Hyper-intense white matter in brain found in frontotemporal dementia

Areas of brain damage called white matter hyperintensities are commonly linked to vascular/blood vessel-related health problems and have also been linked to Alzheimer’s disease. Now a study has shown that white matter hyperintensities are also found in frontotemporal dementia. Frontotemporal dementia, which often affects people under the age of 65, mainly results in changes in personality, behavior and problems with language rather than memory.

The University of Sydney study publishes today in Neurology^®, the medical journal of the American Academy of Neurology.

The senior author, Dr Ramón Landin-Romero, from the Brain and Mind Centre said: “We were expecting to see similar amounts of white matter hyperintensities in frontotemporal dementia and Alzheimer’s disease, but we actually found higher levels in people with frontotemporal dementia.

“We also expected to see that people with more severe disease would have more white matter hyperintensities, regardless of disease, but that was only true in people with frontotemporal dementia,” said Dr Landin-Romero, from the School of Psychology in the Faculty of Science.

The amount of white matter hyperintensities was associated with the severity of a person’s frontotemporal dementia, including the severity of their symptoms and everyday difficulties, but it was not associated with having vascular risk factors such as high blood pressure and high cholesterol as was expected.

“In general, white matter hyperintensities have been associated with these vascular risk factors, so these results suggest that white matter hyperintensities are partly independent of vascular factors and associated with the progressive loss of brain integrity, more specifically the loss of brain cells, due to frontotemporal dementia,” Dr Landin-Romero said.

The researchers also found that higher amounts of white matter hyperintensities in certain areas of the brain were associated with worse cognitive performance.

For example, in both frontotemporal dementia and Alzheimer’s disease, increased white matter hyperintensities in the corpus callosum, a bundle of white matter fibers connecting the left and right hemispheres of the brain, was associated with attention problems.

“White matter hyperintensities should be viewed as a core feature of frontotemporal dementia and Alzheimer’s disease that can contribute to cognitive problems, not simply a marker of vascular disease,” Dr Romero-Landin concluded.