Cerebral small vessel disease (SVD) and amyloid beta (Aβ) pathology frequently co-exist. The impact of concurrent pathology on the pattern of hippocampal atrophy, a key substrate of memory impacted early and extensively in dementia, remains poorly understood.
In a unique cohort of mixed Alzheimer’s disease and moderate–severe SVD, we examined whether total and regional neuroimaging measures of SVD, white matter hyperintensities (WMH), and Aβ, as assessed by 18F-AV45 positron emission tomography, exert additive or synergistic effects on hippocampal volume and shape.
Frontal WMH, occipital WMH, and Aβ were independently associated with smaller hippocampal volume. Frontal WMH had a spatially distinct impact on hippocampal shape relative to Aβ. In contrast, hippocampal shape alterations associated with occipital WMH spatially overlapped with Aβ-vulnerable subregions.
Hippocampal degeneration is differentially sensitive to SVD and Aβ pathology. The pattern of hippocampal atrophy could serve as a disease-specific biomarker, and thus guide clinical diagnosis and individualized treatment strategies for mixed dementia.

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This post is Copyright: Kristiana Xhima,
Julie Ottoy,
Erin Gibson,
Katherine Zukotynski,
Christopher Scott,
Ginelle J. Feliciano,
Sabrina Adamo,
Phillip H. Kuo,
Michael J. Borrie,
Howard Chertkow,
Richard Frayne,
Robert Laforce Jr.,
Michael D. Noseworthy,
Frank S. Prato,
Demetrios J. Sahlas,
Eric E. Smith,
Vesna Sossi,
Alexander Thiel,
Jean‐Paul Soucy,
Jean‐Claude Tardif,
Maged Goubran,
Sandra E. Black,
Joel Ramirez,
for the Medical Imaging Trials Network of Canada (MITNEC) | April 5, 2024

Wiley: Alzheimer’s & Dementia: Table of Contents