Alzheimer’s disease is conceptualized as the progressive consequence of two hallmark pathological changes in gray matter, especially extracellular amyloid plaques and neurofibrillary tangles. However, in the past few years, neuroimaging studies have shown that white matter microscopic and microstructure abnormalities are related to the risk and progression of Alzheimer’s disease, which indicates that in addition to the neuropathological characteristics of the disease, white matter degeneration and degeneration Myelin sheath is an important pathophysiological feature of Alzheimer’s disease. Patients suffering from this disease. Shifting attention to white matter abnormalities rather than gray matter can open up important new avenues for the pathology of Alzheimer’s disease and may become a potential therapeutic target.
White matter and gray matter
The gray matter of the brain is mainly composed of neuron cell bodies. Nerve cells in gray matter are where memories are stored. The neural cell body network processes information in the brain. These neuronal networks are necessary for thinking, speaking, and most activities. White matter is composed of myelinated axons.
White matter disease is the degeneration of tissue in the largest and deepest part of the brain. This tissue contains millions of nerve fibers or axons that connect the brain and other parts of the spinal cord and send signals to your nerves to communicate with each other. This type of brain tissue allows nerve cells to communicate with each other. This helps individuals think fast, walk straight and other important cognitive functions. When it gets sick, myelin sheath (a fatty substance that protects brain fibers) and axons (the part of cells that transmit signals between nerve cell bodies) stop working, and the brain and body stop their normal functions.
More and more studies support Alzheimer’s disease as a white matter disease
The observation that white matter abnormalities are characteristic of Alzheimer’s is relatively new.Although the changes in gray matter in the pathogenesis of Alzheimer’s disease are well known and continue to be studied extensively, the neuropathology of white matter abnormalities is still not fully understood, mainly due to Cerebral small blood vessel degeneration, inflammatory events, and loss of myelin and axon fibersHowever, it has been proven that white matter changes occur very early in the prodromal phase (pre-Alzheimer’s disease) and clinical symptoms of dementia, which emphasizes the importance of further investigation and attention.
A sort of Neuroimaging research In 2020, white matter hyperintensity was identified, which is an important contributor to neuropsychiatric symptoms (NPS), such as indifference, irritability, and depression, appearing in subjects evaluated for Alzheimer’s disease.Another recent study showed Complications have an impact on the white matter integrity of AD patients, and early changes in genes related to myelin protein in white matter occur in AD casesThis indicates that high white matter signal indicates that white matter pathology has clinical relevance. These are just a few examples of the recent growing data that support the important role of white matter abnormalities in the development of Alzheimer’s disease.
The fact that most dementias are still incurable—including cortical dementia in Alzheimer’s disease, which continues to pose such a huge threat to medicine and society—needs a new paradigm that can reveal new ways to respond effectively. Alzheimer’s disease as a white matter concept may stimulate this novel thinking, and in a theoretical sense, it can broaden the perspective of clinicians in dealing with dementia and its origins.
New hope for Alzheimer’s disease treatment
Historically, science has paid less attention to the white matter of our brain than to gray matter.
We now know the importance of white matter to our overall brain health and cognitive ability, and the relationship between the decline in white matter structure and the impairment of brain function. In the broadest sense, dementia must be caused by brain neuron dysfunction or damage. However, the details of where, when, and how cognitive impairment occurs are crucial. Just as pathology of neuronal cell bodies in gray matter is important, so are diseases involving neuronal fragments in white matter and their supporting structures.
The high degree of consideration of white matter as a specific treatment target opens up many new possibilities for the treatment of Alzheimer’s disease. The emerging possibility of treating white matter diseases can help reduce the burden of dementia due to the long-term consequences of myelin damage or dysfunction. Focusing on the white matter abnormalities of patients with Alzheimer’s disease rather than the adaptation and adjustment of gray matter has opened up promising possibilities for the scientific community to develop effective treatments for patients with Alzheimer’s disease, and it is possible to take measures to determine Possible treatment methods.
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