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Author(s):  
Funmi Deinde ◽  
Jay Kotecha ◽  
Lilian Suh Lih Lau ◽  
Sagnik Bhattacharyya ◽  
Latha Velayudhan

<b><i>Background:</i></b> Individuals with Down syndrome (DS) are at high risk of dementia which is difficult to diagnose in DS. Neuroimaging has been identified as a potential tool to aid diagnosis by detecting changes in brain function. We carried out a review comparing functional neuroimaging in DS individuals with and without dementia. <b><i>Summary:</i></b> A literature search was conducted using PubMed to identify relevant studies. In DS subjects with dementia, fluorodeoxyglucose-positron emission tomography (PET) studies showed glucose hypometabolism particularly in the parietal and/or temporal regions whilst magnetic resonance spectroscopy studies showed increased myoinositol and decreased N-acetylaspartate. Ligand-based PET studies revealed significant Pittsburgh compound B binding in DS subjects over the age of 40, particularly if they had dementia. <b><i>Key Messages:</i></b> Neuroimaging may aid the early detection of dementia in DS; however, further longitudinal studies are required.


2021 ◽  
pp. jnumed.121.263281
Author(s):  
Burcu Zeydan ◽  
Christopher G Schwarz ◽  
Scott A Przybelski ◽  
Timothy G Lesnick ◽  
Walter K Kremers ◽  
...  

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 208-209
Author(s):  
Ryan Dougherty ◽  
Amal Wanigatunga ◽  
Murat Bilgel ◽  
Yang An ◽  
Eleanor Simonsick ◽  
...  

Abstract Higher level of and greater longitudinal increase in perceived fatigability are linked to cognitive decline and lower brain volumes in older adults. However, it remains unclear whether perceived fatigability is associated with Alzheimer’s disease-related brain pathology. In the BLSA, 163 participants without neurological disease or cognitive impairment (aged 74.7+/-8.4 years, 45% men) were assessed for perceived fatigability using rating of perceived exertion after a 5-minute (0.67 m/s) treadmill walk and Aß burden using 11C-Pittsburgh compound B (PiB) positron emission tomography. Forty-four participants were PiB+ based on a mean cortical distribution volume ratio (DVR) cut point of 1.066. After adjusting for demographics, body composition, comorbidities and ApoE-e4, higher perceived fatigability was not associated with PiB+ status (OR=0.84; 95% CI: 0.69, 1.05). Results suggest perceived fatigability may contribute to cognitive decline through pathways other than Aß pathology. Future studies should target other mechanisms linking perceived fatigability and cognitive decline.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 371-371
Author(s):  
Fangyu Li ◽  
Amal Wanigatunga ◽  
Qu Tian ◽  
Eleanor Simonsick ◽  
Murat Bilgel ◽  
...  

Abstract Higher energetic costs for mobility are associated with slow and declining gait speed. Slow gait is linked to cognitive decline and Alzheimer’s disease (AD), but the physiological underpinnings are note well-understood. We investigated the cross-sectional association between the energetic cost of walking and amyloid status (+/-) in 174 cognitively unimpaired men and women (52%) aged 78.5±8.6 years. The energetic cost of walking was assessed as the average oxygen consumption (VO2) during 2.5 minutes of customary-paced overground walking. Amyloid status was determined from 11C-Pittsburgh compound B (PiB) positron emission tomography (PET) imaging. Average energetic cost of walking was .169±.0379 ml/kg/m and 30% of the sample was PiB+. In logistic regression adjusted for demographics, APOE-e4, body composition and comorbidities, each 0.01ml/kg/m higher energy cost was associated with 12% increased odds of being PiB+ (OR=1.12; 95% CI:1.01-1.24). Inefficient walking may be a clinically meaningful physiological indicator of emerging AD-related pathology.


2021 ◽  
Vol 13 ◽  
Author(s):  
Yan Chang ◽  
Jiajin Liu ◽  
Liang Wang ◽  
Xin Li ◽  
Zhenjun Wang ◽  
...  

Objective: We aimed to compare amyloid deposition at the lobar cerebral microbleed (CMB) sites of cerebral amyloid angiopathy (CAA), Alzheimer’s disease (AD), and cognitively normal healthy controls (NC) and to propose a novel diagnostic method for differentiating CAA patients from AD patients with integrated 11C-Pittsburgh compound B (PIB) positron emission tomography (PET)/magnetic resonance (MR) and assess its diagnostic value.Methods: Nine CAA, 15 AD patients, and 15 NC subjects were enrolled in this study. Each subject underwent an 11C-PIB brain PET/MR examination. Susceptibility weighted imaging was assessed to detect CMB locations, and standardized uptake value ratios (SUVRs) were measured at these sites. Cortical PIB distributions were quantitatively evaluated. Patients with CAA, AD, and NC subjects were compared with global and regional cortical SUVRs at CMB cites. The diagnostic accuracy of MRI, PIB-PET, and PET/MR in differentiating CAA and AD was evaluated.Results: Lobar CMBs were detected in all the CAA patients, eight of the 15 AD patients (53.3%), and four of the 15 NC subjects (26.7%), respectively. The PIB deposition at CMB sites was significantly higher in CAA patients compared with AD patients and NC subjects in terms of SUVR (1.72 ± 0.10 vs. 1.42 ± 0.16 and 1.17 ± 0.08; p &lt; 0.0001). The PIB deposition was associated with CMB locations and was greatest in the occipital and temporal regions of CAA patients. The global cortical PIB deposition was significantly higher in CAA than in NC subjects (1.66 ± 0.06 vs. 1.21 ± 0.06; p &lt; 0.0001) and significantly lower than in AD patients (1.66 ± 0.06 vs. 1.86 ± 0.17; p &lt; 0.0001). In contrast, the occipital/global PIB uptake ratio was significantly increased in CAA (occipital/global ratio, 1.05 ± 0.02) relative to AD patients (1.05 ± 0.02 vs. 0.99 ± 0.04; p &lt; 0.001). PET/MR had a higher accuracy (sensitivity, 88.9%; specificity, 93.3%) than separate PET and MR.Conclusion: Our results indicate that the CMBs occur preferentially at loci with concentrated amyloid. By combining lobar CMBs with regional cortical amyloid deposition, the proposed workflow can further improve CAA diagnostic accuracy compared to each method alone. These findings improve our knowledge regarding the pathogenesis of CMBs and highlight the potential utility of PIB-PET/MR as a non-invasive tool for distinguishing CAA and AD patients.


