Malignant progression in parietal-dominant atrophy subtype of Alzheimer's disease occurs independent of onset age

Na, Han Kyu; Kang, Dae Ryong; Kim, Sung‐Soo; Seo, Sang Won; Heilman, Kenneth M.; Noh, Young; Na, Duk L.

doi:10.1016/j.neurobiolaging.2016.08.001

Cited by 44 publications

(58 citation statements)

References 46 publications

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“…In light of the pattern of atrophy, the AD pathology of the P subtype appears to be centered preferentially along the default mode network. The parietal lobe is well-known to be responsible for higher cortical function in human and thereby associated with high metabolic demand, but at the same time, known as the most vulnerable region due to thin myelination726. When considering that the degree of parietal vulnerability is highly variable across individuals2627, we surmise that patients who show such vulnerability may develop P subtype of AD dementia.…”

Section: Discussionmentioning

confidence: 94%

“…2 and Supplementary Figure S1 upper row)67. In the SMC dataset, we obtained three subtypes: an MT subtype (medial temporal-predominant atrophy, n = 82), P subtype (parietal-predominant atrophy, n = 79), and D subtype (diffuse atrophy, n = 64).…”

Section: Resultsmentioning

confidence: 99%

“…A computational approach to subtyping has been suggested for AD patients via hierarchical clustering analysis678, which computes the similarity between any pair of subjects in terms of cortical thickness of the whole brain67, or a few selected neuroimaging measures8, and then aggregates subjects in order of descending similarity. With an arbitrary threshold of aggregation levels, this produces plausible AD subtypes.…”

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confidence: 99%

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Robust Identification of Alzheimer’s Disease subtypes based on cortical atrophy patterns

Park

Kim

et al. 2017

Sci Rep

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Accumulating evidence suggests that Alzheimer’s disease (AD) is heterogenous and can be classified into several subtypes. Here, we propose a robust subtyping method for AD based on cortical atrophy patterns and graph theory. We calculated similarities between subjects in their atrophy patterns throughout the whole brain, and clustered subjects with similar atrophy patterns using the Louvain method for modular organization extraction. We applied our method to AD patients recruited at Samsung Medical Center and externally validated our method by using the AD Neuroimaging Initiative (ADNI) dataset. Our method categorized very mild AD into three clinically distinct subtypes with high reproducibility (>90%); the parietal-predominant (P), medial temporal-predominant (MT), and diffuse (D) atrophy subtype. The P subtype showed the worst clinical presentation throughout the cognitive domains, while the MT and D subtypes exhibited relatively mild presentation. The MT subtype revealed more impaired language and executive function compared to the D subtype.

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Section: Discussionmentioning

confidence: 94%

Section: Resultsmentioning

confidence: 99%

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confidence: 99%

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Robust Identification of Alzheimer’s Disease subtypes based on cortical atrophy patterns

Park

Kim

et al. 2017

Sci Rep

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“…Second, as our study population was limited to aMCI and mild AD (global CDR score ≤1.0), our findings cannot be generalized or extrapolated to more severely impaired subjects. Third, when considering that AD-driven cortical atrophy is not uniformly distributed throughout the cortices [34], and that high heterogeneity exists across individuals [35,36], it is possible that the percent change in total cGMV may not perfectly serve as a valid standard of disease progression. Fourth, the follow-up interval was not equal among participants.…”

Section: Discussionmentioning

confidence: 99%

Tracking Cognitive Decline in Amnestic Mild Cognitive Impairment and Early-Stage Alzheimer Dementia: Mini-Mental State Examination versus Neuropsychological Battery

