Amyloid-PET imaging offers small improvements in predictions of future cognitive trajectories.
Amyloid-PET imaging offers small improvements in predictions of future cognitive trajectories.
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DOI：
10.1016/j.nicl.2021.102713
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Maria Glymour M
中科院分区：
文献类型：
--
作者：
Ackley SF;Hayes-Larson E;Brenowitz WD;Swinnerton K;Mungas D;Fletcher E;Singh B;Whitmer RA;DeCarli C;Maria Glymour M
淀粉样蛋白负担只略微改善了记忆和执行功能的预测。定期进行认知评估，淀粉样蛋白pet可能不能改善认知预后。这些发现支持常规认知评估在临床护理中的价值。淀粉样蛋白(A)被认为引发了一系列病理反应，最终导致阿尔茨海默病相关的认知能力下降。在阿尔茨海默病的临床诊断之前的一到二十年，脑组织中的积累可能就开始了。先前的研究表明，用淀粉样体配体正电子发射断层扫描（amyloid- pet）在体内检测到的Aβ可以预测同时测量的认知和未来的认知轨迹。先前的研究没有评估A测量在预测未来认知时的附加价值，而重复的过去认知测量是可用的。我们评估了淀粉样蛋白pet在多大程度上改善了对未来认知变化的预测，而不仅仅是基于社会人口统计学和过去的认知测量。我们使用的数据来自加州大学戴维斯分校阿尔茨海默病研究队列的参与者，他们在基线时认知正常，参加了淀粉样蛋白- pet成像，并在淀粉样蛋白- pet成像之前完成了至少三个认知评估（记忆= 132，执行功能= 135）。我们使用在淀粉样蛋白- pet成像之前采取的社会人口学和认知测量来预测淀粉样蛋白- pet成像后的认知轨迹，并评估淀粉样蛋白负担的测量是否改善了对随后认知变化的预测。预测的改善表现为淀粉样蛋白pet后预测认知的均方误差（MSE）的百分比减少和方差解释的百分比增加。仅使用社会人口统计学和过去的认知表现的基本模型解释了淀粉样蛋白pet后预测记忆测量（55.6%）和执行功能测量（74.5%）的大部分差异。在模型中加入淀粉样蛋白阳性使记忆的MSE降低0.2%,95% CI:(0%, 2.6%), p = 0.48，执行功能的MSE降低3.4%,95% CI:(0.6%, 10.2%), p = 0.002。这对应于解释的百分比方差增加0.1%,95% CI:（0%, 1.2%）用于记忆和0.9%,95% CI:（0.1%, 2.8%）用于执行功能。使用淀粉样蛋白负荷的连续测量获得了类似的结果。在这个队列中，与仅基于过去认知评估和社会人口统计学的模型相比，淀粉样蛋白负担的增加略微改善了对执行功能的预测。当重复的认知评估是可用的，淀粉样蛋白pet在预测未来认知障碍的额外效用可能是有限的。
Amyloid burden only slightly improved predictions of memory and executive function. With regular cognitive assessments, amyloid-PET may not improve cognitive prognosis. These findings support the value of routine cognitive assessments in clinical care. Amyloid (A) is thought to initiate a cascade of pathology culminating in Alzheimer’s disease-related cognitive decline. A accumulation in brain tissues may begin one to two decades prior to clinical diagnosis of Alzheimer’s disease. Prior studies have demonstrated that Aβ detected in vivo with positron emission tomography with amyloid ligands (amyloid-PET) predicts contemporaneously measured cognition and future cognitive trajectories. Prior studies have not evaluated the added value of A measures in predicting future cognition when repeated past cognitive measures are available. We evaluated the extent to which amyloid-PET improves prediction of future cognitive changes over and above predictions based only on sociodemographics and past cognitive measures. We used data from participants in the University of California Davis Alzheimer’s Disease Research cohort who were cognitively normal at baseline, participated in amyloid-PET imaging, and completed at least three cognitive assessments prior to amyloid-PET imaging ( = 132 for memory and = 135 for executive function). We used sociodemographic and cognitive measures taken prior to amyloid-PET imaging to predict cognitive trajectory after amyloid-PET imaging and assessed whether measures of amyloid burden improved predictions of subsequent cognitive change. Improvements in prediction were characterized as percent reduction in the mean squared error (MSE) in predicted cognition post amyloid-PET and increase in percent variance explained. The base model using only sociodemographics and past cognitive performance explained the majority of variance in both predicted memory measures (55.6%) and executive function measures (74.5%) following amyloid-PET. Adding amyloid positivity to the model reduced the MSE for memory by 0.2%, 95% CI: (0%, 2.6%), p = 0.48 and for executive function by 3.4%, 95% CI: (0.6%, 10.2%), p = 0.002. This corresponded to an increase in the percent variance explained of 0.1%, 95% CI: (0%, 1.2%) for memory and 0.9%, 95% CI: (0.1%, 2.8%) for executive function. Similar results were obtained using a continuous measure of amyloid burden. In this cohort, the addition of amyloid burden slightly improved predictions of executive function compared to models based only on past cognitive assessments and sociodemographics. When repeated cognitive assessments are available, the additional utility of amyloid-PET in predicting future cognitive impairment may be limited.
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影响因子：
2.7
作者：
Mathis, CA;Bacskai, BJ;Klunk, WE
通讯作者：
Klunk, WE
影响因子：
10.6
作者：
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DOI：
10.1186/s13195-017-0260-z
发表时间：
2017-04-26
期刊：
Alzheimer's research & therapy
影响因子：
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作者：
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通讯作者：
Alzheimer’s Disease Neuroimaging Initiative (ADNI)
影响因子：
5.7
作者：
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通讯作者：
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影响因子：
9.9
作者：
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通讯作者：
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