20| The Interplay Between Cerebrovascular Disease and Alzheimer’s Disease – A Conversation With Dr. Adam Brickman

Adam Brickman, Ph.D., returns to discuss the involvement of white matter disease in Alzheimer’s disease progression and clinical presentation.  Dr. Brickman discusses his research on the presence of biomarkers of cerebrovascular disease (e.g., white matter hyperintensities), which are present in aging and Alzheimer’s disease.  Although cerebrovascular disease is traditionally associated with its own unique cognitive profile, Dr. Brickman discusses evidence suggesting that the cognitive deficits and underlying etiologies often commingle and complicate our case conceptualization.  Additionally, he proposes the integral role that cerebrovascular disease may play in predicting (and possibly initiating) disease progression and cognitive decline in Alzheimer’s disease.

A pdf of the transcript for this episode is available here.

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Topics Covered (with time stamps)

  • Mechanism of risk factors for cerebrovascular disease (10:20)
  • Reduced cerebral autoregulation of blood pressure increases risk for cerebrovascular disease and cognitive decline (12:50)
  • Cognitive decline and cerebrovascular disease (16:45)
  • Conceptualizing, assessing, and treating mixed dementia (19:20)
  • Patterns of white matter disease and cognitive profiles (24:00)
  • Clinical radiological readings and white matter hyperintensities in aging (28:42)
  • 2016 Annals of Neurology paper discussion (30:40)
  • Cerebral amyloid angiopathy in Alzheimer’s disease (35:05)
  • Cerebrovascular disease as a possible initiator of Alzheimer’s disease (36:55)
  • Moderators of the impact of cerebrovascular disease on cognition (40:20)
  • White matter changes in age-related cognitive decline (47:20)
  • Interventions to reduce risk of cerebrovascular disease (49:52)

Visit the episode 19 show notes for Dr. Brickman’s bio.

Selected References

Brickman, A. M. (2013). Contemplating Alzheimer’s disease and the contribution of white matter hyperintensities. Current neurology and neuroscience reports, 13(12), 415.

Brickman, A. M., Honig, L. S., Scarmeas, N., Tatarina, O., Sanders, L., Albert, M. S., . . . Stern, Y. (2008). Measuring cerebral atrophy and white matter hyperintensity burden to predict the rate of cognitive decline in Alzheimer disease. Archives of neurology, 65(9), 1202-1208.

Brickman, A. M., Muraskin, J., & Zimmerman, M. E. (2009). Structural neuroimaging in Alzheimer’s disease: do white matter hyperintensities matter? Dialogues in clinical neuroscience, 11(2), 181.

Brickman, A. M., Reitz, C., Luchsinger, J. A., Manly, J. J., Schupf, N., Muraskin, J., . . . Mayeux, R. (2010). Long-term blood pressure fluctuation and cerebrovascular disease in an elderly cohort. Archives of neurology, 67(5), 564-569.

Brickman, A. M., Siedlecki, K. L., Muraskin, J., Manly, J. J., Luchsinger, J. A., Yeung, L.-K., . . . Stern, Y. (2011). White matter hyperintensities and cognition: testing the reserve hypothesis. Neurobiology of aging, 32(9), 1588-1598.

Brickman, A. M., Zahodne, L. B., Guzman, V. A., Narkhede, A., Meier, I. B., Griffith, E. Y., . . . Stern, Y. (2015). Reconsidering harbingers of dementia: progression of parietal lobe white matter hyperintensities predicts Alzheimer’s disease incidence. Neurobiology of aging, 36(1), 27-32.

Provenzano, F. A., Muraskin, J., Tosto, G., Narkhede, A., Wasserman, B. T., Griffith, E. Y., . . . Brickman, A. M. (2013). White matter hyperintensities and cerebral amyloidosis: necessary and sufficient for clinical expression of Alzheimer disease? JAMA neurology, 70(4), 455-461.

Van Beek, A. H., Claassen, J. A., Rikkert, M. G. O., & Jansen, R. W. (2008). Cerebral autoregulation: an overview of current concepts and methodology with special focus on the elderly. Journal of Cerebral Blood Flow & Metabolism, 28(6), 1071-1085.