Cognitive trajectories of patients with focal ß-amyloid deposition

Si Eun Kim; Byungju Lee; Hyemin Jang; Juhee Chin; Ching Soong Khoo; Yeong Sim Choe; Ji Sun Kim; Sung Hoon Kang; Hang Rai Kim; Song Hwangbo; Jee Hyang Jeong; Soo Jin Yoon; Kyung Won Park; Eun Joo Kim; Bora Yoon; Jae Won Jang; Jin Yong Hong; Duk L. Na; Sang Won Seo; Seong Hye Choi; Hee Jin Kim

doi:10.1186/s13195-021-00787-7

Cognitive trajectories of patients with focal ß-amyloid deposition

Si Eun Kim, Byungju Lee, Hyemin Jang, Juhee Chin, Ching Soong Khoo, Yeong Sim Choe, Ji Sun Kim, Sung Hoon Kang, Hang Rai Kim, Song Hwangbo, Jee Hyang Jeong, Soo Jin Yoon, Kyung Won Park, Eun Joo Kim, Bora Yoon, Jae Won Jang, Jin Yong Hong, Duk L. Na, Sang Won Seo, Seong Hye ChoiHee Jin Kim

Department of Neurology

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

Background: The presence of ß-amyloid (Aß) in the brain can be identified using amyloid PET. In clinical practice, the amyloid PET is interpreted based on dichotomous visual rating, which renders focal Aß accumulation be read as positive for Aß. However, the prognosis of patients with focal Aß deposition is not well established. Thus, we investigated cognitive trajectories of patients with focal Aß deposition. Methods: We followed up 240 participants (112 cognitively unimpaired [CU], 78 amnestic mild cognitive impairment [aMCI], and 50 Alzheimer’s disease (AD) dementia [ADD]) for 2 years from 9 referral centers in South Korea. Participants were assessed with neuropsychological tests and ¹⁸F-flutemetamol (FMM) positron emission tomography (PET). Ten regions (frontal, precuneus/posterior cingulate (PPC), lateral temporal, parietal, and striatum of each hemisphere) were visually examined in the FMM scan, and participants were divided into three groups: No-FMM, Focal-FMM (FMM uptake in 1–9 regions), and Diffuse-FMM. We used mixed-effects model to investigate the speed of cognitive decline in the Focal-FMM group according to the cognitive level, extent, and location of Aß involvement, in comparison with the No- or Diffuse-FMM group. Results: Forty-five of 240 (18.8%) individuals were categorized as Focal-FMM. The rate of cognitive decline in the Focal-FMM group was faster than the No-FMM group (especially in the CU and aMCI stage) and slower than the Diffuse-FMM group (in particular in the CU stage). Within the Focal-FMM group, participants with FMM uptake to a larger extent (7–9 regions) showed faster cognitive decline compared to those with uptake to a smaller extent (1–3 or 4–6 regions). The Focal-FMM group was found to have faster cognitive decline in comparison with the No-FMM when there was uptake in the PPC, striatum, and frontal cortex. Conclusions: When predicting cognitive decline of patients with focal Aß deposition, the patients’ cognitive level, extent, and location of the focal involvement are important.

Original language	English
Article number	48
Journal	Alzheimer's Research and Therapy
Volume	13
Issue number	1
DOIs	https://doi.org/10.1186/s13195-021-00787-7
State	Published - Dec 2021

Bibliographical note

Publisher Copyright:
© 2021, The Author(s).

Keywords

Alzheimer’s disease
Cognitive decline
F-flutemetamol PET
Longitudinal studies
ß-Amyloid

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10.1186/s13195-021-00787-7

Cite this

Kim, S. E., Lee, B., Jang, H., Chin, J., Khoo, C. S., Choe, Y. S., Kim, J. S., Kang, S. H., Kim, H. R., Hwangbo, S., Jeong, J. H., Yoon, S. J., Park, K. W., Kim, E. J., Yoon, B., Jang, J. W., Hong, J. Y., Na, D. L., Seo, S. W., ... Kim, H. J. (2021). Cognitive trajectories of patients with focal ß-amyloid deposition. Alzheimer's Research and Therapy, 13(1), Article 48. https://doi.org/10.1186/s13195-021-00787-7

