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Mild cognitive impairment with suspected nonamyloid pathology (SNAP) Prediction of progression
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2015 (English)In: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 84, no 5, 508-515 p.Article in journal (Refereed) Published
Abstract [en]

Objectives:The aim of this study was to investigate predictors of progressive cognitive deterioration in patients with suspected non-Alzheimer disease pathology (SNAP) and mild cognitive impairment (MCI).Methods:We measured markers of amyloid pathology (CSF -amyloid 42) and neurodegeneration (hippocampal volume on MRI and cortical metabolism on [F-18]-fluorodeoxyglucose-PET) in 201 patients with MCI clinically followed for up to 6 years to detect progressive cognitive deterioration. We categorized patients with MCI as A+/A- and N+/N- based on presence/absence of amyloid pathology and neurodegeneration. SNAPs were A-N+ cases.Results:The proportion of progressors was 11% (8/41), 34% (14/41), 56% (19/34), and 71% (60/85) in A-N-, A+N-, SNAP, and A+N+, respectively; the proportion of APOE epsilon 4 carriers was 29%, 70%, 31%, and 71%, respectively, with the SNAP group featuring a significantly different proportion than both A+N- and A+N+ groups (p 0.005). Hypometabolism in SNAP patients was comparable to A+N+ patients (p = 0.154), while hippocampal atrophy was more severe in SNAP patients (p = 0.002). Compared with A-N-, SNAP and A+N+ patients had significant risk of progressive cognitive deterioration (hazard ratio = 2.7 and 3.8, p = 0.016 and p < 0.001), while A+N- patients did not (hazard ratio = 1.13, p = 0.771). In A+N- and A+N+ groups, none of the biomarkers predicted time to progression. In the SNAP group, lower time to progression was correlated with greater hypometabolism (r = 0.42, p = 0.073).Conclusions:Our findings support the notion that patients with SNAP MCI feature a specific risk progression profile.

Place, publisher, year, edition, pages
2015. Vol. 84, no 5, 508-515 p.
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Neurology
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URN: urn:nbn:se:uu:diva-248195DOI: 10.1212/WNL.0000000000001209ISI: 000349442200016PubMedID: 25568301OAI: oai:DiVA.org:uu-248195DiVA: diva2:799525
Available from: 2015-03-31 Created: 2015-03-30 Last updated: 2017-12-04Bibliographically approved

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Wall, Anders E.

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