Cerebrovascular Disease and Neurodegeneration in Alzheimer’s Disease with and without a Strong Family History: A Pilot Magnetic Resonance Imaging Study in Dominican Republic

Article type: Research Article

Authors: Piriz, Angel^{a; b} | Reyes, Dolly^{a; b} | Narkhede, Atul^a | Guzman, Vanessa A. ^a | Viqar, Fawad^a | Meier, Irene B. ^a | Budge, Mariana^a | Mena, Pedro^{a; b} | Dashnaw, Stephen^c | Lee, Joseph^{a; b; d} | Reitz, Christiane^{a; b; c; d; e} | Gutierrez, Jose^e | Campos, Luis^f | Medrano, Martin^g | Lantigua, Rafael^{a; b; h} | Mayeux, Richard^{a; b; d; e} | Brickman, Adam M. ^{a; b; e; *}

Affiliations: [a] Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA | [b] G.H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA | [c] Department of Radiology, College of Physicians and Surgeons, Columbia University, New York, NY, USA | [d] Department of Epidemiology, College of Physicians and Surgeons, Columbia University, New York, NY, USA | [e] Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA | [f] Centro de Radiologia Especializada, Santiago, Dominican Republic | [g] School of Medicine, Mother and Teacher Pontifical Catholic University, Santiago, Dominican Republic | [h] Department of Medicine, College of Physicians and Surgeonss, Columbia University, New York, NY, USA

Correspondence: [*] Correspondence to: Adam M. Brickman, Taub Institute, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY 10032, USA. Tel.: +1 212 342 1348; Fax: +1 212 342 1838; E-mail: amb2139@columbia.edu.

Abstract: The incidence and prevalence of Alzheimer’s disease (AD) dementia are higher among Caribbean Hispanics than among non-Hispanic Whites. The causes of this health disparity remain elusive, partially because of the relative limited capacity for biomedical research in the developing countries that comprise Caribbean Latin America. To begin to address this issue, we were awarded a Development Research Award from the US NIH and Fogarty International Center in order to establish the local capacity to integrate magnetic resonance imaging (MRI) into studies of cognitive aging and dementia in Dominican Republic, establish collaborations with Dominican investigators, and conduct a pilot study on the role of cerebrovascular markers in the clinical expression of AD. Ninety older adult participants with and without AD dementia and with and without a strong family history of AD dementia received MRI scans and clinical evaluation. We quantified markers of cerebrovascular disease (white matter hyperintensities [WMH], presence of infarct, and presence of microbleed) and neurodegeneration (entorhinal cortex volume) and compared them across groups. Patients with AD dementia had smaller entorhinal cortex and greater WMH volumes compared with controls, regardless of family history status. This study provides evidence for the capacity to conduct MRI studies of cognitive aging and dementia in Dominican Republic. The results are consistent with the hypothesis that small vessel cerebrovascular disease represents a core feature of AD dementia, as affected participants had elevated WMH volumes irrespective of family history status.

Keywords: Alzheimer’s disease, cerebrovascular disease, developing countries, neurodegeneration

DOI: 10.3233/JAD-180807

Journal: Journal of Alzheimer's Disease, vol. 66, no. 4, pp. 1519-1528, 2018