Young adult-onset, very slowly progressive cognitive decline with spastic paraparesis in Alzheimer’s disease with cotton wool plaques due to a novel presenilin1 G417S mutation

MR images of the present case. a T1-weighted horizontal, b T2-weighted horizontal, c T1-weighted coronal, and d T1-weighted sagittal images at 40 years. Evident bilateral atrophy of the hippocampus and symmetric white matter atrophy with occipital predominance are noted. The width of the corpus callosum is reduced (c). The brain stem doesn’t show evident atrophy (d). e T1-weighted horizontal and f T2-weighted horizontal images at 54 years. Diffuse cortical atrophy is progressed. The symmetric dilatation of the lateral ventricles becomes evident, suggesting the potential complication of idiopathic normal pressure hydrocephalus in addition to the atrophy of the white matte