Vascular dementia in leukoaraiosis may be a consequence of capillary loss not only in the lesions, but in normal-appearing white matter and cortex as well

Abstract We investigated capillary density in 12 subjects with leukoaraiosis (LA), in 9 age-matched normal subjects, in 7 cases of Alzheimer's disease (AD), and 4 after whole-brain irradiation for brain tumors. In the LA study (which as been published), autopsy brains were evaluated by MRI. The...

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Bibliographic Details
Published in:Journal of the neurological sciences 2007-06, Vol.257 (1), p.62-66
Main Authors: Brown, William R, Moody, Dixon M, Thore, Clara R, Challa, Venkata R, Anstrom, John A
Format: Article
Language:English
Subjects:
Adult
Aged
Aging - pathology
Aging changes
Alkaline Phosphatase
Alkaline phosphatase staining
Biological and medical sciences
Biomarkers
Brain Ischemia - pathology
Brain Ischemia - physiopathology
Capillaries - pathology
Capillary loss
Cerebral Arteries - pathology
Cerebral Arteries - physiopathology
Cerebral Cortex - blood supply
Cerebral Cortex - pathology
Cerebral Cortex - physiopathology
Coloring Agents
Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases
Dementia, Vascular - etiology
Dementia, Vascular - pathology
Dementia, Vascular - physiopathology
Female
Humans
Image Processing, Computer-Assisted
Leukoaraiosis
Leukoaraiosis - pathology
Leukoaraiosis - physiopathology
Male
Medical sciences
Nerve Fibers, Myelinated - pathology
Neurology
Stereology
Vascular dementia
Vascular diseases and vascular malformations of the nervous system
Vessel density
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Summary:Abstract We investigated capillary density in 12 subjects with leukoaraiosis (LA), in 9 age-matched normal subjects, in 7 cases of Alzheimer's disease (AD), and 4 after whole-brain irradiation for brain tumors. In the LA study (which as been published), autopsy brains were evaluated by MRI. The presence of LA was indicated by confluent or patchy areas of hyperintensity in the deep white matter. We employed a stereology method using computerized image processing and analysis to determine microvascular density. Afferent vessels (arterioles and capillaries, but not veins or venules) were stained for alkaline phosphatase in 100 μm thick celloidin sections. Microvascular density in LA lesions in the deep white matter (2.56%) was significantly lower than in the corresponding deep white matter of normal subjects (3.20%, p = 0.0180). LA subjects demonstrated decreased vascular density at early ages (55–65 years) when compared to normal subjects. Our findings indicate that LA affects the brain globally, with capillary loss, although the parenchymal damage is found primarily in the deep white matter. In ongoing studies of the deep white matter in AD brains, we found a pattern of decreased vascular density compared to normal, as well as an age-related decline. In the four irradiated brains, we found very low vessel densities, similar to those found in LA, without an additional age-related decline.
ISSN:0022-510X
1878-5883
DOI:10.1016/j.jns.2007.01.015