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Prognostic value of Alzheimer's biomarkers in mild cognitive impairment: the effect of age at onset
Univ Geneva, Lab Neuroimaging Aging LANVIE, Geneva, Switzerland;Memory Clin, Univ Hosp Geneva, Geneva, Switzerland.
IRCCS Ist Ctr San Giovanni di Dio Fatebenefratell, Serv Stat, Via Pilastroni 4, I-25125 Brescia, Italy.ORCID iD: 0000-0002-4101-6872
Ist Ric Farmacol Mario Negri IRCCS, Med Imaging Unit, Bergamo, Italy.
IRCCS Ist Ctr San Giovanni di Dio Fatebenefratell, LANE, Brescia, Italy.ORCID iD: 0000-0001-9804-5669
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2019 (English)In: Journal of Neurology, ISSN 0340-5354, E-ISSN 1432-1459, Vol. 266, no 10, p. 2535-2545Article in journal (Refereed) Published
Abstract [en]

Objective The aim of this study is to assess the impact of age at onset on the prognostic value of Alzheimer's biomarkers in a large sample of patients with mild cognitive impairment (MCI). Methods We measured A beta 42, t-tau, hippocampal volume on magnetic resonance imaging (MRI) and cortical metabolism on fluorodeoxyglucose-positron emission tomography (FDG-PET) in 188 MCI patients followed for at least 1 year. We categorised patients into earlier and later onset (EO/LO). Receiver operating characteristic curves and corresponding areas under the curve (AUCs) were performed to assess and compar the biomarker prognostic performances in EO and LO groups. Linear Model was adopted for estimating the time-to-progression in relation with earlier/later onset MCI groups and biomarkers. Results In earlier onset patients, all the assessed biomarkers were able to predict cognitive decline (p < 0.05), with FDG-PET showing the best performance. In later onset patients, all biomarkers but t-tau predicted cognitive decline (p < 0.05). Moreover, FDG-PET alone in earlier onset patients showed a higher prognostic value than the one resulting from the combination of all the biomarkers in later onset patients (earlier onset AUC 0.935 vs later onset AUC 0.753, p < 0.001). Finally, FDG-PET showed a different prognostic value between earlier and later onset patients (p = 0.040) in time-to-progression allowing an estimate of the time free from disease. Discussion FDG-PET may represent the most universal tool for the establishment of a prognosis in MCI patients and may be used for obtaining an onset-related estimate of the time free from disease.

Place, publisher, year, edition, pages
SPRINGER HEIDELBERG , 2019. Vol. 266, no 10, p. 2535-2545
Keywords [en]
Alzheimer, Cognition, Imaging, Biomarkers, FDG-PET
National Category
Neurology
Identifiers
URN: urn:nbn:se:uu:diva-395732DOI: 10.1007/s00415-019-09441-7ISI: 000487923200022PubMedID: 31267207OAI: oai:DiVA.org:uu-395732DiVA, id: diva2:1365112
Funder
Swedish Research Council, 05817Available from: 2019-10-23 Created: 2019-10-23 Last updated: 2019-10-23Bibliographically approved

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Wall, Anders

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