Overdiagnosing Vascular Dementia using Structural Brain Imaging for Dementia Work-Up

Ellis Niemantsverdriet; Bart F E Feyen; Nathalie Le Bastard; Jean-Jacques Martin; Johan Goeman; Peter Paul De Deyn; Sebastiaan Engelborghs

doi:10.3233/JAD-142103

Overdiagnosing Vascular Dementia using Structural Brain Imaging for Dementia Work-Up

J Alzheimers Dis. 2015;45(4):1039-43. doi: 10.3233/JAD-142103.

Authors

Ellis Niemantsverdriet¹, Bart F E Feyen², Nathalie Le Bastard³, Jean-Jacques Martin¹, Johan Goeman⁴, Peter Paul De Deyn⁵, Sebastiaan Engelborghs⁶

Affiliations

¹ Reference Center for Biological Markers of Dementia (BIODEM), Laboratory of Neurochemistry and Behavior, and Biobank, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium.
² Reference Center for Biological Markers of Dementia (BIODEM), Laboratory of Neurochemistry and Behavior, and Biobank, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium Current affiliation: Department of Neurosurgery, Hospital Network Antwerp, Middelheim, Antwerp, Belgium.
³ Reference Center for Biological Markers of Dementia (BIODEM), Laboratory of Neurochemistry and Behavior, and Biobank, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium Current affiliation: Fujirebio Europe, Ghent, Belgium.
⁴ Department of Neurology and Memory Clinic, Hospital Network Antwerp, Middelheim and Hoge Beuken, Antwerp, Belgium.
⁵ Reference Center for Biological Markers of Dementia (BIODEM), Laboratory of Neurochemistry and Behavior, and Biobank, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium Department of Neurology and Memory Clinic, Hospital Network Antwerp, Middelheim and Hoge Beuken, Antwerp, Belgium Department of Neurology and Alzheimer Research Center, University of Groningen and University Medical Center Groningen (UMCG), Groningen, The Netherlands.
⁶ Reference Center for Biological Markers of Dementia (BIODEM), Laboratory of Neurochemistry and Behavior, and Biobank, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium Department of Neurology and Memory Clinic, Hospital Network Antwerp, Middelheim and Hoge Beuken, Antwerp, Belgium.

PMID: 25633672
DOI: 10.3233/JAD-142103

Abstract

Hypothesizing that non-significant cerebrovascular lesions on structural brain imaging lead to overdiagnosis of a vascular etiology of dementia as compared to autopsy-confirmed diagnosis, we set up a study including 71 patients with autopsy-confirmed diagnoses. Forty-two patients in the population (59%) appeared to have definite Alzheimer's disease (AD), whereas 29 (41%) had a non-AD dementia form. The panel clinically diagnosed possible or probable vascular dementia (VaD) in 27 (38%) patients, whereas only five (19%) patients (p = 0.017) had an autopsy-confirmed diagnosis of VaD. Patients with vascular lesions on structural brain imaging were often misdiagnosed as possible or probable VaD as compared to autopsy-confirmed diagnosis.

Keywords: Alzheimer's disease; brain imaging; dementia; differential dementia diagnosis; magnetic resonance imaging; vascular dementia.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Alzheimer Disease / diagnosis*
Alzheimer Disease / pathology*
Brain / pathology*
Dementia, Vascular / diagnosis*
Dementia, Vascular / pathology*
Diagnosis, Differential
Female
Humans
Magnetic Resonance Imaging
Male
Mental Status Schedule