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  • Ovid Technologies (Wolters Kluwer Health)  (2)
  • Altomare, Daniele  (2)
  • 1
    Online Resource
    Online Resource
    Applying the ATN scheme in a memory clinic population : The ABIDE project
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Neurology Vol. 93, No. 17 ( 2019-10-22), p. e1635-e1646
    Details
    In: Neurology, Ovid Technologies (Wolters Kluwer Health), Vol. 93, No. 17 ( 2019-10-22), p. e1635-e1646
    Abstract: To apply the ATN scheme to memory clinic patients, to assess whether it discriminates patient populations with specific features. Methods We included 305 memory clinic patients (33% subjective cognitive decline [SCD]: 60 ± 9 years, 61% M; 19% mild cognitive impairment [MCI] : 68 ± 9 years, 68% M; 48% dementia: 66 ± 10 years, 58% M) classified for positivity (±) of amyloid (A) ([ 18 F]Florbetaben PET), tau (T) (CSF p-tau), and neurodegeneration (N) (medial temporal lobe atrophy). We assessed ATN profiles' demographic, clinical, and cognitive features at baseline, and cognitive decline over time. Results The proportion of A+T+N+ patients increased with syndrome severity (from 1% in SCD to 14% in MCI and 35% in dementia), while the opposite was true for A−T−N− (from 48% to 19% and 6%). Compared to A−T−N−, patients with the Alzheimer disease profiles (A+T+N− and A+T+N+) were older (both p 〈 0.05) and had a higher prevalence of APOE ε4 (both p 〈 0.05) and lower Mini-Mental State Examination (MMSE) (both p 〈 0.05), memory (both p 〈 0.05), and visuospatial abilities (both p 〈 0.05) at baseline. Non-Alzheimer profiles A−T−N+ and A-T+N+ showed more severe white matter hyperintensities (both p 〈 0.05) and worse language performance (both p 〈 0.05) than A−T−N−. A linear mixed model showed faster decline on MMSE over time in A+T+N− and A+T+N+ ( p = 0.059 and p 〈 0.001 vs A−T−N−), attributable mainly to patients without dementia. Conclusions The ATN scheme identified different biomarker profiles with overlapping baseline features and patterns of cognitive decline. The large number of profiles, which may have different implications in patients with vs without dementia, poses a challenge to the application of the ATN scheme.
    Type of Medium: Online Resource
    ISSN: 0028-3878 , 1526-632X
    URL: Article
    DOI: 10.1212/WNL.0000000000008361
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    Location Call Number Limitation Availability
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    Online Resource
  • 2
    Online Resource
    Online Resource
    Multitracer model for staging cortical amyloid deposition using PET imaging
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Neurology Vol. 95, No. 11 ( 2020-09-15), p. e1538-e1553
    Details
    In: Neurology, Ovid Technologies (Wolters Kluwer Health), Vol. 95, No. 11 ( 2020-09-15), p. e1538-e1553
    Abstract: To develop and evaluate a model for staging cortical amyloid deposition using PET with high generalizability. Methods Three thousand twenty-seven individuals (1,763 cognitively unimpaired [CU], 658 impaired, 467 with Alzheimer disease [AD] dementia, 111 with non-AD dementia, and 28 with missing diagnosis) from 6 cohorts (European Medical Information Framework for AD, Alzheimer's and Family, Alzheimer's Biomarkers in Daily Practice, Amsterdam Dementia Cohort, Open Access Series of Imaging Studies [OASIS]-3, Alzheimer’s Disease Neuroimaging Initiative [ADNI] ) who underwent amyloid PET were retrospectively included; 1,049 individuals had follow-up scans. With application of dataset-specific cutoffs to global standard uptake value ratio (SUVr) values from 27 regions, single-tracer and pooled multitracer regional rankings were constructed from the frequency of abnormality across 400 CU individuals (100 per tracer). The pooled multitracer ranking was used to create a staging model consisting of 4 clusters of regions because it displayed a high and consistent correlation with each single-tracer ranking. Relationships between amyloid stage, clinical variables, and longitudinal cognitive decline were investigated. Results SUVr abnormality was most frequently observed in cingulate, followed by orbitofrontal, precuneal, and insular cortices and then the associative, temporal, and occipital regions. Abnormal amyloid levels based on binary global SUVr classification were observed in 1.0%, 5.5%, 17.9%, 90.0%, and 100.0% of individuals in stage 0 to 4, respectively. Baseline stage predicted decline in Mini-Mental State Examination (MMSE) score (ADNI: n = 867, F = 67.37, p 〈 0.001; OASIS: n = 475, F = 9.12, p 〈 0.001) and faster progression toward an MMSE score ≤25 (ADNI: n = 787, hazard ratio [HR] stage1 2.00, HR stage2 3.53, HR stage3 4.55, HR stage4 9.91, p 〈 0.001; OASIS: n = 469, HR stage4 4.80, p 〈 0.001). Conclusion The pooled multitracer staging model successfully classified the level of amyloid burden in 〉 3,000 individuals across cohorts and radiotracers and detects preglobal amyloid burden and distinct risk profiles of cognitive decline within globally amyloid-positive individuals.
    Type of Medium: Online Resource
    ISSN: 0028-3878 , 1526-632X
    URL: Article
    DOI: 10.1212/WNL.0000000000010256
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
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