset{at}medisin.uio.no

Objective: To analyze a putative relationship between white matter lesions (WMLs), risk factors for WMLs, and Alzheimer disease (AD) as measured with the surrogate marker CSF Aß42.

Methods: The authors analyzed effects of acquired risk factors for cerebrovascular disease and WMLs on AD as measured with an intermediate marker, CSF Aß42. A total of 127 consecutive patients with subjective memory impairment (mean age 66 years; 57 women) investigated at a university-based memory clinic had brain MRI scans. WMLs were rated on a 12-point scale with a semiquantitative procedure. They used path analysis with established and possible risk factors for WMLs and for reduced CSF Aß42 (age, hypertension, hyperhomocysteinemia, hypercholesterolemia, APOE-{varepsilon}4) as variables.

Results: The WML score was 1.5 points higher (p < 0.05) in hypertensive than in nonhypertensive patients and 1.9 points higher (p < 0.05) in patients with hyperhomocysteinemia than in those with normal homocysteine levels. Hypercholesterolemia increased the probability of low CSF Aß42 levels by 0.2 (p < 0.05). For each point increase in WML score, the probability of low CSF Aß42 levels increased by 0.03 (p < 0.05). APOE-{varepsilon}4 was associated with reduced CSF Aß42 (p < 0.01).

Conclusion: Both hypercholesterolemia and white matter lesions may contribute to low CSF Aß42 by independent mechanisms.

Supported by grants from Eastern Norway Regional Health Authority (Helse Øst) and Akershus University Hospital.

Disclosure: The authors report no conflicts of interest.

Received August 11, 2005. Accepted in final form May 4, 2006.






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