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P1‐182: Pattern of aberrant brain activity in patients with mild cognitive impairment and lacunar infarction: A resting‐state functional MRI study
Author(s) -
Nedelska Zuzana,
Ni Ling,
Liu Renyuan,
Yin Zhenyu,
Zhao Hui,
Hort Jakub,
Zhou Fei,
Wu Wenbo,
Zhang Xin,
Li Ming,
Yu Haiping,
Zhu Bin,
Xu Yun,
Zhang Bing
Publication year - 2015
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 - 10.1016/j.jalz.2015.06.381
Subject(s) - cardiology , medicine , resting state fmri , posterior cingulate , dementia , precuneus , magnetic resonance imaging , audiology , montreal cognitive assessment , functional magnetic resonance imaging , neuroimaging , psychology , psychiatry , radiology , disease
Background:Recently proposed diagnostic frameworks for Alzheimer’s disease (AD) include cognitively normal individuals with biomarker evidence of AD pathophysiology, e.g. asymptomatic at risk for AD (International Working Group-2 [IWG2]) or preclinical AD (National Institute of AgingAlzheimer Association [NIA-AA]). We implemented these criteria in an observational cohort of cognitively normal elders (the Alzheimer’s Disease Neuroimaging Initiative, ADNI), compared the classifications at an individual subject level, and assessed outcome by diagnostic group. Methods: Baseline clinical and biomarker data were used to classify 522 cognitively normal subjects from ADNI-1 and 2. Asymptomatic-atrisk subjects (IWG2) had biomarker evidence of AD pathology (either abnormal AV45 PET, or abnormal CSF Ab42 and t-tau or p-tau). Subjects with preclinical AD (NIA-AA) had biomarker evidence of amyloid deposition (abnormal CSF Ab42 or AV45 PET) and were subclassified as Stage 1 if there was no biomarker evidence of neuronal injury (NI; abnormal ttau, flurodeoxyglucose PET, or hippocampal volume), Stage 2 if any NI biomarker was abnormal, and stage 3 if, in addition, there was impaired performance (-1.5 sd) on composite measures of memory or executive function. Subjects without evidence of amyloid deposition were classified suspected nonAD pathology (SNAP) if any NI biomarker was abnormal. Subjects who did not have a biomarker assessment of amyloid were considered inconclusive for AD. Clinical outcome was KaplanMeier (K-M) estimate of progression to cognitive impairment by the 24 month visit. Results:Of 379 subjects having amyloid biomarker assessments, 129 (34%) met IWG2 criteria for asymptomatic-at-risk (Table), and 24.8% progressed (vs 5.8% not-at-risk, p1⁄40.007, Figure 1). Among 161 (42.5%) meeting NIA-AA criteria for preclinical AD, 100, 45, and 16 subjects were stage 1, 2, or 3, respectively; 54 (14.2%) subjects had SNAP. Progression rates were 9.6, 23.2, and 67.4% for Stage 1, 2, and 3, respectively (vs 7.5% for SNAP and 5.4% for biomarker-negative, p < 0.0005, Figure 2). Subjects meeting NIA-AA but not IWG2 criteria had abnormal CSF Ab42 but normal t-tau and p-tau. Conclusions: Both IWG2 and NIA criteria identify cognitively normal elders with increased risk of clinical progression; incorporation of NI biomarkers and additional cognitive measures into the framework increased prognostic accuracy. P1-182 PATTERN OFABERRANT BRAIN ACTIVITY IN PATIENTSWITHMILDCOGNITIVE IMPAIRMENT AND LACUNAR INFARCTION: A RESTING-STATE FUNCTIONAL MRI STUDY Zuzana Nedelska, Ling Ni, Renyuan Liu, Zhenyu Yin, Hui Zhao, Jakub Hort, Fei Zhou, Wenbo Wu, Xin Zhang, Ming Li, Haiping Yu, Bin Zhu, Yun Xu, Bing Zhang, Charles University in Prague, Prague, Czech Republic; International Clinical Research Center, St. Anne’s Uni Hospital, Brno, Czech Republic; The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China; The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China. Contact e-mail: nedelskaz@gmail.com