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Emerging role of vascular burden in AT(N) classification in individuals with Alzheimer’s and concomitant cerebrovascular burdens

Authors :
Chun, Min Young
Jang, Hyemin
Kim, Soo-Jong
Park, Yu Hyun
Yun, Jihwan
Lockhart, Samuel N
Weiner, Michael
De Carli, Charles
Moon, Seung Hwan
Choi, Jae Yong
Nam, Kyung Rok
Byun, Byung-Hyun
Lim, Sang-Moo
Kim, Jun Pyo
Choe, Yeong Sim
Kim, Young Ju
Na, Duk L
Kim, Hee Jin
Seo, Sang Won
Source :
Journal of Neurology, Neurosurgery, & Psychiatry (JNNP); 2024, Vol. 95 Issue: 1 p44-51, 8p
Publication Year :
2024

Abstract

ObjectivesAlzheimer’s disease (AD) is characterised by amyloid-beta accumulation (A), tau aggregation (T) and neurodegeneration (N). Vascular (V) burden has been found concomitantly with AD pathology and has synergistic effects on cognitive decline with AD biomarkers. We determined whether cognitive trajectories of AT(N) categories differed according to vascular (V) burden.MethodsWe prospectively recruited 205 participants and classified them into groups based on the AT(N) system using neuroimaging markers. Abnormal V markers were identified based on the presence of severe white matter hyperintensities.ResultsIn A+ category, compared with the frequency of Alzheimer’s pathological change category (A+T–), the frequency of AD category (A+T+) was significantly lower in V+ group (31.8%) than in V– group (64.4%) (p=0.004). Each AT(N) biomarker was predictive of cognitive decline in the V+ group as well as in the V– group (p<0.001). Additionally, the V+ group showed more severe cognitive trajectories than the V– group in the non-Alzheimer’s pathological changes (A–T+, A–N+; p=0.002) and Alzheimer’s pathological changes (p<0.001) categories.ConclusionThe distribution and longitudinal outcomes of AT(N) system differed according to vascular burdens, suggesting the importance of incorporating a V biomarker into the AT(N) system.

Details

Language :
English
ISSN :
00223050 and 1468330X
Volume :
95
Issue :
1
Database :
Supplemental Index
Journal :
Journal of Neurology, Neurosurgery, & Psychiatry (JNNP)
Publication Type :
Periodical
Accession number :
ejs64905272
Full Text :
https://doi.org/10.1136/jnnp-2023-331603