Background: Early-onset Alzheimer's disease (AD) patients have clinical, neuropsychological, and imaging characteristics that differ from patients with late-onset AD. Although the weight of vascular lesions in early-onset AD is considered to be low, to date no study focused on this topic. Our aim was to evaluate the weight of brain vascular lesions on MRI in a cohort of early-onset AD patients. Methods: In this multicentre study, early-onset AD patients were assessed with clinical examination, standardized neuropsychological tests and brain MRI (3D-T1, gradient echo T2∗, and FLAIR). Subcortical hyperintensities (SH) were evaluated with Fazekas and Scheltens visual semi-quantitative rating scales. We evaluated the medial temporal lobe atrophy (MTLA) with the Scheltens visual scale, and the brain microbleeds (BMBs) with the validated BOMBS rating scale. Bivariate analysis and Spearman correlations were used to describe our population. Results: There was no influence of the centre of recruitment on demographic, radiological and neuropsychological variables. We included 84 early-onset AD patients (median age at first symptoms: 55 years (interquartile range (IQR):51.2-58.0), 40 (47.6%) women). The median MMSE at inclusion was 14.5 points (IQR:9-21). Thirty (36%) patients had hypertension, 35 (42%) dyslipidemia, 5 (6%) diabetes, 6 (7%) ischemic heart disease and 2 patients (2%) had a history of stroke. The median Fazekas total score was 1.0 (IQR:1.0-1.0). Using the Scheltens scale, the median for total PVH score was 3.0 (IQR:1.0-3.0), for total WMH score was 2.5 (IQR:1.0-5.0), for total BGscorewas 0.0 (IQR:0.0-0.0), and for total ITF score was 0.1 (IQR:0.0-0.0). Only two patients had no SH. Hypertension was significantly associated with the Fazekas score (p = 0.02) and with the totalWMH Scheltens score (p = 0.04). The median MTLA score was 2.0 (IQR:1.0-3.0) and its severity was correlated with a lower MMSE (p < ;0.0001). In a subgroup of 33 patients, one or more BMBs were present in 24%. There was no difference in demographic, imaging and neuropsychological variables between patients who suffered their first symptoms before or after the age of 55. Conclusions: In our cohort of early-onset AD patients, vascular risk factors and vascular lesions onMRIwere surprisingly frequent, as reported in late-onset cohorts.
Bombois, S., Campion, D., Hannequin, D., Delmaire, C., Lehéricy, S., Wallon, D., … Pasquier, F. (2011). P1-064: How prevalent are vascular lesions among early-onset Alzheimer’s patients? Alzheimer’s & Dementia, 7, S130–S131. https://doi.org/10.1016/j.jalz.2011.05.343