The neuropathological landscape of small vessel disease and Lewy pathology in a cohort of Hispanic and non-Hispanic White decedents with Alzheimer disease.
Level 4 - case-series / case-control
Case-control postmortem neuropathological study
PubMed 38790074 · doi:10.1186/s40478-024-01773-4
What was done
Postmortem neuropathological evaluation of small vessel disease and α-synuclein pathology was performed on 92 Hispanic decedents (HD) and 184 age- and sex-matched non-Hispanic White decedents (NHWD) with intermediate-to-high Alzheimer disease (AD) neuropathologic change from three Alzheimer's Disease Research Centers. An expert blinded to demographics assessed arteriolosclerosis, cerebral amyloid angiopathy (CAA), and Lewy bodies/neurites (LBs/LNs) using semiquantitative criteria. Groups were compared using Wilcoxon tests and ordinal logistic regression adjusting for age, sex, and center.
What was found
HD and NHWD showed broad similarities across most measures, but HD exhibited significantly more severe cerebellar CAA by Vonsattel grading (p = 0.04), higher CAA density in the posterior hippocampus and cerebellum (both p = 0.01), and higher LB/LN density in the frontal (p = 0.01) and temporal cortices (p = 0.03). After adjusting for age, sex, and center, differences in cerebellar and hippocampal CAA density, cerebellar CAA grade, and frontal LB/LN density remained significant, while temporal LB/LN differences did not.
Why it matters
Demonstrates that Hispanic individuals with AD may have a higher burden of co-occurring cerebellar CAA and frontal α-synuclein pathology compared to non-Hispanic White individuals, highlighting regional neuropathological heterogeneity across ethnic groups.
Limits
The cohort was restricted to individuals from three academic research centers, which may not represent broader community populations. The sample size of Hispanic decedents was relatively modest (n = 92), subgroup diversity within the Hispanic population was not detailed, and clinical-pathological correlates (such as vascular risk factor control or cognitive trajectories) were not reported in the abstract.
Cited by
- supports The vast majority of people with Alzheimer's disease also have vascular pathology or changes in brain blood vessels.