Topographic Distribution of Amyloid-β, Tau, and Atrophy in Patients With Behavioral/Dysexecutive Alzheimer Disease.

Abstract:

OBJECTIVE:To determine the associations between amyloid-PET, tau-PET, and atrophy with the behavioral/dysexecutive presentation of Alzheimer disease (AD), how these differ from amnestic AD, and how they correlate to clinical symptoms. METHODS:We assessed 15 patients with behavioral/dysexecutive AD recruited from a tertiary care memory clinic, all of whom had biologically defined AD. They were compared with 25 patients with disease severity- and age-matched amnestic AD and a group of 131 cognitively unimpaired (CU) elderly individuals. All participants were evaluated with amyloid-PET with [18F]AZD4694, tau-PET with [18F]MK6240, MRI, and neuropsychological testing. RESULTS:Voxelwise contrasts identified patterns of frontal cortical tau aggregation in behavioral/dysexecutive AD, with peaks in medial prefrontal, anterior cingulate, and frontal insular cortices in contrast to amnestic AD. No differences were observed in the distribution of amyloid-PET or atrophy as determined by voxel-based morphometry. Voxelwise area under the receiver operating characteristic curve analyses revealed that tau-PET uptake in the medial prefrontal, anterior cingulate, and frontal insular cortices were best able to differentiate between behavioral/dysexecutive and amnestic AD (area under the curve 0.87). Voxelwise regressions demonstrated relationships between frontal cortical tau load and degree of executive dysfunction. CONCLUSIONS:Our results provide evidence of frontal cortical involvement of tau pathology in behavioral/dysexecutive AD and highlight the need for consensus clinical criteria in this syndrome.

journal_name

Neurology

journal_title

Neurology

authors

Therriault J,Pascoal TA,Savard M,Benedet AL,Chamoun M,Tissot C,Lussier F,Kang MS,Thomas E,Terada T,Rej S,Massarweh G,Nasreddine Z,Vitali P,Soucy JP,Saha-Chaudhuri P,Gauthier S,Rosa-Neto P

doi

10.1212/WNL.0000000000011081

subject

Has Abstract

pub_date

2021-01-05 00:00:00

pages

e81-e92

issue

1

eissn

0028-3878

issn

1526-632X

pii

WNL.0000000000011081

journal_volume

96

pub_type

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