Clinical outcomes up to 9 years after [18F]flutemetamol amyloid-PET in a symptomatic memory clinic population
Abstract Background Previous studies demonstrated increases in diagnostic confidence and change in patient management after amyloid-PET. However, studies investigating longitudinal outcomes over an extended period of time are limited. Therefore, we aimed to investigate clinical outcomes up to 9 year...
| Päätekijät: | , , , , , , , , , |
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| Aineistotyyppi: | Artikkeli |
| Kieli: | English |
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BMC
2023-11-01
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| Sarja: | Alzheimer’s Research & Therapy |
| Aiheet: | |
| Linkit: | https://doi.org/10.1186/s13195-023-01351-1 |
| _version_ | 1827604188709781504 |
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| author | Lyduine E. Collij Gill Farrar Marissa Zwan Elsmarieke van de Giessen Rik Ossenkoppele Frederik Barkhof Annemieke J. M. Rozemuller Yolande A. L. Pijnenburg Wiesje M. van der Flier Femke Bouwman |
| author_facet | Lyduine E. Collij Gill Farrar Marissa Zwan Elsmarieke van de Giessen Rik Ossenkoppele Frederik Barkhof Annemieke J. M. Rozemuller Yolande A. L. Pijnenburg Wiesje M. van der Flier Femke Bouwman |
| author_sort | Lyduine E. Collij |
| collection | DOAJ |
| description | Abstract Background Previous studies demonstrated increases in diagnostic confidence and change in patient management after amyloid-PET. However, studies investigating longitudinal outcomes over an extended period of time are limited. Therefore, we aimed to investigate clinical outcomes up to 9 years after amyloid-PET to support the clinical validity of the imaging technique. Methods We analyzed longitudinal data from 200 patients (M age = 61.8, 45.5% female, M MMSE = 23.3) suspected of early-onset dementia that underwent [18F]flutemetamol-PET. Baseline amyloid status was determined through visual read (VR). Information on mortality was available with a mean follow-up of 6.7 years (range = 1.1–9.3). In a subset of 108 patients, longitudinal cognitive scores and clinical etiological diagnosis (eDx) at least 1 year after amyloid-PET acquisition were available (M = 3.06 years, range = 1.00–7.02). VR − and VR + patients were compared on mortality rates with Cox Hazard’s model, prevalence of stable eDx using chi-square test, and longitudinal cognition with linear mixed models. Neuropathological data was available for 4 patients (mean delay = 3.59 ± 1.82 years, range = 1.2–6.3). Results At baseline, 184 (92.0%) patients were considered to have dementia. The majority of VR + patients had a primary etiological diagnosis of AD (122/128, 95.3%), while the VR − group consisted mostly of non-AD etiologies, most commonly frontotemporal lobar degeneration (30/72, 40.2%). Overall mortality rate was 48.5% and did not differ between VR − and VR + patients. eDx at follow-up was consistent with baseline diagnosis for 92/108 (85.2%) patients, with most changes observed in VR − cases (VR − = 14/35, 40% vs VR + = 2/73, 2.7%, χ 2 = 26.03, p < 0.001), who at no time received an AD diagnosis. VR + patients declined faster than VR − patients based on MMSE (β = − 1.17, p = 0.004), episodic memory (β = − 0.78, p = 0.003), fluency (β = − 1.44, p < 0.001), and attention scores (β = 16.76, p = 0.03). Amyloid-PET assessment was in line with post-mortem confirmation in all cases; two cases were VR + and showed widespread AD pathology, while the other two cases were VR − and showed limited amyloid pathology. Conclusion In a symptomatic population, we observed that amyloid-status did not impact mortality rates, but is predictive of cognitive functioning over time across several domains. Also, we show particular validity for a negative amyloid-PET assessment, as these patients did not receive an AD diagnosis at follow-up. |
| first_indexed | 2024-03-09T05:54:30Z |
| format | Article |
| id | doaj.art-9ccb9c1fcbc94c9aaed34a13510d738f |
| institution | Directory Open Access Journal |
| issn | 1758-9193 |
| language | English |
| last_indexed | 2024-03-09T05:54:30Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Alzheimer’s Research & Therapy |
