White matter damage may be an early sign of Alzheimer’s

Much of the processing that takes place in the brain happens in the gray matter, and for this reason it has been the subject of multiple studies of degenerative brain disorders like Alzheimer's. However, a new study published in the journal Radiology suggests that the white matter, which is mainly involved in the transmission of nerve impulses and the control of physical movement, may also show signs of these disorders early on in their progression.

Using an MRI technique called diffusion tension imaging (DTI), researchers at the Neuroimaging Research Unit at the San Raffaele Scientific Institute in Milan, Italy, examined the white matter of 53 subjects with focal and early onset Alzheimer's. Focal Alzheimer's syndromes affect only certain parts of the brain and can cause language and vision problems. Early onset Alzheimer's is defined as developing before the age of 65. 

The researchers were surprised to find extensive white matter damage in all patients' brains, while damage to the gray matter was much more restricted to certain areas.

"The white matter damage in patients with focal AD syndromes was much more severe and widespread than expected," study author Dr. Federica Agosta wrote. "In early onset AD [Alzheimer's disease] and atypical AD forms, white matter degeneration may be an early marker that precedes gray matter atrophy."

According to Agosta, these findings may support the idea that Alzheimer's travels throughout the brain along white matter fibers. The researchers emphasized the importance of properly diagnosing early onset and focal Alzheimer's patients, who are often misdiagnosed due to the lack of structural damage to their gray matter.

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