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Florbetapir F 18 amyloid PET and 36-month cognitive decline: a prospective multicenter study.

Doraiswamy PM, Sperling RA, Johnson K, Reiman EM, Wong TZ, Sabbagh MN, Sadowsky CH, Fleisher AS, Carpenter A, Joshi AD, Lu M, Grundman M, Mintun MA, Skovronsky DM, Pontecorvo MJ, AV45-A11 Study GroupAV45-A11 Study Gro - Mol. Psychiatry (2014)

Bottom Line: Aβ+ MCI subjects demonstrated greater worsening compared with Aβ- subjects on the ADAS-Cog over 36 months (5.66 ± 1.47 vs -0.71 ± 1.09, P = 0.0014) as well as on the mini-mental state exam (MMSE), digit symbol substitution (DSS) test, and a verbal fluency test (P < 0.05).Aβ+ subjects did not show significantly greater declines on the ADCS-ADL or Wechsler Memory Scale.Overall, these findings suggest that in CN, MCI and AD subjects, florbetapir PET Aβ+ subjects show greater cognitive and global deterioration over a 3-year follow-up than Aβ- subjects do.

View Article: PubMed Central - PubMed

Affiliation: Duke University Medical Center, Durham, NC, USA.

ABSTRACT
This study was designed to evaluate whether subjects with amyloid beta (Aβ) pathology, detected using florbetapir positron emission tomorgraphy (PET), demonstrated greater cognitive decline than subjects without Aβ pathology. Sixty-nine cognitively normal (CN) controls, 52 with recently diagnosed mild cognitive impairment (MCI) and 31 with probable Alzheimer's disease (AD) dementia were included in the study. PET images obtained in these subjects were visually rated as positive (Aβ+) or negative (Aβ-), blind to diagnosis. Fourteen percent (10/69) of CN, 37% (19/52) of MCI and 68% (21/31) of AD were Aβ+. The primary outcome was change in ADAS-Cog score in MCI subjects after 36 months; however, additional outcomes included change on measures of cognition, function and diagnostic status. Aβ+ MCI subjects demonstrated greater worsening compared with Aβ- subjects on the ADAS-Cog over 36 months (5.66 ± 1.47 vs -0.71 ± 1.09, P = 0.0014) as well as on the mini-mental state exam (MMSE), digit symbol substitution (DSS) test, and a verbal fluency test (P < 0.05). Similar to MCI subjects, Aβ+ CN subjects showed greater decline on the ADAS-Cog, digit-symbol-substitution test and verbal fluency (P<0.05), whereas Aβ+ AD patients showed greater declines in verbal fluency and the MMSE (P < 0.05). Aβ+ subjects in all diagnostic groups also showed greater decline on the CDR-SB (P<0.04), a global clinical assessment. Aβ+ subjects did not show significantly greater declines on the ADCS-ADL or Wechsler Memory Scale. Overall, these findings suggest that in CN, MCI and AD subjects, florbetapir PET Aβ+ subjects show greater cognitive and global deterioration over a 3-year follow-up than Aβ- subjects do.

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Related in: MedlinePlus

Example images of Aβ− and Aβ+ subjects clinically classified as CN, MCI and AD. Normalized SUVR images (color) and gray scale images (used for visual interpretation of Aβ− vs Aβ+ status) from representative subjects. Note the absence of gray matter uptake and the difference in average cortical SUVR in the Aβ− vs Aβ+ classified scans. The color images are shown for illustrative purposes.
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fig1: Example images of Aβ− and Aβ+ subjects clinically classified as CN, MCI and AD. Normalized SUVR images (color) and gray scale images (used for visual interpretation of Aβ− vs Aβ+ status) from representative subjects. Note the absence of gray matter uptake and the difference in average cortical SUVR in the Aβ− vs Aβ+ classified scans. The color images are shown for illustrative purposes.

Mentions: Figure 1 depicts illustrative amyloid positive (Aβ+) and negative (Aβ−) PET scans. As reported previously25, 37% (19/52) of MCI, 14% (10/69) of CN and 68% (21/31) of AD dementia subjects were rated as PET Aβ+ (P<0.0001) at study entry.


