Small vessel disease more than Alzheimer's disease determines diffusion MRI alterations in memory clinic patients

Sofia Finsterwalder, Naomi Vlegels, Benno Gesierich, Miguel Araque Caballero, Nick A. Weaver, Nicolai Franzmeier, Marios K. Georgakis, Marek J. Konieczny, Huiberdina L. Koek, Celeste M. Karch, Neill R. Graff-Radford, Stephen Salloway, Hwamee Oh, Ricardo F. Allegri, Jasmeer P. Chhatwal, Frank Jessen, Emrah Düzel, Laura Dobisch, Coraline Metzger, Oliver PetersEnise I. Incesoy, Josef Priller, Eike J. Spruth, Anja Schneider, Klaus Fließbach, Katharina Buerger, Daniel Janowitz, Stefan J. Teipel, Ingo Kilimann, Christoph Laske, Martina Buchmann, Michael T. Heneka, Frederic Brosseron, Annika Spottke, Nina Roy, Birgit Ertl-Wagner, Klaus Scheffler, Sang Won Seo, Yeshin Kim, Duk L. Na, Hee Jin Kim, Hyemin Jang, Michael Ewers, Johannes Levin, Reinhold Schmidt, Ofer Pasternak, Martin Dichgans, Geert Jan Biessels, Marco Duering

Research output: Contribution to journalArticlepeer-review

35 Scopus citations


Introduction: Microstructural alterations as assessed by diffusion tensor imaging (DTI) are key findings in both Alzheimer's disease (AD) and small vessel disease (SVD). We determined the contribution of each of these conditions to diffusion alterations. Methods: We studied six samples (N = 365 participants) covering the spectrum of AD and SVD, including genetically defined samples. We calculated diffusion measures from DTI and free water imaging. Simple linear, multivariable random forest, and voxel-based regressions were used to evaluate associations between AD biomarkers (amyloid beta, tau), SVD imaging markers, and diffusion measures. Results: SVD markers were strongly associated with diffusion measures and showed a higher contribution than AD biomarkers in multivariable analysis across all memory clinic samples. Voxel-wise analyses between tau and diffusion measures were not significant. Discussion: In memory clinic patients, the effect of SVD on diffusion alterations largely exceeds the effect of AD, supporting the value of diffusion measures as markers of SVD.

Original languageEnglish
Pages (from-to)1504-1514
Number of pages11
JournalAlzheimer's and Dementia
Issue number11
StatePublished - Nov 2020


  • Alzheimer's disease
  • biomarker
  • cerebral small vessel disease
  • diffusion tensor imaging
  • free water imaging
  • white matter


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