White matter pathology in Alzheimer's disease and vascular dementia: quantification by amyloid‐β precursor protein immunocytochemistry

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Abstract
Alzheimer's disease (AD) and vascular dementia (VaD) are two of the common dementias in the elderly. Imaging studies have demonstrated white matter changes of vascular etiology to occur in both disorders. While there have increased efforts to differentiate white matter pathology by quantitative magentic resonance imaging in these disorders there is no clear consensus. We assessed white matter lesions in brains of the first 100 demented patients who came to autopsy from our prospectively evaluated series. We examined the extent of axonal pathology by conventional methods including LFB for myelin, and amyloid‐β precursor protein (AβPP) immunocytochemistry with antibodies to 22C11. AβPP has recently been used to examine axonal injury in head trauma. Our results indicated AβPP reactive accumulation along white matter tracts in the temporal cortex encompassing the hippocampal formation to be common. The highest reactivity was evident in tissue from VaD subjects compared with that from AD or dementia with Lewy bodies (DLB). Compared with conventional myelin stains, AβPP immunocytochemistry was more sensitive to visualize subtle changes. We suggest AβPP immunocytochemistry is a useful index to assess ischaemic white matter lesions to differentiate dementias.Acknowledgements:  Supported by the MRC (UK), Alzheimer's Research Trust (UK) and Alzheimer's Association (USA).

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