Multiple sclerosis masquerading as Alzheimer-type dementia: Clinical, radiological and pathological findings

W. O. Tobin, B. F. Popescu, V. Lowe, I. Pirko, J. E. Parisi, K. Kantarci, J. A. Fields, M. B. Bruns, B. F. Boeve, C. F. Lucchinetti

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Background and objectives: We report a comprehensive clinical, radiological, neuropsychometric and pathological evaluation of a woman with a clinical diagnosis of AD dementia (ADem), but whose autopsy demonstrated widespread demyelination, without Alzheimer disease (AD) pathology. Methods and results: Initial neuropsychometric evaluation suggested amnestic mild cognitive impairment (aMCI). Serial magnetic resonance images (MRI) images demonstrated the rate of increase in her ventricular volume was comparable to that of 46 subjects with aMCI who progressed to ADem, without accumulating white matter disease. Myelin immunohistochemistry at autopsy demonstrated extensive cortical subpial demyelination. Subpial lesions involved the upper cortical layers, and often extended through the entire width of the cortex. Conclusions: Multiple sclerosis (MS) can cause severe cortical dysfunction and mimic ADem. Cortical demyelination is not well detected by standard imaging modalities and may not be detected on autopsy without myelin immunohistochemistry.

Original languageEnglish (US)
Pages (from-to)698-704
Number of pages7
JournalMultiple Sclerosis
Volume22
Issue number5
DOIs
StatePublished - Apr 1 2016

Keywords

  • Cortical demyelination
  • cognitive impairment
  • multiple sclerosis

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Fingerprint Dive into the research topics of 'Multiple sclerosis masquerading as Alzheimer-type dementia: Clinical, radiological and pathological findings'. Together they form a unique fingerprint.

  • Cite this