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Subcortical Hyperintensities in Alzheimer's Disease

Associated Clinical and Metabolic Findings

Received August 21, 2001; revised January 15, 2002; accepted January 25, 2002. From the Departments of Psychiatry and Biobehavioral Sciences (S.T.C., J.L.C., C.H.H., D.L.S.) and Neurology (J.L.C., M.E.M.), University of California-Los Angeles; and Psychiatry (S.T.C., M.E.M., D.L.S.), Psychology (C.H.H.), and Nuclear Medicine Services (C.V.B., M.A.M.), Veterans Affairs Greater Los Angeles Healthcare System. The views expressed are those of the authors and do not necessarily represent those of the Department of Veterans Affairs. Address correspondence to Dr. Sultzer, Psychiatry, 3South, 116AF, West Los Angeles VA Healthcare Center, 11301 Wilshire Blvd., Los Angeles, CA 90073. E-mail: dsultzer{at}ucla.edu

The authors measured subcortical hyperintensities (SH) on magnetic resonance images (MRI) in 18 patients with probable Alzheimer's disease and examined the relationships of SH severity with cortical metabolic function and clinical symptoms. Severity of SH was not correlated with absolute metabolic rates in cortical lobes. However, anterior SH severity was inversely correlated with frontal/ parietal metabolic ratios after covarying for cognitive impairment. SH severity in some areas was associated with the severity of global neuropsychiatric symptoms, but marked effects on individual symptoms were not apparent. The small sample size and multiple variables limit conclusions that can be drawn. These preliminary findings indicate that subcortical MRI hyperintensities may play a role in the pathophysiology and clinical expression of Alzheimer's disease.

Key Words: Subcortical Hyperintensities • Alzheimer's Disease • Neuroimaging

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