Abstract:
BACKGROUND:In patients with amyloid-positive mild cognitive impairment (MCI), neurodegenerative biomarkers such as medial temporal lobe atrophy (MTA) are useful to predict disease progression to dementia. Although posterior atrophy (PA) is a well-known neurodegenerative biomarker of Alzheimer's disease, little is known about PA as a predictor in patients with amyloid-positive MCI. METHODS:We included 258 patients with amyloid-positive MCI with at least one follow-up visit, and who had low cerebrospinal fluid (CSF) β-amyloid1-42 concentration. Data were obtained from the Alzheimer's Disease Neuroimaging Initiative study. We assessed PA and MTA on magnetic resonance imaging (MRI) using visual rating scales and retrospectively determined progression to dementia during the follow-up period of up to 3 years (median 24 months). The Cox proportional hazards model was used to analyze hazard ratios (HRs) of PA and MTA for disease progression. Additionally, subjects were divided into four groups according to brain atrophy pattern (no atrophy, MTA only, PA only, both MTA and PA), and HRs for disease progression were compared with the no atrophy reference group. Analyses were conducted with and without adjustment for CSF phosphorylated tau181p (p-tau) and baseline demographics. RESULTS:A total of 123 patients (47.7%) showed MTA and 174 patients (67.4%) showed PA. Of the total cohort, 139 cases (53.9%) progressed to dementia. PA and MTA were associated with an increased risk for progression to dementia (HR 2.244, 95% confidence interval (CI) 1.497-3.364, and HR 1.682, 95% CI 1.203-2.352, respectively). In the analysis according to atrophy pattern, HR (95% CI) for progression was 2.998 (1.443-6.227) in the MTA only group, 3.126 (1.666-5.864) in the PA only group, and 3.814 (2.045-7.110) in both MTA and PA group. These results remained significant after adjustment. CONCLUSIONS:In patients with amyloid-positive MCI, PA could predict progression to dementia independently of MTA.
journal_name
Alzheimers Res Therjournal_title
Alzheimer's research & therapyauthors
Pyun JM,Park YH,Kim HR,Suh J,Kang MJ,Kim BJ,Youn YC,Jang JW,Kim S,Alzheimer’s Disease Neuroimaging Initiative.doi
10.1186/s13195-017-0326-ysubject
Has Abstractpub_date
2017-12-16 00:00:00pages
99issue
1issn
1758-9193pii
10.1186/s13195-017-0326-yjournal_volume
9pub_type
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journal_title:Alzheimer's research & therapy
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journal_title:Alzheimer's research & therapy
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pub_type: 杂志文章,评审
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journal_title:Alzheimer's research & therapy
pub_type: 杂志文章
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journal_title:Alzheimer's research & therapy
pub_type: 杂志文章
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journal_title:Alzheimer's research & therapy
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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journal_title:Alzheimer's research & therapy
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journal_title:Alzheimer's research & therapy
pub_type: 杂志文章,评审
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journal_title:Alzheimer's research & therapy
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