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Longitudinal Accumulation of Cerebral Microhemorrhages in Dominantly Inherited Alzheimer Disease
- Source :
- Neurology 96(12), e1632-e1645 (2021). doi:10.1212/WNL.0000000000011542, Neurology, article-version (Version of Record) 3
- Publication Year :
- 2021
- Publisher :
- Ovid, 2021.
-
Abstract
- ObjectiveTo investigate the inherent clinical risks associated with the presence of cerebral microhemorrhages (CMHs) or cerebral microbleeds and characterize individuals at high risk for developing hemorrhagic amyloid-related imaging abnormality (ARIA-H), we longitudinally evaluated families with dominantly inherited Alzheimer disease (DIAD).MethodsMutation carriers (n = 310) and noncarriers (n = 201) underwent neuroimaging, including gradient echo MRI sequences to detect CMHs, and neuropsychological and clinical assessments. Cross-sectional and longitudinal analyses evaluated relationships between CMHs and neuroimaging and clinical markers of disease.ResultsThree percent of noncarriers and 8% of carriers developed CMHs primarily located in lobar areas. Carriers with CMHs were older, had higher diastolic blood pressure and Hachinski ischemic scores, and more clinical, cognitive, and motor impairments than those without CMHs. APOE ε4 status was not associated with the prevalence or incidence of CMHs. Prevalent or incident CMHs predicted faster change in Clinical Dementia Rating although not composite cognitive measure, cortical thickness, hippocampal volume, or white matter lesions. Critically, the presence of 2 or more CMHs was associated with a significant risk for development of additional CMHs over time (8.95 ± 10.04 per year).ConclusionOur study highlights factors associated with the development of CMHs in individuals with DIAD. CMHs are a part of the underlying disease process in DIAD and are significantly associated with dementia. This highlights that in participants in treatment trials exposed to drugs, which carry the risk of ARIA-H as a complication, it may be challenging to separate natural incidence of CMHs from drug-related CMHs.
- Subjects :
- 0301 basic medicine
Adult
Male
medicine.medical_specialty
Clinical Dementia Rating
Disease
epidemiology [Cerebral Hemorrhage]
Article
03 medical and health sciences
pathology [Alzheimer Disease]
0302 clinical medicine
Neuroimaging
Alzheimer Disease
pathology [Brain]
Internal medicine
medicine
Dementia
Humans
ddc:610
Longitudinal Studies
Cerebral Hemorrhage
pathology [Cerebral Hemorrhage]
business.industry
Incidence (epidemiology)
Neuropsychology
Brain
complications [Alzheimer Disease]
Middle Aged
medicine.disease
etiology [Cerebral Hemorrhage]
Magnetic Resonance Imaging
Hyperintensity
030104 developmental biology
Female
Neurology (clinical)
Alzheimer's disease
business
030217 neurology & neurosurgery
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Neurology 96(12), e1632-e1645 (2021). doi:10.1212/WNL.0000000000011542, Neurology, article-version (Version of Record) 3
- Accession number :
- edsair.doi.dedup.....3edb893204d0bbc0bc95a1a0a2549e28
- Full Text :
- https://doi.org/10.1212/WNL.0000000000011542