| spelling | doaj.art-9ccb9c1fcbc94c9aaed34a13510d738f2023-12-03T12:14:35ZengBMCAlzheimer’s Research & Therapy1758-91932023-11-0115111010.1186/s13195-023-01351-1Clinical outcomes up to 9 years after [18F]flutemetamol amyloid-PET in a symptomatic memory clinic populationLyduine E. Collij0Gill Farrar1Marissa Zwan2Elsmarieke van de Giessen3Rik Ossenkoppele4Frederik Barkhof5Annemieke J. M. Rozemuller6Yolande A. L. Pijnenburg7Wiesje M. van der Flier8Femke Bouwman9Department of Radiology and Nuclear Medicine, Amsterdam UMC – location VUmcGE HealthcareAlzheimer Center and Department of Neurology, Amsterdam UMC – location VUmcDepartment of Radiology and Nuclear Medicine, Amsterdam UMC – location VUmcClinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund UniversityDepartment of Radiology and Nuclear Medicine, Amsterdam UMC – location VUmcDepartment of Pathology, Amsterdam UMC – Location VUmcAlzheimer Center and Department of Neurology, Amsterdam UMC – location VUmcAlzheimer Center and Department of Neurology, Amsterdam UMC – location VUmcAlzheimer Center and Department of Neurology, Amsterdam UMC – location VUmcAbstract Background Previous studies demonstrated increases in diagnostic confidence and change in patient management after amyloid-PET. However, studies investigating longitudinal outcomes over an extended period of time are limited. Therefore, we aimed to investigate clinical outcomes up to 9 years after amyloid-PET to support the clinical validity of the imaging technique. Methods We analyzed longitudinal data from 200 patients (M age = 61.8, 45.5% female, M MMSE = 23.3) suspected of early-onset dementia that underwent [18F]flutemetamol-PET. Baseline amyloid status was determined through visual read (VR). Information on mortality was available with a mean follow-up of 6.7 years (range = 1.1–9.3). In a subset of 108 patients, longitudinal cognitive scores and clinical etiological diagnosis (eDx) at least 1 year after amyloid-PET acquisition were available (M = 3.06 years, range = 1.00–7.02). VR − and VR + patients were compared on mortality rates with Cox Hazard’s model, prevalence of stable eDx using chi-square test, and longitudinal cognition with linear mixed models. Neuropathological data was available for 4 patients (mean delay = 3.59 ± 1.82 years, range = 1.2–6.3). Results At baseline, 184 (92.0%) patients were considered to have dementia. The majority of VR + patients had a primary etiological diagnosis of AD (122/128, 95.3%), while the VR − group consisted mostly of non-AD etiologies, most commonly frontotemporal lobar degeneration (30/72, 40.2%). Overall mortality rate was 48.5% and did not differ between VR − and VR + patients. eDx at follow-up was consistent with baseline diagnosis for 92/108 (85.2%) patients, with most changes observed in VR − cases (VR − = 14/35, 40% vs VR + = 2/73, 2.7%, χ 2 = 26.03, p < 0.001), who at no time received an AD diagnosis. VR + patients declined faster than VR − patients based on MMSE (β = − 1.17, p = 0.004), episodic memory (β = − 0.78, p = 0.003), fluency (β = − 1.44, p < 0.001), and attention scores (β = 16.76, p = 0.03). Amyloid-PET assessment was in line with post-mortem confirmation in all cases; two cases were VR + and showed widespread AD pathology, while the other two cases were VR − and showed limited amyloid pathology. Conclusion In a symptomatic population, we observed that amyloid-status did not impact mortality rates, but is predictive of cognitive functioning over time across several domains. Also, we show particular validity for a negative amyloid-PET assessment, as these patients did not receive an AD diagnosis at follow-up.https://doi.org/10.1186/s13195-023-01351-1[18F]flutemetamol amyloid-PETEarly-onset dementiaDiagnosisSurvivalNeuropathology |
| spellingShingle | Lyduine E. Collij Gill Farrar Marissa Zwan Elsmarieke van de Giessen Rik Ossenkoppele Frederik Barkhof Annemieke J. M. Rozemuller Yolande A. L. Pijnenburg Wiesje M. van der Flier Femke Bouwman Clinical outcomes up to 9 years after [18F]flutemetamol amyloid-PET in a symptomatic memory clinic population Alzheimer’s Research & Therapy [18F]flutemetamol amyloid-PET Early-onset dementia Diagnosis Survival Neuropathology |
| title | Clinical outcomes up to 9 years after [18F]flutemetamol amyloid-PET in a symptomatic memory clinic population |
| title_full | Clinical outcomes up to 9 years after [18F]flutemetamol amyloid-PET in a symptomatic memory clinic population |
| title_fullStr | Clinical outcomes up to 9 years after [18F]flutemetamol amyloid-PET in a symptomatic memory clinic population |
| title_full_unstemmed | Clinical outcomes up to 9 years after [18F]flutemetamol amyloid-PET in a symptomatic memory clinic population |
| title_short | Clinical outcomes up to 9 years after [18F]flutemetamol amyloid-PET in a symptomatic memory clinic population |
| title_sort | clinical outcomes up to 9 years after 18f flutemetamol amyloid pet in a symptomatic memory clinic population |
| topic | [18F]flutemetamol amyloid-PET Early-onset dementia Diagnosis Survival Neuropathology |
| url | https://doi.org/10.1186/s13195-023-01351-1 |
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