@article{bbcd68711dab4ffab127ce4a3ff241be,

title = "Cognitive trajectories of patients with focal {\ss}-amyloid deposition",

abstract = "Background: The presence of {\ss}-amyloid (A{\ss}) in the brain can be identified using amyloid PET. In clinical practice, the amyloid PET is interpreted based on dichotomous visual rating, which renders focal A{\ss} accumulation be read as positive for A{\ss}. However, the prognosis of patients with focal A{\ss} deposition is not well established. Thus, we investigated cognitive trajectories of patients with focal A{\ss} deposition. Methods: We followed up 240 participants (112 cognitively unimpaired [CU], 78 amnestic mild cognitive impairment [aMCI], and 50 Alzheimer{\textquoteright}s disease (AD) dementia [ADD]) for 2 years from 9 referral centers in South Korea. Participants were assessed with neuropsychological tests and 18F-flutemetamol (FMM) positron emission tomography (PET). Ten regions (frontal, precuneus/posterior cingulate (PPC), lateral temporal, parietal, and striatum of each hemisphere) were visually examined in the FMM scan, and participants were divided into three groups: No-FMM, Focal-FMM (FMM uptake in 1–9 regions), and Diffuse-FMM. We used mixed-effects model to investigate the speed of cognitive decline in the Focal-FMM group according to the cognitive level, extent, and location of A{\ss} involvement, in comparison with the No- or Diffuse-FMM group. Results: Forty-five of 240 (18.8%) individuals were categorized as Focal-FMM. The rate of cognitive decline in the Focal-FMM group was faster than the No-FMM group (especially in the CU and aMCI stage) and slower than the Diffuse-FMM group (in particular in the CU stage). Within the Focal-FMM group, participants with FMM uptake to a larger extent (7–9 regions) showed faster cognitive decline compared to those with uptake to a smaller extent (1–3 or 4–6 regions). The Focal-FMM group was found to have faster cognitive decline in comparison with the No-FMM when there was uptake in the PPC, striatum, and frontal cortex. Conclusions: When predicting cognitive decline of patients with focal A{\ss} deposition, the patients{\textquoteright} cognitive level, extent, and location of the focal involvement are important.",

keywords = "Alzheimer{\textquoteright}s disease, Cognitive decline, F-flutemetamol PET, Longitudinal studies, {\ss}-Amyloid",

author = "Kim, {Si Eun} and Byungju Lee and Hyemin Jang and Juhee Chin and Khoo, {Ching Soong} and Choe, {Yeong Sim} and Kim, {Ji Sun} and Kang, {Sung Hoon} and Kim, {Hang Rai} and Song Hwangbo and Jeong, {Jee Hyang} and Yoon, {Soo Jin} and Park, {Kyung Won} and Kim, {Eun Joo} and Bora Yoon and Jang, {Jae Won} and Hong, {Jin Yong} and Na, {Duk L.} and Seo, {Sang Won} and Choi, {Seong Hye} and Kim, {Hee Jin}",

note = "Publisher Copyright: {\textcopyright} 2021, The Author(s).",

year = "2021",

month = dec,

doi = "10.1186/s13195-021-00787-7",

language = "English",

volume = "13",

journal = "Alzheimer's Research and Therapy",

issn = "1758-9193",

publisher = "BioMed Central Ltd.",

number = "1",

}

Kim, SE, Lee, B, Jang, H, Chin, J, Khoo, CS, Choe, YS, Kim, JS, Kang, SH, Kim, HR, Hwangbo, S, Jeong, JH, Yoon, SJ, Park, KW, Kim, EJ, Yoon, B, Jang, JW, Hong, JY, Na, DL, Seo, SW, Choi, SH & Kim, HJ 2021, 'Cognitive trajectories of patients with focal ß-amyloid deposition', Alzheimer's Research and Therapy, vol. 13, no. 1, 48. https://doi.org/10.1186/s13195-021-00787-7

TY - JOUR

T1 - Cognitive trajectories of patients with focal ß-amyloid deposition

AU - Kim, Si Eun

AU - Lee, Byungju

AU - Jang, Hyemin

AU - Chin, Juhee

AU - Khoo, Ching Soong

AU - Choe, Yeong Sim

AU - Kim, Ji Sun

AU - Kang, Sung Hoon

AU - Kim, Hang Rai

AU - Hwangbo, Song

AU - Jeong, Jee Hyang

AU - Yoon, Soo Jin

AU - Park, Kyung Won

AU - Kim, Eun Joo

AU - Yoon, Bora

AU - Jang, Jae Won

AU - Hong, Jin Yong

AU - Na, Duk L.

