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...

Full description

Saved in:
Bibliographic Details
Published in:Annals of neurology Vol. 65; no. 5; pp. 557 - 568
Main Authors: Wolk, David A., Price, Julie C., Saxton, Judy A., Snitz, Beth E., James, Jeffrey A., Lopez, Oscar L., Aizenstein, Howard J., Cohen, Ann D., Weissfeld, Lisa A., Mathis, Chester A., Klunk, William E., DeKosky, Steven T.
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
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
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
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