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White Matter Changes Associated With Psychotic Symptoms in Alzheimer’s Disease Patients

Received November 22, 2004; revised April 25, 2005; accepted May 16, 2005. From the Department of Neuropsychiatry and Clinical Research Institute, Seoul National University Hospital, Seoul, Korea; the Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Kyunggi, Korea; the Department of Neuropsychiatry, Kangwom National University Hospital, Chuncheon, Korea; the Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, Kyunggi, Korea; the Neuroscience Research Institute of the Medical Research Center, Seoul National University, Seoul, Korea. Address correspondence to Dr. Woo, Department of Neuropsychiatry, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, Korea; jiwoomd{at}plaza.snu.ac.kr (E-mail).

This study explored the relationship between white matter changes seen on magnetic resonance imaging (MRI) and neuropsychiatric symptoms of Alzheimer’s disease patients. Fifty-five probable Alzheimer’s disease patients were assessed with Behavioral Rating Scale for Dementia (BRSD) and MRI. White matter changes in the bilateral frontal or parieto-occipital region and left basal ganglia significantly corresponded with the score of the Psychotic Symptoms subscale of BRSD. Secondary analyses revealed that white matter changes were not associated with paranoid delusion and hallucination, but only with delusional misidentification. Our results suggest that white matter changes in Alzheimer’s disease patients probably contribute to the development of specific psychotic symptoms, namely delusional misidentification.

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