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

William Tobin, B. F. Popescu, Val Lowe, I. Pirko, Joseph E Parisi, Kejal M Kantarci, Julie A Fields, M. B. Bruns, Bradley F Boeve, Claudia F Lucchinetti

Research output: Contribution to journalArticle

7 Citations (Scopus)

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

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Demyelinating Diseases
Multiple Sclerosis
Autopsy
Alzheimer Disease
Myelin Sheath
Dementia
Immunohistochemistry
Leukoencephalopathies
Magnetic Resonance Spectroscopy
Pathology
Cognitive Dysfunction

Keywords

  • cognitive impairment
  • Cortical demyelination
  • multiple sclerosis

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Multiple sclerosis masquerading as Alzheimer-type dementia : Clinical, radiological and pathological findings. / Tobin, William; Popescu, B. F.; Lowe, Val; Pirko, I.; Parisi, Joseph E; Kantarci, Kejal M; Fields, Julie A; Bruns, M. B.; Boeve, Bradley F; Lucchinetti, Claudia F.

In: Multiple Sclerosis, Vol. 22, No. 5, 01.04.2016, p. 698-704.

Research output: Contribution to journalArticle

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