Comparison of white matter lesion load and topography between patients with cerebral amyloid angiopathy versus other neurodegenerative diseases in a Memory Clinic cohort.
Details
Under indefinite embargo.UNIL restricted access
State: Public
Version: After imprimatur
License: Not specified
Serval ID
serval:BIB_AA23E30979B6
Type
A Master's thesis.
Publication sub-type
Master (thesis) (master)
Collection
Publications
Institution
Title
Comparison of white matter lesion load and topography between patients with cerebral amyloid angiopathy versus other neurodegenerative diseases in a Memory Clinic cohort.
Director(s)
ALLALI G.
Institution details
Université de Lausanne, Faculté de biologie et médecine
Publication state
Accepted
Issued date
2024
Language
english
Number of pages
22
Abstract
Background
Cerebral amyloid angiopathy (CAA) is characterized by deposits of ß-amyloid in the walls of the small and medium blood vessels of the brain due to an imbalance between production and clearance of that protein. As the disease can be asymptomatic at first, the diagnosis relies on neuroradiological features. The “Boston v2.0 criteria for sporadic cerebral amyloid angiopathy” are currently the state-of-the-art clinical tool to diagnose CAA based on neuroradiological signs including hemorrhagic evidence and white matter hyperintensities (WMHs). However, these criteria do not take into account the spatial topography of WMHs and their lobar loading, which may contribute to the CAA differential diagnosis. In this direction, the aim of this study is to compare the white matter lesion load and spatial topography between patients with CAA and other neurodegenerative diseases.
Methods
The cohort included 109 consecutive patients (76.8 ± 7.5 yo, 42% women) examined at the Leenaards Memory Center (CLM) of Lausanne University Hospital with a neurodegenerative disorder diagnosis.
Patients were divided into two , using the Boston Criteria v2.0 : the CAA group including probable and possible CAA patients, and the no-CAA group.
CAA neuroradiological features were assessed semi-quantitatively using the FAZEKAS and the ARWMC scale for WMHs, and the MARS scale for microbleeds.
Results
After exclusion of 12 patients due to technical reasons, the CAA and no-CAA groups included 53 and 44 patients, respectively. Age, sex and overall cognitive performances were similar between the two groups. Of all patients included in the study, 22 presented chronic hemorrhagic lesions on MRI.
The overall WMH lesion load was higher in the CAA group compared to the no-CAA group. Regarding the topography of the WMH, investigated using the ARWMC scores, there was no statistically significant difference between the two groups. WMH lesions were mainly localized in periventricular areas, frontal lobe and parieto-occipital lobes, irrespectively of CAA diagnosis.
Conclusions
Our study demonstrated an increased load of WMH in Memory Clinic patients with CAA in comparison to those without CAA. These findings should increase the level of confidence for CAA detection in patients with high WMH load.
Cerebral amyloid angiopathy (CAA) is characterized by deposits of ß-amyloid in the walls of the small and medium blood vessels of the brain due to an imbalance between production and clearance of that protein. As the disease can be asymptomatic at first, the diagnosis relies on neuroradiological features. The “Boston v2.0 criteria for sporadic cerebral amyloid angiopathy” are currently the state-of-the-art clinical tool to diagnose CAA based on neuroradiological signs including hemorrhagic evidence and white matter hyperintensities (WMHs). However, these criteria do not take into account the spatial topography of WMHs and their lobar loading, which may contribute to the CAA differential diagnosis. In this direction, the aim of this study is to compare the white matter lesion load and spatial topography between patients with CAA and other neurodegenerative diseases.
Methods
The cohort included 109 consecutive patients (76.8 ± 7.5 yo, 42% women) examined at the Leenaards Memory Center (CLM) of Lausanne University Hospital with a neurodegenerative disorder diagnosis.
Patients were divided into two , using the Boston Criteria v2.0 : the CAA group including probable and possible CAA patients, and the no-CAA group.
CAA neuroradiological features were assessed semi-quantitatively using the FAZEKAS and the ARWMC scale for WMHs, and the MARS scale for microbleeds.
Results
After exclusion of 12 patients due to technical reasons, the CAA and no-CAA groups included 53 and 44 patients, respectively. Age, sex and overall cognitive performances were similar between the two groups. Of all patients included in the study, 22 presented chronic hemorrhagic lesions on MRI.
The overall WMH lesion load was higher in the CAA group compared to the no-CAA group. Regarding the topography of the WMH, investigated using the ARWMC scores, there was no statistically significant difference between the two groups. WMH lesions were mainly localized in periventricular areas, frontal lobe and parieto-occipital lobes, irrespectively of CAA diagnosis.
Conclusions
Our study demonstrated an increased load of WMH in Memory Clinic patients with CAA in comparison to those without CAA. These findings should increase the level of confidence for CAA detection in patients with high WMH load.
Keywords
Cerebral amyloid angiopathy, Boston v2.0 criteria, microbleeds, white matter hyperintensity, white matter lesion load
Create date
24/04/2025 9:42
Last modification date
25/04/2025 7:10
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