2021 ◽  
Author(s):  
Jee Wook Kim ◽  
Min Soo Byun ◽  
Jun Ho Lee ◽  
Dahyun Yi ◽  
Min Jung Kim ◽  
...  

Abstract Background: Partner bereavement is one of life’s greatest stresses and has been suggested to trigger or accelerate cognitive decline and dementia. However, little information is available about potential brain pathologies underlying the association between partner bereavement and cognitive decline. Aims: We aimed to test the hypothesis that lifetime partner bereavement is associated with in vivo human brain pathologies underlying cognitive decline. Method: A total of 319 ever-married older adults between 61 and 90 years of age underwent comprehensive clinical assessments and multimodal brain imaging including [11C] Pittsburgh compound B-positron emission tomography (PET), AV-1451 PET, [18F] fluorodeoxyglucose (FDG)-PET, and magnetic resonance imaging. Results: Participants were classified as experiencing no partner bereavement or partner bereavement, and comparisons using propensity score matching (59 cases and 59 controls) were performed. Partner bereavement was significantly associated with higher cerebral white matter hyperintensities (WMH) volume compared to no partner bereavement. Interactions and subsequent subgroup analyses showed that partner bereavement was significantly associated with higher WMH in the older (>75 years) subgroup and among those with no- or low-skill occupations. In addition, partner bereavement at 60 years or over affect WMH volume compared to no partner bereavement, whereas partner bereavement at 60 years did not. No group differences were observed in other brain pathologies between partner bereavement categories. Conclusions: The findings suggest that the partner bereavement may contribute to dementia or cognitive decline by increasing cerebrovascular injury, particularly in older individuals and those with no- or low-skill occupations.


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Xuezhu Wang ◽  
Yining Wang ◽  
Jian Li ◽  
Li Huo ◽  
Shuyang Zhang

Stroke ◽  
2021 ◽  
Author(s):  
Hsin-Hsi Tsai ◽  
Marco Pasi ◽  
Li-Kai Tsai ◽  
Chi-Ching Huang ◽  
Ya-Fang Chen ◽  
...  

Background and Purpose: We explored whether high-degree magnetic resonance imaging–visible perivascular spaces in centrum semiovale (CSO) are more prevalent in cerebral amyloid angiopathy (CAA) than hypertensive small vessel disease and their relationship to brain amyloid retention in patients with primary intracerebral hemorrhage (ICH). Methods: One hundred and eight spontaneous ICH patients who underwent magnetic resonance imaging and Pittsburgh compound B were enrolled. Topography and severity of enlarged perivascular spaces were compared between CAA-related ICH (CAA-ICH) and hypertensive small vessel disease–related ICH (non-CAA ICH). Clinical and image characteristics associated with high-degree perivascular spaces were evaluated in univariate and multivariable analyses. Univariate and multivariable models were performed to evaluate associations between the severity of perivascular spaces in CSO and amyloid retention in CAA-ICH and non–CAA-ICH cases. Results: Patients with CAA-ICH (n=29) and non–CAA-ICH (n=79) had similar prevalence of high-degree perivascular spaces in CSO (44.8% versus 36.7%; P =0.507) and in basal ganglia (34.5% versus 51.9%; P =0.131). High-degree perivascular spaces in CSO were independently associated with the presence of lobar microbleed (odds ratio, 3.0 [95% CI, 1.1–8.0]; P =0.032). The amyloid retention was higher in those with high-degree than those with low-degree CSO-perivascular spaces in CAA-ICH (global Pittsburgh compound B standardized uptake value ratio, 1.55 [1.33–1.61] versus 1.13 [1.01–1.48]; P =0.003) but not in non–CAA-ICH. In CAA-ICH, the association between cerebral amyloid retention and the degree of perivascular spaces in CSO remained significant after adjustment for age and lobar microbleed number ( P =0.004). Conclusions: Although high-degree magnetic resonance imaging–visible perivascular spaces are equally prevalent between CAA-ICH and non–CAA-ICH in the Asian cohort, the severity of magnetic resonance imaging–visible CSO-perivascular spaces may be an indicator of higher brain amyloid deposition in patients with CAA-ICH.


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