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Effects of amyloid and vascular markers on cognitive decline in subcortical vascular dementia

Title
Effects of amyloid and vascular markers on cognitive decline in subcortical vascular dementia
Authors
Ye, Byoung SeokSeo, Sang WonKim, Jung-HyunKim, Geon HaCho, HannaNoh, YoungKim, Hee JinYoon, Cindy W.Woo, Sook-youngKim, Sook HuiPark, Hee KyungKim, Sung TaeChoe, Yearn SeongLee, Kyung HanKim, Jae SeungOh, Seung JunKim, ChangsooWeiner, MichaelLee, Jae-HongNa, Duk L.
Ewha Authors
김건하
SCOPUS Author ID
김건하scopus
Issue Date
2015
Journal Title
NEUROLOGY
ISSN
0028-3878JCR Link1526-632XJCR Link
Citation
vol. 85, no. 19, pp. 1687 - 1693
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Indexed
SCI; SCIE; SCOPUS WOS scopus
Abstract
Objective:To determine the independent and synergistic effects of amyloid and small vessel disease (SVD) burden on longitudinal cognitive decline in patients with subcortical vascular dementia (SVaD). Methods:A longitudinal cohort study was conducted involving patients from outpatient clinics of 2 tertiary referral centers. Sixty-one patients with SVaD were prospectively recruited and underwent MRI, 11C-Pittsburgh compound B (PiB) PET at baseline, and a 3-year annual neuropsychological follow-up. Effects of PiB positivity and SVD markers (white matter hyperintensities [WMH], lacunes, and microbleeds) on longitudinal cognitive decline were evaluated using generalized estimation equation after controlling for age, sex, education, APOE4 allele, and follow-up interval. Results:When individual neuropsychological tests were used as outcome measures, PiB positivity was associated with faster cognitive decline in attention, visuospatial, visual memory, and global cognition function. Higher WMH burden was associated with faster cognitive decline in attention, visuospatial, visual recognition memory, and semantic/phonemic fluency function, whereas lacunes and microbleeds had no significant effects. When global dementia rating (Clinical Dementia Rating sum of boxes) was considered as an outcome measure, however, only PiB positivity was associated with faster cognitive decline. Significant interactions between PiB positivity and higher SVD burden were found to affect cognitive decline in semantic word fluency (from WMH burden) and global dementia rating (from microbleed burden). Conclusions:In SVaD patients, amyloid burden, independently or interactively with SVD, contributed to longitudinal cognitive decline. Amyloid deposition was the strongest poor prognostic factor.
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연구기관 > 뇌융합과학연구원 > Journal papers
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