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Abstract
Background and Objectives To determine the contribution of cerebral amyloid angiopathy (CAA) to Pittsburgh compound B (PiB)–PET tracer retention.
Methods Participants from the Mayo Clinic Study of Aging and Mayo Clinic Alzheimer's Disease Research Center with antemortem PiB-PET imaging for β-amyloid (Aβ) who later underwent autopsy were included in this study. Pathologic regional leptomeningeal, parenchymal, capillary CAA, and Aβ plaque burden were calculated from one hemisphere. Regional lobar amyloid standardized uptake value ratio (SUVR) on PET was calculated from the same hemisphere sampled at autopsy. Single- and multiple-predictor linear regression models were used to evaluate the relative contributions of pathologically determined regional CAA and Aβ plaques to antemortem PiB-PET SUVR.
Results Forty-one participants (30 male, 11 female) with a mean (SD) age at death of 75.7 (10.6) years were included. Twenty-seven (66%) had high PiB signal with a mean (SD) of 2.3 (1.2) years from time of PET scan to death; 24 (59%) had a pathologic diagnosis of Alzheimer disease. On multivariate analysis, CAA was not associated with PiB-PET SUVR, while plaques remained associated with PiB-PET SUVR in all regions (all p < 0.05). In patients without frequent amyloid plaques, CAA was not associated with PiB-PET in any region.
Discussion We did not find evidence that pathologically confirmed regional CAA burden contributes significantly to proximal antemortem regional PiB-PET signal, suggesting that amyloid PET imaging for measurement of cortical amyloid burden is unconfounded by CAA on a lobar level. Whether CAA burden contributes to PiB-PET signal in patients with severe CAA phenotypes, such as lobar hemorrhage, requires further investigation.
Glossary
- Aβ=
- β-amyloid;
- AD=
- Alzheimer disease;
- ADRC=
- Alzheimer's Disease Research Center;
- CAA=
- cerebral amyloid angiopathy;
- CERAD=
- Consortium to Establish a Registry for Alzheimer's Disease;
- CMB=
- cerebral microbleed;
- D-CAA=
- Dutch-type hereditary cerebral amyloid angiopathy;
- ICH=
- intracerebral hemorrhage;
- MCSA=
- Mayo Clinic Study of Aging;
- PiB=
- Pittsburgh compound B;
- ROI=
- region of interest;
- SUVR=
- standardized uptake ratio
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
- Received March 31, 2021.
- Accepted in final form August 12, 2021.
- © 2021 American Academy of Neurology
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