Amyloid-Related Imaging Abnormalities and Other MRI Findings in a Cognitively Unimpaired Population With and Without Cerebral Amyloid - 21/11/24
, K.C. Holdridge 1, J. Choi 2, M.C. Donohue 2, K. Kantarci 3, C.R. Jack 3, S.M. Zuk 3, J.R. Sims 1, K.A. Johnson 4, P.S. Aisen 2, R.A. Sperling 4, 5 A4 Study Team
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Abstract |
Background |
Screening data from the Anti-Amyloid Treatment in Asymptomatic Alzheimer’s Disease (A4) and Longitudinal Evaluation of Amyloid Risk and Neurodegeneration (LEARN) studies provide a unique opportunity to compare magnetic resonance imaging (MRI) findings such as amyloid-related imaging abnormalities (ARIA) in cognitively unimpaired elderly with and without elevated cerebral amyloid.
Objectives |
To compare screening MRI findings, such as ARIA, in the cognitively unimpaired potential participants of a clinical trial with and without elevated cerebral amyloid.
Design |
Cross-sectional analysis of structural MRI findings in screening data from the A4 and LEARN studies.
Setting |
The A4 Study is a multi-center international clinical trial. The LEARN Study is a multi center observational study in the United States.
Participants |
Clinically normal older adults (65–85 years) with elevated cerebral amyloid (Aβ+; n = 1250, A4) and without elevated cerebral amyloid (Aβ-; n = 538, LEARN).
Measurements |
Participants underwent florbetapir positron emission tomography for Aβ+/- classification. A centrally read 3T MRI to assess for study eligibility was conducted on study qualified MRI scanners.
Results |
No ARIA-effusions (ARIA-E) was detected on screening MRI in the Aβ+ or Aβ- cohorts. At least one ARIA-H (microhemorrhages [MCH] or superficial siderosis [SS]) was present in 18% of the Aβ+ cohort compared with 8% in Aβ- (P < 0.001). In the Aβ+ cohort, approximately 2% of screening MRIs demonstrated MCH ≥4 compared with 0% in Aβ-. The presence of two apolipoprotein E ε4 (APOEε4) alleles (vs no ε4 alleles) in the Aβ+ cohort increased the odds for presence of MCH (odds ratio [OR] = 2.03; 95% CI, 1.23 to 3.27, P = 0.004). Cortical infarctions (4% vs 0%) and subcortical infarctions (10% vs 1%) were observed at statistically significantly higher prevalence in the Aβ+ cohort compared with Aβ- (P < 0.001). Females showed reduced odds of MCH in the Aβ+ cohort by a factor of 0.63 (95% CI, 0.47 to 0.84, P = 0.002).
Conclusions |
ARIA-E is rare in cognitively unimpaired Aβ+ and Aβ- populations prior to anti-amyloid drug intervention. ARIA-H in Aβ+ was greater than in Aβ- populations.
Le texte complet de cet article est disponible en PDF.Key words : Amyloid-related imaging abnormalities, preclinical Alzheimer’s disease, magnetic resonance imaging, florbetapir positron emission tomography
Plan
Vol 9 - N° 4
P. 617-624 - octobre 2022 Retour au numéro
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