Cognitive Profile and its Association with Neuroimaging Markers of Non-Demented Cerebral Amyloid Angiopathy Patients in a Stroke Unit

Xiong, Li; Davidsdottir, Sigurros; Reijmer, Yaël D.; Shoamanesh, Ashkan; Roongpiboonsopit, Duangnapa; Thanprasertsuk, Sekh; Martínez-Ramírez, Sergi; Charidimou, Andreas; Ayres, Alison; Fotiadis, Panagiotis; Gurol, M. Edip; Blacker, Deborah; Greenberg, Steven M.; Viswanathan, Anand

doi:10.3233/jad-150890

Cited by 51 publications

(66 citation statements)

References 44 publications

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“…Our literature reviews found only one other paper which systematically assessed neuropsychological test performance in living CAA patients. 28 Concordant with our findings, processing speed and executive function were the most impaired compared with controls. 28 We extend on these prior findings by providing the first comparisons with AD, MCI, and IS patients.…”

Section: Discussionsupporting

confidence: 79%

“…28 Concordant with our findings, processing speed and executive function were the most impaired compared with controls. 28 We extend on these prior findings by providing the first comparisons with AD, MCI, and IS patients. Our findings may be generalized to living patients with CAA-related syndromes; however, in our study, we may have underestimated the severity of cognitive impairment in symptomatic CAA patients because we excluded CAA patients with dementia, aphasia, or visual field deficits, and many CAA patients with ICH do not survive or have severe disabilities and therefore would either not meet eligibility criteria for our study or potentially be less likely to participate.…”

Section: Discussionsupporting

confidence: 79%

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Cerebral Amyloid Angiopathy Is Associated With Executive Dysfunction and Mild Cognitive Impairment

Case

Charlton

Zwiers

et al. 2016

Stroke

100

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Background and Purpose— Autopsy studies suggest that cerebral amyloid angiopathy (CAA) is associated with cognitive impairment and risk for dementia. We analyzed neuropsychological test data from a prospective cohort study of patients with CAA to identify the prevalence of cognitive impairment and its associations with brain magnetic resonance imaging features and the apolipoprotein E genotype. Methods— Data were analyzed from 34 CAA, 16 Alzheimer’s disease, 69 mild cognitive impairment, and 27 ischemic stroke participants. Neuropsychological test results were expressed as z scores in relation to normative data provided by the test manuals and then grouped into domains of memory, executive function, and processing speed. Results— Mean test scores in CAA participants were significantly lower than norms for memory (−0.44±1.03; P =0.02), executive function (−1.14±1.07; P <0.001), and processing speed (−1.06±1.12; P <0.001). Twenty-seven CAA participants (79%) had mild cognitive impairment based on low cognitive performance accompanied by cognitive concerns. CAA participants had similarly low executive function scores as Alzheimer’s disease, but relatively preserved memory. CAA participants’ scores were lower than those of ischemic stroke controls for executive function and processing speed. Lower processing speed scores in CAA were associated with higher magnetic resonance imaging white matter hyperintensity volume. There were no associations with the apolipoprotein E ε4 allele. Conclusions— Mild cognitive impairment is very prevalent in CAA. The overall cognitive profile of CAA is more similar to that seen in vascular cognitive impairment rather than Alzheimer’s disease. White matter ischemic lesions may underlie some of the impaired processing speed in CAA.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionsupporting

confidence: 79%

Cerebral Amyloid Angiopathy Is Associated With Executive Dysfunction and Mild Cognitive Impairment

Case

Charlton

Zwiers

et al. 2016

Stroke

100

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“…Both WMH and MTA are increasingly recognized as core Alzheimer's disease features and as a manifestation of CAA [30]. We found a gradient in WMH extension in all groups [31], but we also found more extended WMH in those subjects fulfilling the mBCAA criteria.…”

Section: Discussionmentioning

confidence: 51%

Cerebral amyloid angiopathy in Down syndrome and sporadic and autosomal‐dominant Alzheimer's disease

Carmona-Iragui

Balasa

Benejam³

et al. 2017

Alzheimer's & Dementia

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Introduction We aimed to investigate if cerebral amyloid angiopathy (CAA) is more frequent in genetically determined than in sporadic early onset forms of Alzheimer disease (EOAD). Methods Neuroimaging features of CAA, APOE, and cerebrospinal fluid-Aβ40 levels were studied in subjects with Down syndrome (DS, n=117), autosomal dominant AD (ADAD, n=29), sporadic EOAD (n=42), and healthy controls (n=68). Results CAA was present in 31%, 38% and 12% of cognitively impaired DS, symptomatic ADAD, and sporadic EOAD subjects, and in 13% and 4% of cognitively unimpaired DS individuals and healthy controls, respectively. APOE-ε4 genotype was borderline significantly associated with CAA in sporadic EOAD (p=0.06), but not with DS or ADAD. There were no differences in Aβ40 levels between groups or between subjects with and without CAA. Discussion CAA is more frequently found in genetically determined AD than in sporadic EOAD. Cerebrospinal fluid-Aβ40 levels are not a useful biomarker for CAA in AD.

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“…; Xiong et al . ) in the absence of clinically symptomatic stroke. In light of this new evidence, it is now appropriate to consider whether CAA is a neurodegenerative disease, as well as a common cause of stroke.…”

mentioning

confidence: 99%

Cerebral amyloid angiopathy as a cause of neurodegeneration

Smith

2017

Journal of Neurochemistry

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Sporadic, age-related cerebral amyloid angiopathy (CAA) is most commonly recognized clinically as a cause of hemorrhagic stroke and transient focal neurological episodes in older persons. But a growing body of research in the last 5 years shows that the pathophysiology of CAA is much more complex than previously believed, leading to many different types of brain injury. CAA has now been linked with brain atrophy in regions remote from those directly affected by intracerebral hematomas, and with risk for progressive cognitive decline in the absence of new hemorrhagic strokes. Therefore, CAA is associated with features -brain atrophy and progressive cognitive decline -that are typically considered hallmarks of neurodegenerative disease. Although CAA is usually accompanied by some degree of Alzheimer's disease pathology, the profiles of cortical thinning and cognitive impairment do not fully overlap with those seen in Alzheimer's disease, suggesting that there are CAA-specific pathways of neurodegeneration. CAA-related brain ischemia may be an important mechanism that leads to brain injury, cortical disconnection, and cognitive impairment.

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Cognitive Profile and its Association with Neuroimaging Markers of Non-Demented Cerebral Amyloid Angiopathy Patients in a Stroke Unit

Abstract: Non-demented patients with CAA had cognitive deficits in multiple areas. Lower TBV was related to slower processing speed and worse executive function.

Cited by 51 publications

References 44 publications

Cerebral Amyloid Angiopathy Is Associated With Executive Dysfunction and Mild Cognitive Impairment

Cerebral Amyloid Angiopathy Is Associated With Executive Dysfunction and Mild Cognitive Impairment

Cerebral amyloid angiopathy in Down syndrome and sporadic and autosomal‐dominant Alzheimer's disease

Cerebral amyloid angiopathy as a cause of neurodegeneration

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