Kim

Byun

et al. 2017

Dement Geriatr Cogn Disord

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Background/Aims: Although the Mini-Mental State Examination (MMSE), Clinical Dementia Rating-Sum of Boxes (CDR-SOB), and neuropsychological batteries are widely used for evaluating cognitive function, it remains elusive which instrument best reflects the longitudinal disease progression in amnestic mild cognitive impairment (aMCI) and probable Alzheimer disease (AD). We investigated whether changes in these three instruments over time correlate with loss of cortical gray matter volume (cGMV). Methods: We retrospectively investigated 204 patients (aMCI, n = 114; AD, n = 90) who had undergone MMSE, CDR-SOB, the dementia version of the Seoul Neuropsychological Screening Battery (SNSB-D), and 3-dimensional T1-weighted magnetic resonance images at least twice. We investigated the partial correlation between annual decline in test scores and percent change of cGMV. Results: In aMCI patients, changes in the SNSB-D total score (r = 0.340, p < 0.001) and CDR-SOB (r = 0.222, p = 0.020), but not MMSE, showed a correlation with cGMV loss, with the SNSB-D total score showing the strongest correlation. In AD patients, decline in all three test scores correlated significantly with cGMV loss, with MMSE exhibiting the strongest correlation (r = 0.464, p < 0.001). Conclusion: In aMCI patients, neuropsychological battery, though time-consuming, was the most adequate tool in tracking disease progression. In AD patients, however, MMSE may be the most effective longitudinal monitoring tool when considering cost-effectiveness.

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“…30 According to the concept of cognitive reserve, individuals with higher cognitive reserve have more advanced neuropathology in the brain at the same degree of cognitive impairment and a more rapid rate of disease progression than individuals with lower cognitive reserve. 37 Thus, the results of our study might indicate that in AD patients, PA represents more advanced pathology with respect for cognitive reserve. 36 For example, a previous study using cortical thickness cluster analysis showed that AD patients with parietaldominant atrophy exhibited a faster rate of cognitive decline than AD patients with medial temporal dominant atrophy or diffuse brain atrophy.…”

Section: Discussionmentioning

confidence: 59%

The usefulness of visual rating of posterior atrophy in predicting rapid cognitive decline in Alzheimer disease: A preliminary study

Suh

Park

Kim³

et al. 2019

Int J Geriat Psychiatry

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Background Approximately 10% to 30% of Alzheimer disease (AD) patients progress rapidly in severity and become more dependent on caregivers. Although several studies have investigated whether imaging biomarkers such as medial temporal atrophy (MTA) and posterior atrophy (PA) are useful for predicting the rapid progression of AD, their results have been inconsistent. Objective The study aims to investigate the association of visually rated MTA and PA with rapid disease progression in AD. Methods This was a retrospective cohort study of 159 AD patients who were initially diagnosed with mild AD and were followed for 1 year to determine whether they progressed rapidly (a decrease of three points or more on the Mini‐Mental State Examination over 1 year). We used 5‐point and 4‐point visual rating scales to assess MTA and PA, respectively. MTA and PA scores for each patient were dichotomized as normal (without atrophy) or abnormal (atrophy). We performed a logistic regression analysis to determine the odds ratios (ORs) of MTA and PA for rapid disease progression with adjustment for covariates. Results Within the study population, 47 (29.6%) patients progressed rapidly. Visual assessment of the magnetic resonance imaging (MRI) scans revealed that 112 patients (70.4%) showed MTA, whereas 80 patients (50.3%) showed PA. The ORs with 95% confidence intervals for MTA and PA were 1.825 (0.819‐4.070) and 2.844 (1.378‐5.835), respectively. The association of visually assessed PA, but not MTA, with rapid progression was significant after adjustment for covariates. Conclusion In patients with mild AD, visual assessment of PA exhibits independent predictive value for rapid disease progression.

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Malignant progression in parietal-dominant atrophy subtype of Alzheimer's disease occurs independent of onset age

Cited by 44 publications

References 46 publications

Robust Identification of Alzheimer’s Disease subtypes based on cortical atrophy patterns

Robust Identification of Alzheimer’s Disease subtypes based on cortical atrophy patterns

Tracking Cognitive Decline in Amnestic Mild Cognitive Impairment and Early-Stage Alzheimer Dementia: Mini-Mental State Examination versus Neuropsychological Battery

The usefulness of visual rating of posterior atrophy in predicting rapid cognitive decline in Alzheimer disease: A preliminary study

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