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Relationship between neuropsychiatric symptoms and Alzheimer's disease pathology: An in vivo positron emission tomography study
Author(s) -
Yasuno Fumihiko,
Minami Hiroyuki,
Hattori Hideyuki
Publication year - 2021
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.5459
Subject(s) - positron emission tomography , standardized uptake value , medicine , receiver operating characteristic , logistic regression , apathy , neurodegeneration , dementia , psychology , alzheimer's disease , pathology , neuroimaging , disease , oncology , nuclear medicine , psychiatry
Objectives To investigate the relationship between amyloid‐β‐ and tau‐based Alzheimer's disease (AD) pathologies assessed using positron emission tomography imaging and neuropsychiatric symptoms (NPS) in a sample of AD continuum including clinically normal subjects and patients with mild cognitive impairment or AD. Methods We analyzed datasets of the Alzheimer's disease Neuroimaging Initiative and included amyloid‐positive subjects who underwent an AV‐45 scan within 1 year of an AV‐1451 scan ( n = 99). Correlation between standardized uptake value ratio (SUVR) of AV‐45 and AV‐1451 and the Neuropsychiatric Inventory (NPI) score (and its four domain subscores for hyperactivity, psychosis, affective, and apathy) was evaluated. Stepwise logistic regression analysis was used to examine the influence of SUVRs on the presence of NPS. SUVRs were also tested for their ability to discriminate the group with NPS using receiver operating characteristic (ROC) curve analyses. Results Significant positive relationships were found between the total NPI score and affective symptoms and Braak 1&2 (transentorhinal region) AV‐1451 SUVR. Stepwise logistic regression analysis identified tau accumulation in the area of Braak 1&2 as a significant covariate discriminating the presence of affective symptoms. The area under the ROC curve analysis showed that subjects with affective symptoms were discriminated by AV‐1451 SUVR with an accuracy of 77.7%. Conclusions Tau aggregation in the transentorhinal region, where neurodegeneration affected by tau pathology was seen in the early stage of AD, correlated with more severe NPS, especially affective symptoms. Therefore, tau pathology in the transentorhinal cortex might be associated with affective symptoms in the early stage of AD.