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Regional white matter integrity differentiates between vascular dementia and Alzheimer disease
Zarei M, Damoiseaux JS, Morgese C, Beckmann CF, Smith SM, Matthews PM, Scheltens P, Rombouts SA et al.. Stroke, 2009-01-22
Topic: Amyloid, tau and blood-test diagnosis
Background and purpose Considerable clinical and radiological overlap between vascular dementia (VaD) and Alzheimer disease (AD) often makes the diagnosis difficult. Diffusion-tensor imaging studies showed that fractional anisotropy (FA) could be a useful marker for white matter changes. This study aimed to identify regional FA changes to identify a biomarker that could be used to differentiate VaD from AD. Methods T1-weighted and diffusion-tensor imaging scans were obtained in 13 VaD patients, 16 AD patients, and 22 healthy elderly controls. We used tract-based spatial statistics to study regional changes in fractional anisotropy in AD, VaD, and elderly controls. We then used probabilistic tractography to parcel the corpus callosum in 7 regions according to its connectivity with major cerebral cortices using diffusion-tensor imaging data set. We compared the volume and mean FA in each set of transcallosal fibers between groups using ANOVA and then applied a discriminant analysis based on FA and T2-weighted imaging measures. Results FA reduction in forceps minor was the most significant area of difference between AD and VaD. Segmentation of the corpus callosum using tractography and comparison of FA changes of each segment confirmed the FA changes in transcallosal prefrontal tracts of patients with VaD when compared to AD. The best discriminant model was the combination of transcallosal prefrontal FA and Fazekas score with 87.5% accuracy, 100% specificity, and 93% sensitivity (P Conclusions Integrating mean FA in the forceps minor to the Fazekas score provides a useful quantitative marker for differentiating AD from VaD.
Key findings
- Diffusion-tensor imaging studies showed that fractional anisotropy (FA) could be a useful marker for white matter changes.
- Results FA reduction in forceps minor was the most significant area of difference between AD and VaD.
- Segmentation of the corpus callosum using tractography and comparison of FA changes of each segment confirmed the FA changes in transcallosal prefrontal tracts of patients with VaD when compared to AD.
Why it matters
This study found that reduced fractional anisotropy in the forceps minor and transcallosal prefrontal tracts helped differentiate vascular dementia from Alzheimer's disease. It is about using imaging to tell these dementias apart, not about treating, curing, or preventing Alzheimer's disease.
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Study details
- Effect size87.5%
- Evidence strengthLow
How this study scored 46/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Stroke) |
| Journal's citation record | 3 / 4 | Stroke: journal h-index 455 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2009 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 4 / 7 | Cited 99 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 5.2 citations a year over 19 year(s) since 2009 |
| Impact for its field and year | 3 / 6 | Cited 5.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 3 other studies in this library |
| Still being cited | 1 / 4 | Cited 8 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Frederik Barkhof: h-index 184 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Oxford: institution h-index 2,205 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 19164789) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 46 / 100 | — |
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Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Zarei, M., Damoiseaux, J. S., Morgese, C., Beckmann, C. F., Smith, S. M., Matthews, P. M., et al. (2009). Regional white matter integrity differentiates between vascular dementia and Alzheimer disease. Stroke. https://doi.org/10.1161/strokeaha.108.530832
Vancouver
Zarei M, Damoiseaux JS, Morgese C, Beckmann CF, Smith SM, Matthews PM, et al. Regional white matter integrity differentiates between vascular dementia and Alzheimer disease. Stroke. 2009. doi:10.1161/strokeaha.108.530832. PMID: 19164789.
BibTeX
@article{zarei2009-19164789,
author = {Zarei, M. and Damoiseaux, J. S. and Morgese, C. and Beckmann, C. F. and Smith, S. M. and Matthews, P. M. and Scheltens, P. and Rombouts, S. A. and others},
title = {{Regional white matter integrity differentiates between vascular dementia and Alzheimer disease}},
journal = {Stroke},
year = {2009},
doi = {10.1161/strokeaha.108.530832},
pmid = {19164789},
url = {https://doi.org/10.1161/strokeaha.108.530832}
}
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