1. Extracranial carotid atherosclerosis is associated with increased neurofibrillary tangle accumulation.
- Author
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Arias JC, Edwards M, Vitali F, Beach TG, Serrano GE, and Weinkauf CC
- Subjects
- Aged, Aged, 80 and over, Alzheimer Disease diagnosis, Alzheimer Disease pathology, CA1 Region, Hippocampal pathology, Cerebral Amyloid Angiopathy diagnosis, Cerebral Amyloid Angiopathy pathology, Cognitive Dysfunction diagnosis, Cognitive Dysfunction pathology, Entorhinal Cortex pathology, Humans, Longitudinal Studies, Male, Middle Aged, Plaque, Amyloid diagnosis, Plaque, Amyloid pathology, Prospective Studies, Risk Assessment statistics & numerical data, Risk Factors, Alzheimer Disease epidemiology, Carotid Artery Diseases epidemiology, Cerebral Amyloid Angiopathy epidemiology, Cognitive Dysfunction epidemiology, Neurofibrillary Tangles pathology, Plaque, Amyloid epidemiology
- Abstract
Objective: We sought to determine whether extracranial carotid atherosclerotic disease (ECAD) is associated with increased key neurodegenerative pathology such as neurofibrillary tangle (NFT), beta-amyloid plaque, or cerebral amyloid angiopathy (CAA) accumulation, findings associated with Alzheimer's disease (AD) and other dementias., Methods: Our prospective, longitudinal, clinicopathologic study, the AZSAND (Arizona study of aging and neurodegenerative disorders) and Brain and Body Donation Program, recorded the presence or absence of clinically diagnosed ECAD and performed semiquantitative density estimates of NFT, beta-amyloid plaque, and CAA at death. After adjusting for potential confounding factors determined by logistic regression analysis, histopathology density scores were evaluated in individuals with ECAD (n = 66) and those without ECAD (n = 125)., Results: We found that the presence of ECAD was associated with a 21% greater NFT burden at death compared with no ECAD (P = .02). Anatomically, an increased NFT burden was seen throughout the brain regions evaluated but was significant in the temporal lobe (P < .05) and entorhinal cortex (P = .02). In addition, we found that subjects who had undergone carotid endarterectomy (CEA), the surgical treatment of ECAD (n = 32), had decreased NFT densities compared with those with ECAD who had not undergone CEA (n = 66; P = .04). In contrast to NFT, ECAD was not associated with beta-amyloid plaques or CAA density., Conclusions: These findings indicate that ECAD is associated with the NFT burden in the temporal lobe and entorhinal cortex, which has clinical significance for AD and non-AD dementias and cognitive dysfunction. Further understanding of whether ECAD increases the risk of neurodegenerative brain changes is highly relevant because ECAD is a treatable disease that has not, otherwise, been evaluated for nor specifically treated as a dementia risk factor., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)
- Published
- 2022
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