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Emerging β-amyloid pathology and accelerated cortical atrophy
Niklas Mattsson1, Philip S Insel2, Rachel Nosheny3
1Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, California2Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Möl.
JAMA Neurology
|May 1, 2014
Summary
Early beta-amyloid (Aβ) buildup is linked to brain atrophy in cognitively normal individuals, particularly in frontoparietal regions. As Alzheimer's disease (AD) progresses, atrophy accelerates in the hippocampus and temporal regions.
Area of Science:
- Neuroscience
- Neurology
- Biomarkers
Background:
- Beta-amyloid (Aβ) accumulation is a hallmark of Alzheimer's disease (AD), but its effect on early structural brain changes in cognitively normal (CN) individuals is not fully understood.
- Understanding these early changes is crucial for developing timely interventions.
Purpose of the Study:
- To investigate the relationship between the development of Aβ pathology and regional brain atrophy in cognitively normal individuals.
- To determine if early Aβ accumulation predicts future brain structural changes.
Main Methods:
- A longitudinal clinicobiomarker cohort study was conducted with 47 CN individuals and 15 AD dementia patients.
- Participants underwent repeated cerebrospinal fluid Aβ42 measurements and structural MRI for up to 4 years.
- CN individuals were categorized into stable Aβ-negative, declining Aβ-negative, and Aβ-positive groups based on Aβ42 levels.
Main Results:
- No significant differences in baseline gray matter volumes were observed among CN Aβ groups.
- Increased atrophy rates in frontoparietal regions were found in declining Aβ-negative and Aβ-positive CN groups.
- Aβ-positive individuals, including those with AD dementia, showed accelerated atrophy in amygdala, temporal, hippocampal, and cingulate regions.
Conclusions:
- Emerging Aβ pathology is associated with increased atrophy rates in frontoparietal regions in early stages.
- Atrophy patterns evolve, with temporal and hippocampal involvement accelerating as the disease progresses towards dementia.
- Early Aβ pathology may subtly impact frontoparietal integrity, with more pronounced and delayed effects on temporal regions characteristic of AD.
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