Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026
Temporal dynamics of white matter hyperintensities related to Alzheimer's disease in adults with Down syndrome.
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Morcillo-Nieto Alejandra O, Rozalem-Aranha Mateus, Maure-Blesa Lucia, Rodríguez-Baz Íñigo, Arriola-Infante José Enrique, Franquesa-Mullerat Maria, Zsadanyi Sara E, Vaqué-Alcázar Lídia, Parra José Allende, Zhao Zili, Arranz Javier, Videla Laura, Barroeta Isabel, Del Hoyo Soriano Laura, Benejam Bessy, Fernández Susana, Hernandez Aida Sanjuan, Pertierra Lucia, Giménez Sandra, Alcolea Daniel, Belbin Olivia, Lleó Alberto, Carmona-Iragui María, Fortea Juan, Bejanin Alexandre
Аннотация
INTRODUCTION: White matter hyperintensities (WMH) are common in Down syndrome (DS), yet their longitudinal evolution and associations with Alzheimer's disease (AD) remain unclear.
METHODS: Longitudinal MRI study, including 80 DS adults and 53 euploid controls. WMH were segmented on serial FLAIR using a longitudinal pipeline. We assessed the effects of demographic, genetic factors, AD clinical stage, AD-related fluid, and cerebrovascular biomarkers on annual WMH volume changes.
RESULTS: In DS, annual WMH changes were relatively stable until age 40, and then exhibited fluctuations, with a significant decrease at the group level. Declines were larger in symptomatic cases, particularly in periventricular and fronto-parieto-occipital regions. Higher baseline WMH and microbleeds presence related to greater WMH reduction. Visual ratings and adjustment for white matter volume supported the robustness of the results.
DISCUSSION: WMH trajectories were heterogeneous in DS and declined over time with AD symptoms. This unexpected reduction may reflect different underlying pathological processes, including neurodegeneration or neuroinflammation.
METHODS: Longitudinal MRI study, including 80 DS adults and 53 euploid controls. WMH were segmented on serial FLAIR using a longitudinal pipeline. We assessed the effects of demographic, genetic factors, AD clinical stage, AD-related fluid, and cerebrovascular biomarkers on annual WMH volume changes.
RESULTS: In DS, annual WMH changes were relatively stable until age 40, and then exhibited fluctuations, with a significant decrease at the group level. Declines were larger in symptomatic cases, particularly in periventricular and fronto-parieto-occipital regions. Higher baseline WMH and microbleeds presence related to greater WMH reduction. Visual ratings and adjustment for white matter volume supported the robustness of the results.
DISCUSSION: WMH trajectories were heterogeneous in DS and declined over time with AD symptoms. This unexpected reduction may reflect different underlying pathological processes, including neurodegeneration or neuroinflammation.