New findings by Columbia University researchers suggest that along with amyloid deposits, something called white matter hyperintensities, or WMHs, might be a second necessary factor for the development of Alzheimer's disease.

Most current approaches to Alzheimer's disease focus on the accumulation of amyloid plaque in the brain. The researchers at Columbia's Taub Institute for Research on Alzheimer's Disease and the Aging Brain, led by Adam M. Brickman, assistant professor of neuropsychology, examined the additional contribution of small-vessel cerebrovascular disease, which they visualized as WMHs.

The study included 20 subjects with clinically defined Alzheimer's disease, 59 subjects with mild cognitive impairment, and 21 normal control subjects. Using data from the Alzheimer's Disease Neuroimaging Initiative public database, the researchers found that amyloid and WHMs were equally associated with an Alzheimer's diagnosis. Amyloid and WMHs also were equally predictive of which subjects with mild cognitive impairment would go on to develop Alzheimer's. Among those with significant amyloid, WMHs were more prevalent in those with Alzheimer's than in normal control subjects.

Because the risk factors for WMHs, which are mainly vascular, can be controlled, the findings suggest potential ways to prevent the development of Alzheimer's in those with amyloid deposits.

The researchers' findings were published online in mid-February inJAMA Neurology.

The Taub Institute for Research on Alzheimer's Disease and the Aging Brain at Columbia University Medical Center is a multidisciplinary group that says it has forged links between researchers and clinicians to try to uncover the causes of Alzheimer's, Parkinson's, and other age-related brain diseases and to discover ways to prevent and cure these diseases.

The Taub Institute has partnered with the Gertrude H. Sergievsky Center at Columbia University Medical Center and the Departments of Pathology & Cell Biology and of Neurology to allow the seamless integration of genetic analysis, molecular and cellular studies, and clinical investigation to explore all phases of diseases of the nervous system. The Sergievsky Center was established by an endowment in 1977 to focus on diseases of the nervous system.

Columbia University Medical Center provides basic, pre-clinical, and clinical research; medical and health sciences education; and patient care.