Clinical and multimodal biomarker correlates of ADNI neuropathological findings
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- 作者：Jon B Toledo (1)
Nigel J Cairns (2)
Xiao Da (3)
Kewei Chen (4)
Deborah Carter (2)
Adam Fleisher (4)
Erin Householder (2)
Napatkamon Ayutyanont (4)
Auttawut Roontiva (4)
Robert J Bauer (4)
Paul Eisen (5)
Leslie M Shaw (1)
Christos Davatzikos (3)
Michael W Weiner (6)
Eric M Reiman (4)
John C Morris (2)
John Q Trojanowski (1) - 关键词：Alzheimer’s disease ; Mild cognitive impairment ; CSF ; MRI ; Autopsy ; Neuropathology ; Dementia ; Biomarkers ; Amyloid ; Tau
- 刊名：Acta Neuropathologica Communications
- 出版年：2013
- 出版时间：December 2013
- 年：2013
- 卷：1
- 期：1
- 全文大小：1,473 KB
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Nigel J Cairns (2)
Xiao Da (3)
Kewei Chen (4)
Deborah Carter (2)
Adam Fleisher (4)
Erin Householder (2)
Napatkamon Ayutyanont (4)
Auttawut Roontiva (4)
Robert J Bauer (4)
Paul Eisen (5)
Leslie M Shaw (1)
Christos Davatzikos (3)
Michael W Weiner (6)
Eric M Reiman (4)
John C Morris (2)
John Q Trojanowski (1)
1. Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
2. Departments of Neurology and Pathology & Immunology, Washington University School of Medicine, St. Louis, MO, USA
3. Section of Biomedical Image Analysis, Department of Radiology, and Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, USA
4. Banner Alzheimer’s Institute, 901 East Willetta Street, Phoenix, AZ, USA
5. University of California at San Diego, San Diego, CA, USA
6. Center for Imaging of Neurodegenerative Diseases, Department of Radiology, San Francisco VA Medical Center/University of California San Francisco, San Francisco, CA, USA - ISSN：2051-5960
文摘
Background Autopsy series commonly report a high percentage of coincident pathologies in demented patients, including patients with a clinical diagnosis of dementia of the Alzheimer type (DAT). However many clinical and biomarker studies report cases with a single neurodegenerative disease. We examined multimodal biomarker correlates of the consecutive series of the first 22 Alzheimer’s Disease Neuroimaging Initiative autopsies. Clinical data, neuropsychological measures, cerebrospinal fluid Aβ, total and phosphorylated tau and α-synuclein and MRI and FDG-PET scans. Results Clinical diagnosis was either probable DAT or Alzheimer’s disease (AD)-type mild cognitive impairment (MCI) at last evaluation prior to death. All patients had a pathological diagnosis of AD, but only four had pure AD. A coincident pathological diagnosis of dementia with Lewy bodies (DLB), medial temporal lobe pathology (TDP-43 proteinopathy, argyrophilic grain disease and hippocampal sclerosis), referred to collectively here as MTL, and vascular pathology were present in 45.5%, 40.0% and 22.7% of these patients, respectively. Hallucinations were a strong predictor of coincident DLB (100% specificity) and a more severe dysexecutive profile was also a useful predictor of coincident DLB (80.0% sensitivity and 83.3% specificity). Occipital FDG-PET hypometabolism accurately classified coincident DLB (80% sensitivity and 100% specificity). Subjects with coincident MTL showed lower hippocampal volume. Conclusions Biomarkers can be used to independently predict coincident AD and DLB pathology, a common finding in amnestic MCI and DAT patients. Cohorts with comprehensive neuropathological assessments and multimodal biomarkers are needed to characterize independent predictors for the different neuropathological substrates of cognitive impairment.