Florbetapir F 18 amyloid PET and 36-month cognitive decline: a prospective multicenter study.

Doraiswamy PM, Sperling RA, Johnson K, Reiman EM, Wong TZ, Sabbagh MN, Sadowsky CH, Fleisher AS, Carpenter A, Joshi AD, Lu M, Grundman M, Mintun MA, Skovronsky DM, Pontecorvo MJ, AV45-A11 Study GroupAV45-A11 Study Gro - Mol. Psychiatry (2014)

Example images of Aβ− and Aβ+ subjects clinically classified as CN, MCI and AD. Normalized SUVR images (color) and gray scale images (used for visual interpretation of Aβ− vs Aβ+ status) from representative subjects. Note the absence of gray matter uptake and the difference in average cortical SUVR in the Aβ− vs Aβ+ classified scans. The color images are shown for illustrative purposes.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4195975&req=5

fig1: Example images of Aβ− and Aβ+ subjects clinically classified as CN, MCI and AD. Normalized SUVR images (color) and gray scale images (used for visual interpretation of Aβ− vs Aβ+ status) from representative subjects. Note the absence of gray matter uptake and the difference in average cortical SUVR in the Aβ− vs Aβ+ classified scans. The color images are shown for illustrative purposes.
Mentions: Figure 1 depicts illustrative amyloid positive (Aβ+) and negative (Aβ−) PET scans. As reported previously25, 37% (19/52) of MCI, 14% (10/69) of CN and 68% (21/31) of AD dementia subjects were rated as PET Aβ+ (P<0.0001) at study entry.

Bottom Line: Aβ+ MCI subjects demonstrated greater worsening compared with Aβ- subjects on the ADAS-Cog over 36 months (5.66 ± 1.47 vs -0.71 ± 1.09, P = 0.0014) as well as on the mini-mental state exam (MMSE), digit symbol substitution (DSS) test, and a verbal fluency test (P < 0.05).Aβ+ subjects did not show significantly greater declines on the ADCS-ADL or Wechsler Memory Scale.Overall, these findings suggest that in CN, MCI and AD subjects, florbetapir PET Aβ+ subjects show greater cognitive and global deterioration over a 3-year follow-up than Aβ- subjects do.

View Article: PubMed Central - PubMed

Affiliation: Duke University Medical Center, Durham, NC, USA.

ABSTRACT
This study was designed to evaluate whether subjects with amyloid beta (Aβ) pathology, detected using florbetapir positron emission tomorgraphy (PET), demonstrated greater cognitive decline than subjects without Aβ pathology. Sixty-nine cognitively normal (CN) controls, 52 with recently diagnosed mild cognitive impairment (MCI) and 31 with probable Alzheimer's disease (AD) dementia were included in the study. PET images obtained in these subjects were visually rated as positive (Aβ+) or negative (Aβ-), blind to diagnosis. Fourteen percent (10/69) of CN, 37% (19/52) of MCI and 68% (21/31) of AD were Aβ+. The primary outcome was change in ADAS-Cog score in MCI subjects after 36 months; however, additional outcomes included change on measures of cognition, function and diagnostic status. Aβ+ MCI subjects demonstrated greater worsening compared with Aβ- subjects on the ADAS-Cog over 36 months (5.66 ± 1.47 vs -0.71 ± 1.09, P = 0.0014) as well as on the mini-mental state exam (MMSE), digit symbol substitution (DSS) test, and a verbal fluency test (P < 0.05). Similar to MCI subjects, Aβ+ CN subjects showed greater decline on the ADAS-Cog, digit-symbol-substitution test and verbal fluency (P<0.05), whereas Aβ+ AD patients showed greater declines in verbal fluency and the MMSE (P < 0.05). Aβ+ subjects in all diagnostic groups also showed greater decline on the CDR-SB (P<0.04), a global clinical assessment. Aβ+ subjects did not show significantly greater declines on the ADCS-ADL or Wechsler Memory Scale. Overall, these findings suggest that in CN, MCI and AD subjects, florbetapir PET Aβ+ subjects show greater cognitive and global deterioration over a 3-year follow-up than Aβ- subjects do.

Show MeSH
Related in: MedlinePlus