AU - Seo, Sang Won

AU - Choi, Seong Hye

AU - Kim, Hee Jin

PY - 2021/12

Y1 - 2021/12

N2 - Background: The presence of ß-amyloid (Aß) in the brain can be identified using amyloid PET. In clinical practice, the amyloid PET is interpreted based on dichotomous visual rating, which renders focal Aß accumulation be read as positive for Aß. However, the prognosis of patients with focal Aß deposition is not well established. Thus, we investigated cognitive trajectories of patients with focal Aß deposition. Methods: We followed up 240 participants (112 cognitively unimpaired [CU], 78 amnestic mild cognitive impairment [aMCI], and 50 Alzheimer’s disease (AD) dementia [ADD]) for 2 years from 9 referral centers in South Korea. Participants were assessed with neuropsychological tests and 18F-flutemetamol (FMM) positron emission tomography (PET). Ten regions (frontal, precuneus/posterior cingulate (PPC), lateral temporal, parietal, and striatum of each hemisphere) were visually examined in the FMM scan, and participants were divided into three groups: No-FMM, Focal-FMM (FMM uptake in 1–9 regions), and Diffuse-FMM. We used mixed-effects model to investigate the speed of cognitive decline in the Focal-FMM group according to the cognitive level, extent, and location of Aß involvement, in comparison with the No- or Diffuse-FMM group. Results: Forty-five of 240 (18.8%) individuals were categorized as Focal-FMM. The rate of cognitive decline in the Focal-FMM group was faster than the No-FMM group (especially in the CU and aMCI stage) and slower than the Diffuse-FMM group (in particular in the CU stage). Within the Focal-FMM group, participants with FMM uptake to a larger extent (7–9 regions) showed faster cognitive decline compared to those with uptake to a smaller extent (1–3 or 4–6 regions). The Focal-FMM group was found to have faster cognitive decline in comparison with the No-FMM when there was uptake in the PPC, striatum, and frontal cortex. Conclusions: When predicting cognitive decline of patients with focal Aß deposition, the patients’ cognitive level, extent, and location of the focal involvement are important.

AB - Background: The presence of ß-amyloid (Aß) in the brain can be identified using amyloid PET. In clinical practice, the amyloid PET is interpreted based on dichotomous visual rating, which renders focal Aß accumulation be read as positive for Aß. However, the prognosis of patients with focal Aß deposition is not well established. Thus, we investigated cognitive trajectories of patients with focal Aß deposition. Methods: We followed up 240 participants (112 cognitively unimpaired [CU], 78 amnestic mild cognitive impairment [aMCI], and 50 Alzheimer’s disease (AD) dementia [ADD]) for 2 years from 9 referral centers in South Korea. Participants were assessed with neuropsychological tests and 18F-flutemetamol (FMM) positron emission tomography (PET). Ten regions (frontal, precuneus/posterior cingulate (PPC), lateral temporal, parietal, and striatum of each hemisphere) were visually examined in the FMM scan, and participants were divided into three groups: No-FMM, Focal-FMM (FMM uptake in 1–9 regions), and Diffuse-FMM. We used mixed-effects model to investigate the speed of cognitive decline in the Focal-FMM group according to the cognitive level, extent, and location of Aß involvement, in comparison with the No- or Diffuse-FMM group. Results: Forty-five of 240 (18.8%) individuals were categorized as Focal-FMM. The rate of cognitive decline in the Focal-FMM group was faster than the No-FMM group (especially in the CU and aMCI stage) and slower than the Diffuse-FMM group (in particular in the CU stage). Within the Focal-FMM group, participants with FMM uptake to a larger extent (7–9 regions) showed faster cognitive decline compared to those with uptake to a smaller extent (1–3 or 4–6 regions). The Focal-FMM group was found to have faster cognitive decline in comparison with the No-FMM when there was uptake in the PPC, striatum, and frontal cortex. Conclusions: When predicting cognitive decline of patients with focal Aß deposition, the patients’ cognitive level, extent, and location of the focal involvement are important.

KW - Alzheimer’s disease

KW - Cognitive decline

KW - F-flutemetamol PET

KW - Longitudinal studies

KW - ß-Amyloid

UR - http://www.scopus.com/inward/record.url?scp=85101191337&partnerID=8YFLogxK

U2 - 10.1186/s13195-021-00787-7

DO - 10.1186/s13195-021-00787-7

M3 - Article

C2 - 33608041

AN - SCOPUS:85101191337

SN - 1758-9193

VL - 13

JO - Alzheimer's Research and Therapy

JF - Alzheimer's Research and Therapy

IS - 1

M1 - 48

ER -

Cognitive trajectories of patients with focal ß-amyloid deposition

Abstract

Bibliographical note

Keywords

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