Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Dec 16;9(1):99.
doi: 10.1186/s13195-017-0326-y.

Posterior atrophy predicts time to dementia in patients with amyloid-positive mild cognitive impairment

Jung-Min Pyun  1   2 , Young Ho Park  1   2 , Hang-Rai Kim  3 , Jeewon Suh  1 , Min Ju Kang  1 , Beom Joon Kim  1 , Young Chul Youn  4 , Jae-Won Jang  5 , SangYun Kim  6   7 ; Alzheimer’s Disease Neuroimaging Initiative
Affiliations

Posterior atrophy predicts time to dementia in patients with amyloid-positive mild cognitive impairment

Jung-Min Pyun et al. Alzheimers Res Ther. .

Abstract

Background: In patients with amyloid-positive mild cognitive impairment (MCI), neurodegenerative biomarkers such as medial temporal lobe atrophy (MTA) are useful to predict disease progression to dementia. Although posterior atrophy (PA) is a well-known neurodegenerative biomarker of Alzheimer's disease, little is known about PA as a predictor in patients with amyloid-positive MCI.

Methods: We included 258 patients with amyloid-positive MCI with at least one follow-up visit, and who had low cerebrospinal fluid (CSF) β-amyloid1-42 concentration. Data were obtained from the Alzheimer's Disease Neuroimaging Initiative study. We assessed PA and MTA on magnetic resonance imaging (MRI) using visual rating scales and retrospectively determined progression to dementia during the follow-up period of up to 3 years (median 24 months). The Cox proportional hazards model was used to analyze hazard ratios (HRs) of PA and MTA for disease progression. Additionally, subjects were divided into four groups according to brain atrophy pattern (no atrophy, MTA only, PA only, both MTA and PA), and HRs for disease progression were compared with the no atrophy reference group. Analyses were conducted with and without adjustment for CSF phosphorylated tau181p (p-tau) and baseline demographics.

Results: A total of 123 patients (47.7%) showed MTA and 174 patients (67.4%) showed PA. Of the total cohort, 139 cases (53.9%) progressed to dementia. PA and MTA were associated with an increased risk for progression to dementia (HR 2.244, 95% confidence interval (CI) 1.497-3.364, and HR 1.682, 95% CI 1.203-2.352, respectively). In the analysis according to atrophy pattern, HR (95% CI) for progression was 2.998 (1.443-6.227) in the MTA only group, 3.126 (1.666-5.864) in the PA only group, and 3.814 (2.045-7.110) in both MTA and PA group. These results remained significant after adjustment.

Conclusions: In patients with amyloid-positive MCI, PA could predict progression to dementia independently of MTA.

Keywords: Alzheimer’s disease; Biomarkers; Disease progression; Mild cognitive impairment; Posterior atrophy.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

The study procedures were approved by the institutional review board of all participating centers (http://adni.loni.usc.edu/wp-content/uploads/how_to_apply/ADNI_Acknowledgement_List.pdf) and written informed consent was obtained from all participants or authorized representatives.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Cox proportional hazards model for progression to dementia in amyloid-positive mild cognitive impairment patients according to brain atrophy on MRI. PA (a), MTA (b), and atrophy pattern (no atrophy, MTA only, PA only, both MTA and PA) (c). MTA medial temporal lobe atrophy, PA posterior atrophy
See this image and copyright information in PMC

References

    1. Selkoe DJ, Hardy J. The amyloid hypothesis of Alzheimer’s disease at 25 years. EMBO Mol Med. 2016;8:595–608. doi: 10.15252/emmm.201606210. - DOI - PMC - PubMed
    1. Wolk DA, Price JC, Saxton JA, Snitz BE, James JA, Lopez OL, et al. Amyloid imaging in mild cognitive impairment subtypes. Ann Neurol. 2009;65:557–568. doi: 10.1002/ana.21598. - DOI - PMC - PubMed
    1. Hansson O, Zetterberg H, Buchhave P, Londos E, Blennow K, Minthon L. Association between CSF biomarkers and incipient Alzheimer’s disease in patients with mild cognitive impairment: a follow-up study. Lancet Neurol. 2006;5:228–234. doi: 10.1016/S1474-4422(06)70355-6. - DOI - PubMed
    1. Bateman RJ, Xiong C, Benzinger TL, Fagan AM, Goate A, Fox NC, et al. Clinical and biomarker changes in dominantly inherited Alzheimer’s disease. N Engl J Med. 2012;367:795–804. doi: 10.1056/NEJMoa1202753. - DOI - PMC - PubMed
    1. van Rossum IA, Vos SJ, Burns L, Knol DL, Scheltens P, Soininen H, et al. Injury markers predict time to dementia in subjects with MCI and amyloid pathology. Neurology. 2012;79:1809–1816. doi: 10.1212/WNL.0b013e3182704056. - DOI - PMC - PubMed

MeSH terms