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Amyloid and tau PET imaging studies as a clinical prognostic marker in Alzheimer’s disease
Author(s) -
Kim HanKyeol,
Baek Min Seok,
Lee Jae Hoon,
Chun JoongHyun,
Ryu Young Hoon,
Cho Hanna,
Lyoo Chul Hyoung
Publication year - 2021
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.052464
Subject(s) - clinical dementia rating , medicine , dementia , atrophy , standardized uptake value , biomarker , cognitive impairment , nuclear medicine , oncology , disease , positron emission tomography , biochemistry , chemistry
Background To investigate prognostic value of amyloid (A) and tau (T) imaging biomarkers in a long term follow up cohort study. Method We included 273 AD spectrum participants [96 cognitive unimpaired (CU), 106 mild cognitive impairment (MCI) and 71 AD dementia (DEM)] who completed 18 F‐florbetaben, 18 F‐flortaucipir PET and T1‐weighted MRI. Global cortical standardized uptake value ratios (SUVR) of 18 F‐florbetaben, temporal meta‐region‐of‐interest SUVR of 18 F‐flortaucipir and hippocampal atrophy of T1‐weighted MRI were used to define AT(N) classification. Longitudinal cognitive change was evaluated by repeated Mini‐Mental State Examination (MMSE) and Clinical Dementia Rating Sum of Boxes (CDR‐SB). Participants were categorized according to their A/T imaging biomarker, 18 F‐florbetaben PET positive/negative (A+/A‐) and 18 F‐flortaucipir PET positive/negative (T+/T‐) profiles. For measuring prognosis, we investigated the nursing care facility admission rate for all participants and the AD conversion rate for CU and MCI over 60 months. Result Participants were included CU (77/96 A‐T‐, 1/96 A‐T+, 11/96 A+T‐ and 7/96 A+T+), MCI (59/106 A‐T‐, 2/106 A‐T+, 18/106 A+T‐ and 27/106 A+T+) and DEM (20/71 A‐T‐, 1/71 A‐T+, 16/71 A+T‐ and 34/71 A+T+). Annual cognitive function change of all participants was correlated with A+ (MMSE: B=‐0.5944, p <0.000; CDR‐SB: B=0.6288, p <0.000), T+ (MMSE: ‐0.8187, p <0.000; CDR‐SB: B=0.7524, p <0.000), hippocampal atrophy (MMSE: B=‐0.3940, p <0.000; CDR‐SB: B=0.5577, p <0.000) and A+T+ compared with A‐T‐ (MMSE: B=‐0.8917, p <0.000; CDR‐SB: 0.8680, p <0.000, Figure 1). Admission rate of nursing care facility of all participants was higher with A+ (HR=2.37, p =0.026), T+ (HR=2.65, p =0.006) and A+T+ (HR=3.06, p=0.006). AD conversion rate in CU and MCI (n=202) was higher with A+ (HR=2.98, p=0.003), T+ (HR=3.19, p<0.000) and A+T+ (HR=3.897, p <0.000, Figure 2). Conclusion A/T imaging biomarkers have prognostic value for annual cognitive decline rate, anticipating admission rates to nursing care facility, and AD conversion rate.