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Abstract
Objective: To examine neurodegenerative imaging biomarkers in Alzheimer disease (AD) dementia from middle to old age.
Methods: Persons with AD dementia and elevated brain β-amyloid with Pittsburgh compound B (PiB)-PET imaging underwent [18F]-fluorodeoxyglucose (FDG)-PET and structural MRI. We evaluated 3 AD-related neurodegeneration biomarkers: hippocampal volume adjusted for total intracranial volume (HVa), FDG standardized uptake value ratio (SUVR) in regions of interest linked to AD, and cortical thickness in AD-related regions of interest. We examined associations of each biomarker with age and evaluated age effects on cutpoints defined by the 90th percentile in AD dementia. We assembled an age-, sex-, and intracranial volume-matched group of 194 similarly imaged clinically normal (CN) persons.
Results: The 97 participants with AD dementia (aged 49–93 years) had PiB SUVR ≥1.8. A nonlinear (inverted-U) relationship between FDG SUVR and age was seen in the AD group but an inverse linear relationship with age was seen in the CN group. Cortical thickness had an inverse linear relationship with age in AD but a nonlinear (flat, then inverse linear) relationship in the CN group. HVa showed an inverse linear relationship with age in both AD and CN groups. Age effects on 90th percentile cutpoints were small for FDG SUVR and cortical thickness, but larger for HVa.
Conclusions: In persons with AD dementia with elevated PiB SUVR, values of each neurodegeneration biomarker were associated with age. Cortical thickness had the smallest differences in 90th percentile cutpoints from middle to old age, and HVa the largest differences.
GLOSSARY
- AD=
- Alzheimer disease;
- CDR=
- Clinical Dementia Rating;
- CDR-SB=
- Clinical Dementia Rating–Sum of Boxes;
- CI=
- confidence interval;
- CN=
- clinically normal;
- FDG=
- [18F]-fluorodeoxyglucose;
- HVa=
- adjusted hippocampal volume;
- MCSA=
- Mayo Clinic Study of Aging;
- MMSE=
- Mini-Mental State Examination;
- PiB=
- Pittsburgh compound B;
- ROI=
- region of interest;
- SUVR=
- standardized uptake value ratio;
- TIV=
- total intracranial volume
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at Neurology.org
- Received December 23, 2015.
- Accepted in final form May 9, 2016.
- © 2016 American Academy of Neurology
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