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Amyloid deposition, hypometabolism, and longitudinal cognitive decline

2012· article· en· 753 citations· W2160597466 on OpenAlex· 10.1002/ana.23650

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Abstract

OBJECTIVE: Using data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) population, we examined (1) cross-sectional relationships between amyloid deposition, hypometabolism, and cognition, and (2) associations between amyloid and hypometabolism measurements and longitudinal cognitive measurements. METHODS: We examined associations between mean cortical florbetapir uptake, mean (18) F-fluorodeoxyglucose-positron emission tomography (FDG-PET) within a set of predefined regions, and Alzhiemer's Disease Assessment Scale (ADAS-cog) performance in 426 ADNI participants (126 normal, 162 early mild cognitive impairment [EMCI], 85 late MCI [LMCI], 53 Alzheimer disease [AD] patients). For a subset of these (76 normal, 81 LMCI) we determined whether florbetapir and FDG-PET were associated with retrospective decline in longitudinal ADAS-cog measurements. RESULTS: Twenty-nine percent of normal subjects, 43% of EMCI patients, 62% of LMCI patients, and 77% of AD patients were categorized as florbetapir positive. Florbetapir was negatively associated with concurrent FDG and ADAS-cog in both MCI groups. In longitudinal analyses, florbetapir-positive subjects in both normal and LMCI groups had greater ongoing ADAS-cog decline than those who were florbetapir negative. However, in normal subjects, florbetapir positivity was associated with greater ADAS-cog decline than FDG, whereas in LMCI, FDG positivity was associated with greater decline than florbetapir. INTERPRETATION: Although both hypometabolism and β-amyloid (Aβ) deposition are detectable in normal subjects and all diagnostic groups, Aβ showed greater associations with cognitive decline in normal participants. In view of the minimal cognitive deterioration overall in this group, this suggests that amyloid deposition has an early and subclinical impact on cognition that precedes metabolic changes. At moderate and later stages of disease (LMCI/AD), hypometabolism becomes more pronounced and more closely linked to ongoing cognitive decline.

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The record

Venue
Annals of Neurology
Topic
Dementia and Cognitive Impairment Research
Field
Medicine
Canadian institutions
Funders
National Institute on AgingAvid RadiopharmaceuticalsUniversity of California, San DiegoNational Institute of Biomedical Imaging and BioengineeringCanadian Institutes of Health ResearchUniversity of California, Los AngelesNational Institutes of HealthServierElanAstellas PharmaEisaiGenentechUniversity of OxfordNorthern California Institute for Research and EducationPfizerBiogenBioClinicaAlzheimer's AssociationAmorfix Life SciencesDana FoundationBayer HealthCareAlzheimer's Disease Neuroimaging InitiativeMeso Scale DiagnosticsF. Hoffmann-La RocheMedpaceAstraZenecaEli Lilly and CompanyBristol-Myers SquibbNovartis Pharmaceuticals CorporationAmgenSynarcFoundation for the National Institutes of Health
Keywords
Cognitive declineNeuroimagingPositron emission tomographyCognitionInternal medicineSubclinical infectionAlzheimer's diseaseCogPsychologyMedicineLongitudinal studyFluorodeoxyglucoseDementiaDiseaseEndocrinologyPathologyNeuroscience
Has abstract in OpenAlex
yes