Is damage to white matter always caused by problems with blood flow?

Read about a research project we funded into the influence of cortical neurodegenerative pathology on white matter integrity.

Lead investigator: Professor Johannes Attems

  • Institution: Newcastle University 
  • Grant Type: Project Grant 
  • Grant amount: ÂŁ262,133
  • Start date: August 2014
  • Completion date: July 2017

What did the researchers do?

The brain contains 'grey matter' and 'white matter'. Grey matter consists of the 'bodies' of nerve cells. White matter contains the connections between cells and different areas of the brain. Healthy white matter is essential for good communication between different brain regions.

In brains of elderly people this white matter may show damage, called white matter lesions. Researchers think this may be caused by either small vessel disease (SVD), Alzheimer’s or both.

Professor Attems and his team analysed donated brain tissue for white matter lesions. Using special techniques, they aimed to identify whether these lesions are related to SVD or neurodegeneration such as Alzheimer’s.

The research team also used Magnetic Resonance Imagining (MRI) to find out if the lesions appeared differently depending on the underlying cause.

What were the key results? 

The research team were able to show the difference in white matter between people with and without Alzheimer’s. They found two mechanisms that could lead to changes in the white matter.

In tissue affected by Alzheimer’s the team found that there was more death of the long branches of the nerve cells. This appeared to be caused by the presence of tau but not amyloid-beta, two proteins closely associated with Alzheimer’s. When there was little tau present, the changes to white matter was caused by SVD.

When the team compared tissue from people with and without Alzheimer’s they found there was much more white matter damage in people with Alzheimer’s. In people who didn’t have Alzheimer’s the white matter changes were linked to a lack of blood to the cells but they could not show this was caused by SVD.

How will this help in the fight against dementia?

This research is vital in understanding the changes to the white matter in Alzheimer’s as well as SVD. It is possible that these white matter lesions are found in Alzheimer’s but not in vascular dementia. 

This could in turn help us to accurately diagnose Alzheimer’s and vascular dementia thus allowing clinicians to treat people appropriately. 

What are the next steps?

Dr Kirsty McAleese is undertaking a Junior Fellowship to continue this research aiming to better understand white matter changes in Alzheimer’s and if these changes can be seen using MRI scanning.

Dr McAleese will be examining white matter from donated tissue from 200 people with and without Alzheimer’s.

The team hope the next steps of this research will help diagnose dementia accurately and lead to better treatment and support for people affected by dementia and their carers. 

Sharing this research

The research team have published the results of this research in a number of journals including:

  • McAleese K et al. (2017) Parietal white matter lesions in Alzheimer's disease are associated with cortical neurodegenerative pathology, but not with small vessel disease. Acta Neuropathol.
  • Dr McAleese spoke about this research at the 13th International Conference on Alzheimer’s Disease and Parkinson’s Disease in Vienna, Austria in March 2017.
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