Cerebral amyloid deposition predicts long-term cognitive decline in hemorrhagic small vessel disease.

Abstract

BACKGROUND:

To investigate the association between cerebral amyloid deposition and long-term cognitive outcomes in patients with hemorrhagic small vessel disease (SVD) and survivors of intracerebral hemorrhage (ICH).

METHODS:

Patients experiencing an ICH without overt dementia were prospectively recruited (n = 68) for brain MRI and Pittsburgh compound B (PiB) positron emission tomography scans at baseline. Cognitive function was assessed using the mini-mental status examination (MMSE) and clinical dementia rating after an overall median follow-up of 3.8 years. A positive amyloid scan was defined as a global PiB standardized uptake value ratio >1.2. Associations between follow-up cognitive outcomes and neuroimaging markers were explored using multivariable Cox regression models.

RESULTS:

PiB(+) patients were older (72.1 ± 7.8 vs. 59.9 ± 11.7, p = .002) and more frequently had cerebral amyloid angiopathy (CAA) (63.6% vs. 15.8%, p = .002) than PiB(-) patients. PiB(+) was associated with a higher risk of dementia conversion (32.9 vs. 4.0 per 100-person-years, hazard ratio [HR] = 15.7 [3.0-80.7], p = .001) and MMSE score decline (58.8 vs. 9.9 per 100-person-years, HR = 6.2 [1.9-20.0], p = .002). In the non-CAA subgroup (n = 52), PiB(+) remained an independent predictor of dementia conversion, p = .04). In the Cox models, PiB(+) was an independent predictor of dementia conversion (HR = 15.8 [2.6-95.4], p = .003) and MMSE score decline (HR = 5.7 [1.6-20.3], p = .008) after adjusting for confounders.

CONCLUSIONS:

Cerebral amyloid deposition potentially contributes to long-term cognitive decline in SVD-related ICH.

• Authors: Ya-Chin Tsai, Hsin-Hsi Tsai, Chia-Ju Liu, Sheng-Sian Lin, Ya-Fang Chen, Jiann-Shing Jeng, Li-Kai Tsai, Ruoh-Fang Yen
• Journal: Brain and behavior (Brain Behav) Vol. 13 Issue 10 Pg. e3189 (Oct 2023) ISSN: 2162-3279 [Electronic] United States
• PMID: 37533346 (Publication Type: Journal Article)
• Copyright: © 2023 The Authors. Brain and Behavior published by Wiley Periodicals LLC.