Amyloid imaging in mild cognitive impairment subtypes
Objective We utilized the amyloid imaging ligand Pittsburgh Compound B (PiB) to determine the presence of Alzheimer's disease (AD) pathology in different mild cognitive impairment (MCI) subtypes and to relate increased PiB binding to other markers of early AD and longitudinal outcome. Methods T...
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| Published in: | Annals of neurology Vol. 65; no. 5; pp. 557 - 568 |
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| Main Authors: | , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Hoboken
Wiley Subscription Services, Inc., A Wiley Company
01.05.2009
Wiley-Liss |
| Subjects: | |
| ISSN: | 0364-5134, 1531-8249, 1531-8249 |
| Online Access: | Get full text |
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| Summary: | Objective
We utilized the amyloid imaging ligand Pittsburgh Compound B (PiB) to determine the presence of Alzheimer's disease (AD) pathology in different mild cognitive impairment (MCI) subtypes and to relate increased PiB binding to other markers of early AD and longitudinal outcome.
Methods
Twenty‐six patients with MCI (13 single‐domain amnestic‐MCI [a‐MCI], 6 multidomain a‐MCI, and 7 nonamnestic MCI) underwent PiB imaging. Twenty‐three had clinical follow‐up (21.2 ± 16.0 [standard deviation] months) subsequent to their PiB scan.
Results
Using cutoffs established from a control cohort, we found that 14 (54%) patients had increased levels of PiB retention and were considered “amyloid‐positive.” All subtypes were associated with a significant proportion of amyloid‐positive patients (6/13 single‐domain a‐MCI, 5/6 multidomain a‐MCI, 3/7 nonamnestic MCI). There were no obvious differences in the distribution of PiB retention in the nonamnestic MCI group. Predictors of conversion to clinical AD in a‐MCI, including poorer episodic memory, and medial temporal atrophy, were found in the amyloid‐positive relative to amyloid‐negative a‐MCI patients. Longitudinal follow‐up demonstrated 5 of 13 amyloid‐positive patients, but 0 of 10 amyloid‐negative patients, converted to clinical AD. Further, 3 of 10 amyloid‐negative patients “reverted to normal.”
Interpretation
These data support the notion that amyloid‐positive patients are likely to have early AD, and that the use of amyloid imaging may have an important role in determining which patients are likely to benefit from disease‐specific therapies. In addition, our data are consistent with longitudinal studies that suggest a significant percentage of all MCI subtypes will develop AD. Ann Neurol 2009;65:557–568 |
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| Bibliography: | istex:11E2050AE940DA2DA72D7BDCB849D9C4D6F88970 US Department of Energy - No. DE-FD02-03 ER63590 Alzheimer's Association - No. TLL-01-3381 National Institute of Mental Health - No. R01 MH070729 National Institute of Aging - No. K02 AG001039; No. K02 AG027998; No. K23 AG028018; No. R01 AG018402; No. R01 AG020098; No. R01 AG020226; No. R37 AG025516; No. P01 AG025204; No. P50 AG005133 ark:/67375/WNG-LPKWN2W6-8 Potential conflict of interest: GE Healthcare holds a license agreement with the University of Pittsburgh based on the technology described in this manuscript. Drs. Klunk and Mathis are co-inventors of PiB and, as such, have a financial interest in this license agreement. GE Healthcare provided no grant support for this study and had no role in the design or interpretation of results or preparation of this manuscript. All other authors have no conflicts of interest with this work and had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Dana Foundation ArticleID:ANA21598 Potential conflict of interest: GE Healthcare holds a license agreement with the University of Pittsburgh based on the technology described in this manuscript. Drs. Klunk and Mathis are co‐inventors of PiB and, as such, have a financial interest in this license agreement. GE Healthcare provided no grant support for this study and had no role in the design or interpretation of results or preparation of this manuscript. All other authors have no conflicts of interest with this work and had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| ISSN: | 0364-5134 1531-8249 1531-8249 |
| DOI: | 10.1002/ana.21598 |