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Grey zone amyloid burden affects memory function: the SCIENCe project.

J L Ebenau1, S C J Verfaillie2, K A van den Bosch3

  • 1Alzheimer Centre, Department of Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands. j.ebenau@amsterdamumc.nl.

European Journal of Nuclear Medicine and Molecular Imaging
|September 5, 2020
PubMed
Summary
This summary is machine-generated.

This study defines a "grey zone" for amyloid beta accumulation, finding that even this intermediate level subtly impacts memory. Researchers suggest using a lower threshold for amyloid positivity to include this grey zone in clinical assessments.

Keywords:
AmyloidCognitionGrey zoneSubjective cognitive decline[18F] florbetapir

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Area of Science:

  • Neuroscience
  • Biomarkers
  • Cognitive Aging

Background:

  • Amyloid beta (Aβ) pathology is a key hallmark of Alzheimer's disease.
  • Establishing precise thresholds for Aβ accumulation is crucial for early detection and intervention.
  • Understanding the clinical relevance of early-stage Aβ is essential for managing cognitive decline.

Purpose of the Study:

  • To determine thresholds for amyloid beta (Aβ) pathology using PET imaging.
  • To evaluate the association between varying levels of Aβ accumulation and longitudinal memory performance.
  • To identify and investigate the clinical relevance of a "grey zone" of early Aβ accumulation.

Main Methods:

  • 162 cognitively normal individuals with subjective cognitive decline underwent [18F]florbetapir PET scans and MRI.
  • Amyloid positivity was assessed visually and quantitatively using binding potential (BPND) and standardized uptake value ratio (SUVR).
  • Data-driven methods defined six Aβ positivity thresholds, and a "grey zone" was operationalized (0.19-0.29 BPND / 1.28-1.43 SUVR).
  • Linear mixed models analyzed the relationship between Aβ load and memory decline (RAVLT delayed recall).

Main Results:

  • 24% of participants were visually amyloid positive; quantitative thresholds showed good concordance.
  • All determined Aβ thresholds, including the grey zone, were associated with memory decline.
  • Memory decline steepened progressively with increasing amyloid load.
  • Individuals in the grey zone showed intermediate memory performance between healthy and high amyloid groups.

Conclusions:

  • Both high and intermediate (grey zone) amyloid beta burden subtly impact memory function.
  • A relatively low threshold for amyloid positivity is recommended for binary classification to include grey zone pathology.
  • This approach may improve the identification of individuals at risk for cognitive decline.