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

 Byoung Seok Ye  ;  Sang Won Seo  ;  Jung-Hyun Kim  ;  Geon Ha Kim  ;  Hanna Cho  ;  Young Noh  ;  Hee Jin Kim  ;  Cindy W. Yoon  ;  Sook-young Woo  ;  Sook Hui Kim  ;  Hee Kyung Park  ;  Sung Tae Kim  ;  Yearn Seong Choe  ;  Kyung Han Lee  ;  Jae Seung Kim  ;  Seung Jun Oh  ;  Changsoo Kim  ;  Michael Weiner  ;  Jae-Hong Lee  ;  Duk L. Na 
 NEUROLOGY, Vol.85(19) : 1687-1693, 2015 
Journal Title
Issue Date
Aged ; Aged, 80 and over ; Amyloid/metabolism* ; Amyloid beta-Peptides/metabolism* ; Cognition Disorders/diagnosis* ; Cognition Disorders/metabolism* ; Cohort Studies ; Dementia, Vascular/diagnosis* ; Dementia, Vascular/metabolism* ; Female ; Follow-Up Studies ; Humans ; Longitudinal Studies ; Magnetic Resonance Imaging/trends ; Male ; Middle Aged ; Prospective Studies
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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1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Chang Soo(김창수) ORCID logo https://orcid.org/0000-0002-5940-5649
Ye, Byoung Seok(예병석) ORCID logo https://orcid.org/0000-0003-0187-8440
Cho, Hanna(조한나) ORCID logo https://orcid.org/0000-0001-5936-1546
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