1. Cerebral Amyloid Angiopathy and Cerebral Amyloid Angiopathy-Related Inflammation: Comparison of Hemorrhagic and DWI MRI Features
- Author
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Lavinia Tatu, Xavier Ayrignac, Nicolas Gaillard, Sylvain Lehmann, Mahmoud Charif, Eric Thouvenot, Yassine Boukriche, Souhayla Azakri, Anne Wacongne, Laurent Collombier, Genevieve Fourcade, Dimitri Renard, Laura Chiper, Erick Mercier, Université de Montpellier (UM), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Hôpital Universitaire Carémeau [Nîmes] (CHU Nîmes), Département de neurologie [Montpellier], Hôpital Gui de Chauliac [Montpellier]-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires (EA 2992), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut de Génomique Fonctionnelle (IGF), and Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS)
- Subjects
Male ,0301 basic medicine ,Apolipoprotein E ,[SDV]Life Sciences [q-bio] ,Gastroenterology ,Cohort Studies ,0302 clinical medicine ,Cerebrospinal fluid ,Image Processing, Computer-Assisted ,ComputingMilieux_MISCELLANEOUS ,Aged, 80 and over ,General Neuroscience ,General Medicine ,Middle Aged ,Superficial siderosis ,3. Good health ,Psychiatry and Mental health ,Clinical Psychology ,Female ,Cerebral amyloid angiopathy ,Vasculitis ,medicine.medical_specialty ,tau Proteins ,Standardized uptake value ,03 medical and health sciences ,Apolipoproteins E ,Fluorodeoxyglucose F18 ,Internal medicine ,mental disorders ,medicine ,Humans ,cardiovascular diseases ,Florbetaben ,Aged ,Cerebral Hemorrhage ,Intracerebral hemorrhage ,Amyloid beta-Peptides ,business.industry ,nutritional and metabolic diseases ,medicine.disease ,Peptide Fragments ,Cerebral Amyloid Angiopathy ,Diffusion Magnetic Resonance Imaging ,030104 developmental biology ,ROC Curve ,Positron-Emission Tomography ,Geriatrics and Gerontology ,business ,030217 neurology & neurosurgery - Abstract
BACKGROUND Cerebral amyloid angiopathy (CAA) can be associated with primary vasculitis of small/medium-sized leptomeningeal and cortical arteries, called CAA-related inflammation (CAA-ri). OBJECTIVE To compare hemorrhagic and diffusion-weighted imaging (DWI) MRI features in CAA and CAA-ri. METHODS We prospectively scored in a consecutive CAA and CAA-ri cohort: presence/number of chronic intracerebral hemorrhage (ICH), cerebral microbleeds (CMB), and cortical superficial siderosis (CSS) on initial T2*-weighted imaging, and DWI lesions on both initial and follow-up imaging. In a subgroup, ApoE, CSF, and 18F-florbetaben-positron emission tomography (FBB-PET) were also analyzed. RESULTS In CAA-ri, CMB presence was more frequent (100% versus 40%, p < 0.001) and CMB numbers higher (mean 137 versus 8, p < 0.001). No difference was observed for chronic ICH or CSS. DWI lesions were more frequent in acute compared to chronic CAA-ri (p = 0.025), whereas no such difference was observed between acute and chronic CAA (p = 0.18). Both ApoE4 (genotyping available in 22 CAA-ri and 48 CAA patients) carriers and homozygosity were more frequent in CAA-ri (48% versus 19% [p = 0.014] and 32% versus 2% [p < 0.001] respectively). CSF biomarker analyses (performed in 20 CAA-ri and 45 CAA patients) showed lower Aβ42 levels in CAA-ri compared to CAA (median 312 versus 422 pg/mL, p = 0.0032). FBB-PET (performed in 11 CAA-ri and 20 CAA patients) showed higher standardized uptake value ratios in CAA-ri compared with CAA, only significant when the pons was used as reference (p = 0.037). CONCLUSION Compared to CAA, CAA-ri was associated with higher CMB numbers, more frequent ApoE4 carriers and homozygotes, lower CSF Aβ42 levels, and more severe amyloid load on FBB-PET.
- Published
- 2018
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