Cognitive changes of older adults with an equivocal amyloid load.


Journal

Journal of neurology
ISSN: 1432-1459
Titre abrégé: J Neurol
Pays: Germany
ID NLM: 0423161

Informations de publication

Date de publication:
Apr 2019
Historique:
received: 03 08 2018
accepted: 18 01 2019
revised: 05 12 2018
pubmed: 29 1 2019
medline: 30 6 2019
entrez: 29 1 2019
Statut: ppublish

Résumé

Observational and interventional studies addressing the link between amyloid (Aβ) burden and cognitive decline are increasing, but a clear definition of amyloid positivity is still lacking. This may represent a great stake for therapeutic studies enrolling Aβ + patients only. The main objective of this study was to define a population with "equivocal" amyloid status, and evaluate their cognitive changes. Sixty-five participants over 75 years old, from the Control group of the interventional MAPT study, at risk to develop Alzheimer's disease, were included. Participants were classified into three groups in terms of amyloid load: Aβ +, Aβ - and Equivocal participants (according to visual reading, global standardized uptake (SUVR) cut-offs, or a k-mean clustering method). The cognitive changes over time (memory, executive functions, attention and processing speed) of this Equivocal group were then compared to Aβ + and Aβ - participants. When classified by visual read, Equivocal participants' memory scores were comparable to the Aβ- participants, and greater than in Aβ + participants over time. Secondary analyses, using SUVR cut-offs classification, showed different trajectories with Equivocal participants being comparable to the Aβ + participants, and lower than Aβ-, on executive performance over time. This original work pointed out a population that may be of great interest for interventional studies, raising the question of how amyloid status should be defined and integrated in such studies. These findings should be replicated in future studies on larger datasets, to confirm what methodological approach would be the most suitable to highlight this specific neuroimaging entity.

Sections du résumé

BACKGROUND BACKGROUND
Observational and interventional studies addressing the link between amyloid (Aβ) burden and cognitive decline are increasing, but a clear definition of amyloid positivity is still lacking. This may represent a great stake for therapeutic studies enrolling Aβ + patients only. The main objective of this study was to define a population with "equivocal" amyloid status, and evaluate their cognitive changes.
METHODS METHODS
Sixty-five participants over 75 years old, from the Control group of the interventional MAPT study, at risk to develop Alzheimer's disease, were included. Participants were classified into three groups in terms of amyloid load: Aβ +, Aβ - and Equivocal participants (according to visual reading, global standardized uptake (SUVR) cut-offs, or a k-mean clustering method). The cognitive changes over time (memory, executive functions, attention and processing speed) of this Equivocal group were then compared to Aβ + and Aβ - participants.
RESULTS RESULTS
When classified by visual read, Equivocal participants' memory scores were comparable to the Aβ- participants, and greater than in Aβ + participants over time. Secondary analyses, using SUVR cut-offs classification, showed different trajectories with Equivocal participants being comparable to the Aβ + participants, and lower than Aβ-, on executive performance over time.
CONCLUSIONS CONCLUSIONS
This original work pointed out a population that may be of great interest for interventional studies, raising the question of how amyloid status should be defined and integrated in such studies. These findings should be replicated in future studies on larger datasets, to confirm what methodological approach would be the most suitable to highlight this specific neuroimaging entity.

Identifiants

pubmed: 30689016
doi: 10.1007/s00415-019-09203-5
pii: 10.1007/s00415-019-09203-5
doi:

Substances chimiques

Amyloid 0
Aniline Compounds 0
Ethylene Glycols 0
Radiopharmaceuticals 0
florbetapir 6867Q6IKOD

Types de publication

Journal Article Multicenter Study Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

835-843

Subventions

Organisme : French Ministry of Health
ID : PHRC 2008

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Auteurs

Kristell Pothier (K)

Gérontopôle de Toulouse, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), Toulouse, France. kristell.pothier@univ-tours.fr.
EA 2114, Département de Psychologie-Psychologie des Ages de la Vie et Adaptation, University of Tours, 3, Rue des Tanneurs, 37041, Tours Cedex 1, France. kristell.pothier@univ-tours.fr.

Laure Saint-Aubert (L)

Department of Nuclear Medicine, Imaging Pole, Toulouse University Hospital, Toulouse, France.
Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France.

Claudie Hooper (C)

Gérontopôle de Toulouse, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), Toulouse, France.

Julien Delrieu (J)

Gérontopôle de Toulouse, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), Toulouse, France.
Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France.

Pierre Payoux (P)

Department of Nuclear Medicine, Imaging Pole, Toulouse University Hospital, Toulouse, France.
Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France.

Philipe de Souto Barreto (P)

Gérontopôle de Toulouse, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), Toulouse, France.
UMR INSERM 1027, University of Toulouse III, Toulouse, France.

Bruno Vellas (B)

Gérontopôle de Toulouse, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), Toulouse, France.
UMR INSERM 1027, University of Toulouse III, Toulouse, France.

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Classifications MeSH