Accelerating rates of cognitive decline and imaging markers associated with β-amyloid pathology

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift

Standard

Accelerating rates of cognitive decline and imaging markers associated with β-amyloid pathology. / Insel, Philip S.; Mattsson, Niklas; Mackin, R. Scott; Schöll, Michael; Nosheny, Rachel L.; Tosun, Duygu; Donohue, Michael C.; Aisen, Paul S.; Jagust, William J.; Weiner, Michael W.

I: Neurology, Vol. 86, Nr. 20, 17.05.2016, s. 1887-1896.

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift

Harvard

Insel, PS, Mattsson, N, Mackin, RS, Schöll, M, Nosheny, RL, Tosun, D, Donohue, MC, Aisen, PS, Jagust, WJ & Weiner, MW 2016, 'Accelerating rates of cognitive decline and imaging markers associated with β-amyloid pathology', Neurology, vol. 86, nr. 20, s. 1887-1896. https://doi.org/10.1212/WNL.0000000000002683

APA

CBE

MLA

Vancouver

Author

Insel, Philip S. ; Mattsson, Niklas ; Mackin, R. Scott ; Schöll, Michael ; Nosheny, Rachel L. ; Tosun, Duygu ; Donohue, Michael C. ; Aisen, Paul S. ; Jagust, William J. ; Weiner, Michael W. / Accelerating rates of cognitive decline and imaging markers associated with β-amyloid pathology. I: Neurology. 2016 ; Vol. 86, Nr. 20. s. 1887-1896.

RIS

TY - JOUR

T1 - Accelerating rates of cognitive decline and imaging markers associated with β-amyloid pathology

AU - Insel, Philip S.

AU - Mattsson, Niklas

AU - Mackin, R. Scott

AU - Schöll, Michael

AU - Nosheny, Rachel L.

AU - Tosun, Duygu

AU - Donohue, Michael C.

AU - Aisen, Paul S.

AU - Jagust, William J.

AU - Weiner, Michael W.

PY - 2016/5/17

Y1 - 2016/5/17

N2 - Objective: To estimate points along the spectrum of β-amyloid pathology at which rates of change of several measures of neuronal injury and cognitive decline begin to accelerate. Methods: In 460 patients with mild cognitive impairment (MCI), we estimated the points at which rates of florbetapir PET, fluorodeoxyglucose (FDG) PET, MRI, and cognitive and functional decline begin to accelerate with respect to baseline CSF Aβ 42. Points of initial acceleration in rates of decline were estimated using mixed-effects regression. Results: Rates of neuronal injury and cognitive and even functional decline accelerate substantially before the conventional threshold for amyloid positivity, with rates of florbetapir PET and FDG PET accelerating early. Temporal lobe atrophy rates also accelerate prior to the threshold, but not before the acceleration of cognitive and functional decline. Conclusions: A considerable proportion of patients with MCI would not meet inclusion criteria for a trial using the current threshold for amyloid positivity, even though on average, they are experiencing cognitive/functional decline associated with prethreshold levels of CSF Aβ 42. Future trials in early Alzheimer disease might consider revising the criteria regarding β-amyloid thresholds to include the range of amyloid associated with the first signs of accelerating rates of decline.

AB - Objective: To estimate points along the spectrum of β-amyloid pathology at which rates of change of several measures of neuronal injury and cognitive decline begin to accelerate. Methods: In 460 patients with mild cognitive impairment (MCI), we estimated the points at which rates of florbetapir PET, fluorodeoxyglucose (FDG) PET, MRI, and cognitive and functional decline begin to accelerate with respect to baseline CSF Aβ 42. Points of initial acceleration in rates of decline were estimated using mixed-effects regression. Results: Rates of neuronal injury and cognitive and even functional decline accelerate substantially before the conventional threshold for amyloid positivity, with rates of florbetapir PET and FDG PET accelerating early. Temporal lobe atrophy rates also accelerate prior to the threshold, but not before the acceleration of cognitive and functional decline. Conclusions: A considerable proportion of patients with MCI would not meet inclusion criteria for a trial using the current threshold for amyloid positivity, even though on average, they are experiencing cognitive/functional decline associated with prethreshold levels of CSF Aβ 42. Future trials in early Alzheimer disease might consider revising the criteria regarding β-amyloid thresholds to include the range of amyloid associated with the first signs of accelerating rates of decline.

UR - http://www.scopus.com/inward/record.url?scp=84969242548&partnerID=8YFLogxK

U2 - 10.1212/WNL.0000000000002683

DO - 10.1212/WNL.0000000000002683

M3 - Article

VL - 86

SP - 1887

EP - 1896

JO - Neurology

T2 - Neurology

JF - Neurology

SN - 1526-632X

IS - 20

ER -