W O Tobin1, B F Popescu2, V Lowe3, I Pirko1, J E Parisi4, K Kantarci3, J A Fields5, M B Bruns1, B F Boeve1, C F Lucchinetti6. 1. Division of Neurology, Mayo Clinic, USA. 2. Department Anatomy and Cell Biology, University of Saskatchewan, Canada. 3. Division of Radiology, Mayo Clinic, USA. 4. Division of Anatomical Pathology, Mayo Clinic, USA. 5. Division of Psychology, Mayo Clinic, USA. 6. Division of Neurology, Mayo Clinic, USA Claudia.lucchinetti@mayo.edu.
Abstract
BACKGROUND AND OBJECTIVES: We report a comprehensive clinical, radiological, neuropsychometric and pathological evaluation of a woman with a clinical diagnosis of AD dementia (ADem), but whose autopsy demonstrated widespread demyelination, without Alzheimer disease (AD) pathology. METHODS AND RESULTS: Initial neuropsychometric evaluation suggested amnestic mild cognitive impairment (aMCI). Serial magnetic resonance images (MRI) images demonstrated the rate of increase in her ventricular volume was comparable to that of 46 subjects with aMCI who progressed to ADem, without accumulating white matter disease. Myelin immunohistochemistry at autopsy demonstrated extensive cortical subpial demyelination. Subpial lesions involved the upper cortical layers, and often extended through the entire width of the cortex. CONCLUSIONS: Multiple sclerosis (MS) can cause severe cortical dysfunction and mimic ADem. Cortical demyelination is not well detected by standard imaging modalities and may not be detected on autopsy without myelin immunohistochemistry.
BACKGROUND AND OBJECTIVES: We report a comprehensive clinical, radiological, neuropsychometric and pathological evaluation of a woman with a clinical diagnosis of AD dementia (ADem), but whose autopsy demonstrated widespread demyelination, without Alzheimer disease (AD) pathology. METHODS AND RESULTS: Initial neuropsychometric evaluation suggested amnestic mild cognitive impairment (aMCI). Serial magnetic resonance images (MRI) images demonstrated the rate of increase in her ventricular volume was comparable to that of 46 subjects with aMCI who progressed to ADem, without accumulating white matter disease. Myelin immunohistochemistry at autopsy demonstrated extensive cortical subpial demyelination. Subpial lesions involved the upper cortical layers, and often extended through the entire width of the cortex. CONCLUSIONS:Multiple sclerosis (MS) can cause severe cortical dysfunction and mimic ADem. Cortical demyelination is not well detected by standard imaging modalities and may not be detected on autopsy without myelin immunohistochemistry.
Authors: Guy M McKhann; David S Knopman; Howard Chertkow; Bradley T Hyman; Clifford R Jack; Claudia H Kawas; William E Klunk; Walter J Koroshetz; Jennifer J Manly; Richard Mayeux; Richard C Mohs; John C Morris; Martin N Rossor; Philip Scheltens; Maria C Carrillo; Bill Thies; Sandra Weintraub; Creighton H Phelps Journal: Alzheimers Dement Date: 2011-04-21 Impact factor: 21.566
Authors: Jane Marian Anderson; Rickie Patani; Richard Reynolds; Richard Nicholas; Alastair Compston; Maria Grazia Spillantini; Siddharthan Chandran Journal: Acta Neuropathol Date: 2010-03-21 Impact factor: 17.088
Authors: Assunta Dal Bianco; Monika Bradl; Josa Frischer; Alexandra Kutzelnigg; Kurt Jellinger; Hans Lassmann Journal: Ann Neurol Date: 2008-02 Impact factor: 10.422
Authors: C R Jack; S D Weigand; M M Shiung; S A Przybelski; P C O'Brien; J L Gunter; D S Knopman; B F Boeve; G E Smith; R C Petersen Journal: Neurology Date: 2007-11-21 Impact factor: 9.910
Authors: Farzaneh A Sorond; Shawn Whitehead; Ken Arai; Douglas Arnold; S Thomas Carmichael; Charles De Carli; Marco Duering; Myriam Fornage; Rafael E Flores-Obando; Jonathan Graff-Radford; Edith Hamel; David C Hess; Massafumi Ihara; Majken K Jensen; Hugh S Markus; Axel Montagne; Gary Rosenberg; Andy Y Shih; Eric E Smith; Alex Thiel; Kai Hei Tse; Donna Wilcock; Frank Barone Journal: Geroscience Date: 2019-12-06 Impact factor: 7.713
Authors: Diana P Londoño; Kogulavadanan Arumaithurai; Eleni Constantopoulos; Michael R Basso; R Ross Reichard; Eoin P Flanagan; B Mark Keegan Journal: Brain Commun Date: 2022-06-22
Authors: Hsueh-Sheng Chiang; Alka Khera; Barbara E Stopschinski; Olaf Stuve; John Hart; Brendan Kelley; Trung Nguyen Journal: Geriatrics (Basel) Date: 2022-06-05
Authors: Lynn van Olst; Carla Rodriguez-Mogeda; Carmen Picon; Svenja Kiljan; Rachel E James; Alwin Kamermans; Susanne M A van der Pol; Lydian Knoop; Iliana Michailidou; Evelien Drost; Marc Franssen; Geert J Schenk; Jeroen J G Geurts; Sandra Amor; Nicholas D Mazarakis; Jack van Horssen; Helga E de Vries; Richard Reynolds; Maarten E Witte Journal: Acta Neuropathol Date: 2021-03-29 Impact factor: 17.088
Authors: Bogdan F Popescu; Josa M Frischer; Samuel M Webb; Mylyne Tham; Reginald C Adiele; Christopher A Robinson; Patrick D Fitz-Gibbon; Stephen D Weigand; Imke Metz; Susan Nehzati; Graham N George; Ingrid J Pickering; Wolfgang Brück; Simon Hametner; Hans Lassmann; Joseph E Parisi; Guo Yong; Claudia F Lucchinetti Journal: Acta Neuropathol Date: 2017-03-22 Impact factor: 17.088
Authors: Burcu Zeydan; Val J Lowe; Ross R Reichard; Scott A Przybelski; Timothy G Lesnick; Christopher G Schwarz; Matthew L Senjem; Jeffrey L Gunter; Joseph E Parisi; Mary M Machulda; Prashanthi Vemuri; Michelle M Mielke; David S Knopman; Ronald C Petersen; Clifford R Jack; Orhun H Kantarci; Kejal Kantarci Journal: Ann Neurol Date: 2020-02-08 Impact factor: 10.422