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Comparing PET and MRI Biomarkers Predicting Cognitive Decline in Preclinical Alzheimer Disease.
Mayblyum, Danielle V; Becker, J Alex; Jacobs, Heidi I L; Buckley, Rachel F; Schultz, Aaron P; Sepulcre, Jorge; Sanchez, Justin S; Rubinstein, Zoe B; Katz, Samantha R; Moody, Kirsten A; Vannini, Patrizia; Papp, Kathryn V; Rentz, Dorene M; Price, Julie C; Sperling, Reisa A; Johnson, Keith A; Hanseeuw, Bernard J.
Afiliação
  • Mayblyum DV; Department of Radiology, Massachusetts General Hospital, Gordon Center for Medical Imaging and the Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA 02114, USA.
  • Becker JA; Department of Radiology, Massachusetts General Hospital, Gordon Center for Medical Imaging and the Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA 02114, USA.
  • Jacobs HIL; Department of Radiology, Massachusetts General Hospital, Gordon Center for Medical Imaging and the Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA 02114, USA.
  • Buckley RF; Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands.
  • Schultz AP; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Womens Hospital, Harvard Medical School, Boston, MA 02115, USA.
  • Sepulcre J; The Florey Institute, The University of Melbourne, Victoria, Australia.
  • Sanchez JS; Melbourne School of Psychological Science, University of Melbourne, Victoria Australia.
  • Rubinstein ZB; Department of Neurology, Massachusetts General Hospital, Harvard Medical School.
  • Katz SR; Department of Radiology, Massachusetts General Hospital, Gordon Center for Medical Imaging and the Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA 02114, USA.
  • Moody KA; Department of Radiology, Massachusetts General Hospital, Gordon Center for Medical Imaging and the Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA 02114, USA.
  • Vannini P; Department of Radiology, Massachusetts General Hospital, Gordon Center for Medical Imaging and the Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA 02114, USA.
  • Papp KV; Department of Radiology, Massachusetts General Hospital, Gordon Center for Medical Imaging and the Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA 02114, USA.
  • Rentz DM; Department of Radiology, Massachusetts General Hospital, Gordon Center for Medical Imaging and the Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA 02114, USA.
  • Price JC; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Womens Hospital, Harvard Medical School, Boston, MA 02115, USA.
  • Sperling RA; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Womens Hospital, Harvard Medical School, Boston, MA 02115, USA.
  • Johnson KA; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Womens Hospital, Harvard Medical School, Boston, MA 02115, USA.
  • Hanseeuw BJ; Department of Radiology, Massachusetts General Hospital, Gordon Center for Medical Imaging and the Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA 02114, USA.
Neurology ; 2021 May 05.
Article em En | MEDLINE | ID: mdl-33952655
ABSTRACT

OBJECTIVE:

To compare how structural MRI, Fluorodeoxyglucose (FDG), and Flortaucipir (FTP) PET signal predict cognitive decline in high-amyloid versus low-amyloid participants with the goal of determining which biomarker combination would result in the highest increase of statistical power for prevention trials.

METHODS:

In this prospective cohort study, we analyzed data from clinically-normal adults from the Harvard Aging Brain Study with MRI, FDG, FTP, and PiB-PET acquired within a year, and prospective cognitive evaluations over a mean three-year follow-up. We focused analyses on pre-defined regions-of-interest inferior temporal, isthmus cingulate, hippocampus, and entorhinal cortex. Cognition was assessed using the Preclinical Alzheimer's Cognitive Composite (PACC5). We evaluated the association between biomarkers and cognitive decline using linear-mixed-effect models with random intercepts and slopes, adjusting for demographics. We generated power curves simulating prevention trials.

RESULTS:

Data from 131 participants [52 females, 73.98±8.29 years old] were analyzed in the study. In separate models, most biomarkers had a closer association with cognitive decline in the high-PiB compared to the low-PiB participants. A backward stepwise regression including all biomarkers demonstrated that only neocortical PiB, entorhinal FTP, and entorhinal FDG were independent predictors of subsequent cognitive decline. Power analyses revealed that using both high-PiB and low entorhinal FDG as inclusion criteria reduced 3-fold the number of participants needed in a hypothetical trial compared to using only high-PiB.

DISCUSSION:

In preclinical Alzheimer's disease, entorhinal hypometabolism is a strong and independent predictor of subsequent cognitive decline, making FDG a potentially useful biomarker to increase power in clinical trials. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that in people with preclinical Alzheimer's disease, entorhinal hypometabolism identified by FDG-PET is predictive of subsequent cognitive decline.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Neurology Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Neurology Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Estados Unidos