February 1995

Clinical Correlates of Alzheimer's Disease With and Without Silent Radiographic Abnormalities

Author Affiliations

From the Departments of Neurology (Drs Marder, Richards, Bell, Sano, and Stern and Ms Miller), Psychiatry (Dr Stern), the H. Sergievsky Center (Drs Marder, Richards, and Stern), and The Center for Alzheimer's Disease Research (Drs Marder, Bell, Sano, and Stern), College of Physicians and Surgeons, Columbia University, New York, NY; the Division of Neuroradiology, Albert Einstein College of Medicine, Bronx, NY (Dr Bello); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Md (Dr Folstein); and the Departments of Psychiatry and Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (Dr Albert).

Arch Neurol. 1995;52(2):146-151. doi:10.1001/archneur.1995.00540260050015

Objective:  To determine whether patients with Alzheimer's disease (AD) who do not have historical or clinical evidence of stroke but who do have computed tomographic or magnetic resonance imaging evidence of noncortical lesions smaller than 2 cm or periventricular "caps" differ from other patients with AD.

Methods:  The computed tomographic or magnetic resonance imaging scans of 158 patients meeting criteria of the National Institute of Neurological Disorders and Stroke—Alzheimer's Disease and Related Disorders Association for probable AD were reviewed by one neuroradiologist. Two measures of disease severity—the Modified Mini-Mental State examination and the Blessed Dementia Rating Scale (Part I)—were subjected to two-way analysis of variance with scan type (computed tomography or magnetic resonance imaging) and lesion number as between-group factors and age and disease duration as covariates.

Results:  No relationship was seen between lesion number or periventricular caps and disease severity.

Conclusion:  In this cross-sectional analysis using these clinical measures, patients with AD who have well-defined radiographic abnormalities cannot be differentiated from patients with AD who do not have them.