Introduction: In recent years Alzheimer’s disease research has focused on white matter pathology and microvascular involvement. Case report: A 79-year-old Italian woman presented with rapidly-progressing cognitive impairment, leading to akinetic mutism in ~ 3 weeks and to death in 1 month. Laboratory assays and cerebrospinal fluid (CSF) examination were unremarkable, except from CSF τ-protein which was increased. EEG showed widespread abnormalities with occasional periodic synchronous discharges, prevailing on the right hemisphere. A brain MRI performed at the beginning of the rapid deterioration only showed moderate leukoaraiosis. A new brain MRI performed 2 weeks after the first showed widespread white matter damage, which was ascribed to subacute demyelinization. Post-mortem examination led to a diagnosis of AD and not confirmed other hypotheses (e.g., Creutzfeldt-Jakob disease, inflammatory processes, cerebral amyloid angiopathy with ischemic lesions). In addition, there were multifocal areas of severe demylineation in subcortical white matter of all lobes, sparing the U-fibers tracts. Conclusions: This case suggests that, at least in some instances, a rapidly aggressive course of AD could directly reflect a subacute white matter involvement, possibly linked to microvascular pathology. Further systematic studies are needed to confirm this isolated observation and to better elucidate the pathophysiological mechanisms.
|Titolo:||Subacute Alzheimer’s disease with prominent white matter involvement. Report of a pathologically-confirmed case|
|Anno del prodotto:||2013|
|Appare nelle tipologie:||4.2 Abstract in Atti di convegno|