Several studies report a strong association between Alzheimer’s Disease (AD) and cerebral WMH on MRI. These WMHs can grow in volume, regress or remain stable over time. We hypothesize that WMH progression is associated with higher levels of CSF tau/Amyloid beta (Aβ) and amyloid deposition quantified using amyloid (Florbetapir(¹⁸F); ¹⁸F-AV-45) positron emission tomography (PET).

To examine the differences between the white matter hyperintensities (WMH) progression versus the WMH regression groups in terms of cerebrospinal fluid amyloid beta level and amyloid deposition in the brain.

The sample consisted of 377 the Alzheimer’s Disease Neuroimaging Initiative 2 (ADNI2) participants who were evaluated with WMH quantification, cerebrospinal fluid levels of tau/Aβ and both total and regional amyloid deposition using an amyloid PET scan. All measures were collected at baseline with WMH additionally assessed 2 years later. Participants were categorized into three groups based on WMH change (Δ): Regression, Stable, and Progression.

Controlling for age and sex, there were no significant differences between those with WMH regression vs. progression in CSF tau/Aβ (p = 0.219), whole brain amyloid concentration (p = 0.169), or region-wise amyloid concentration (frontal, p = 0.177); cingulate, p = 0.153; parietal, p = 0.218; temporal, p = 0.164). Within-groups, change in WMH was positively correlated with tau/Aβ in the progression, but not regression group (p = 0.036 and p = 0.747, respectively). Amyloid PET scans showed that the change in WMH was not positively correlated with whole brain amyloid concentrations (p = 0.136), but there was a positive trend in the temporal region (p = 0.067) in the progression group. There were no significant differences in the regression group.

There were no significant differences in the regression group.WMH progression is associated with higher tau/Aβ and possibly temporal amyloid concentration based on amyloid PET scans. These results suggest that use of three WMH categories may help predict patient prognosis.