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Regional brain amyloid-β accumulation associates with domain-specific cognitive performance in Parkinson disease without dementia.
PLoS One 2017; 12(5):e0177924Plos

Abstract

Parkinson disease patients develop clinically significant cognitive impairment at variable times over their disease course, which is often preceded by milder deficits in memory, visuo-spatial, and executive domains. The significance of amyloid-β accumulation to these problems is unclear. We hypothesized that amyloid-β PET imaging by 18F-florbetapir, a radiotracer that detects fibrillar amyloid-β plaque deposits, would identify subjects with global cognitive impairment or poor performance in individual cognitive domains in non-demented Parkinson disease patients. We assessed 61 non-demented Parkinson disease patients with detailed cognitive assessments and 18F-florbetapir PET brain imaging. Scans were interpreted qualitatively (positive or negative) by two independent nuclear medicine physicians blinded to clinical data, and quantitatively by a novel volume-weighted method. The presence of mild cognitive impairment was determined through an expert consensus process using Level 1 criteria from the Movement Disorder Society. Nineteen participants (31.2%) were diagnosed with mild cognitive impairment and the remainder had normal cognition. Qualitative 18F-florbetapir PET imaging was positive in 15 participants (24.6%). Increasing age and presence of an APOE ε4 allele were associated with higher composite 18F-florbetapir binding. In multivariable models, an abnormal 18F-florbetapir scan by expert rating was not associated with a diagnosis of mild cognitive impairment. However, 18F-florbetapir retention values in the posterior cingulate gyrus inversely correlated with verbal memory performance. Retention values in the frontal cortex, precuneus, and anterior cingulate gyrus retention values inversely correlated with naming performance. Regional cortical amyloid-β amyloid, as measured by 18F-florbetapir PET, may be a biomarker of specific cognitive deficits in non-demented Parkinson disease patients.

Authors+Show Affiliations

Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America. Center for Neurodegenerative Disease Research and Institute on Aging, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.Department of Radiology, Division of Nuclear Medicine and Clinical Molecular Imaging, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.Department of Radiology, Division of Nuclear Medicine and Clinical Molecular Imaging, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.Center for Neurodegenerative Disease Research and Institute on Aging, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America. Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.Center for Neurodegenerative Disease Research and Institute on Aging, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America. Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America. AVID Radiopharmaceuticals, Philadelphia, Pennsylvania, United States of America.Department of Radiology, Division of Nuclear Medicine and Clinical Molecular Imaging, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America. Department of Psychiatry, Perelman School of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America. Parkinson's Disease and Mental Health Research, Education, and Clinical Centers (PADRECC and MIRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, United States of America.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28542444

Citation

Akhtar, Rizwan S., et al. "Regional Brain Amyloid-β Accumulation Associates With Domain-specific Cognitive Performance in Parkinson Disease Without Dementia." PloS One, vol. 12, no. 5, 2017, pp. e0177924.
Akhtar RS, Xie SX, Chen YJ, et al. Regional brain amyloid-β accumulation associates with domain-specific cognitive performance in Parkinson disease without dementia. PLoS ONE. 2017;12(5):e0177924.
Akhtar, R. S., Xie, S. X., Chen, Y. J., Rick, J., Gross, R. G., Nasrallah, I. M., ... Weintraub, D. (2017). Regional brain amyloid-β accumulation associates with domain-specific cognitive performance in Parkinson disease without dementia. PloS One, 12(5), pp. e0177924. doi:10.1371/journal.pone.0177924.
Akhtar RS, et al. Regional Brain Amyloid-β Accumulation Associates With Domain-specific Cognitive Performance in Parkinson Disease Without Dementia. PLoS ONE. 2017;12(5):e0177924. PubMed PMID: 28542444.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Regional brain amyloid-β accumulation associates with domain-specific cognitive performance in Parkinson disease without dementia. AU - Akhtar,Rizwan S, AU - Xie,Sharon X, AU - Chen,Yin J, AU - Rick,Jacqueline, AU - Gross,Rachel G, AU - Nasrallah,Ilya M, AU - Van Deerlin,Vivianna M, AU - Trojanowski,John Q, AU - Chen-Plotkin,Alice S, AU - Hurtig,Howard I, AU - Siderowf,Andrew D, AU - Dubroff,Jacob G, AU - Weintraub,Daniel, Y1 - 2017/05/25/ PY - 2017/01/29/received PY - 2017/05/05/accepted PY - 2017/5/26/entrez PY - 2017/5/26/pubmed PY - 2017/9/12/medline SP - e0177924 EP - e0177924 JF - PloS one JO - PLoS ONE VL - 12 IS - 5 N2 - Parkinson disease patients develop clinically significant cognitive impairment at variable times over their disease course, which is often preceded by milder deficits in memory, visuo-spatial, and executive domains. The significance of amyloid-β accumulation to these problems is unclear. We hypothesized that amyloid-β PET imaging by 18F-florbetapir, a radiotracer that detects fibrillar amyloid-β plaque deposits, would identify subjects with global cognitive impairment or poor performance in individual cognitive domains in non-demented Parkinson disease patients. We assessed 61 non-demented Parkinson disease patients with detailed cognitive assessments and 18F-florbetapir PET brain imaging. Scans were interpreted qualitatively (positive or negative) by two independent nuclear medicine physicians blinded to clinical data, and quantitatively by a novel volume-weighted method. The presence of mild cognitive impairment was determined through an expert consensus process using Level 1 criteria from the Movement Disorder Society. Nineteen participants (31.2%) were diagnosed with mild cognitive impairment and the remainder had normal cognition. Qualitative 18F-florbetapir PET imaging was positive in 15 participants (24.6%). Increasing age and presence of an APOE ε4 allele were associated with higher composite 18F-florbetapir binding. In multivariable models, an abnormal 18F-florbetapir scan by expert rating was not associated with a diagnosis of mild cognitive impairment. However, 18F-florbetapir retention values in the posterior cingulate gyrus inversely correlated with verbal memory performance. Retention values in the frontal cortex, precuneus, and anterior cingulate gyrus retention values inversely correlated with naming performance. Regional cortical amyloid-β amyloid, as measured by 18F-florbetapir PET, may be a biomarker of specific cognitive deficits in non-demented Parkinson disease patients. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/28542444/Regional_brain_amyloid_β_accumulation_associates_with_domain_specific_cognitive_performance_in_Parkinson_disease_without_dementia_ L2 - http://dx.plos.org/10.1371/journal.pone.0177924 DB - PRIME DP - Unbound Medicine ER -