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J Alzheimers Dis. 2016;49(2):387-98. doi: 10.3233/JAD-150181.

Associations between Neuropsychiatric Symptoms and Cerebral Amyloid Deposition in Cognitively Impaired Elderly People.

Author information

1
Centre Memoire de Ressources et de Recherche, Institut Claude Pompidou, EA CoBTek, University of Nice Sophia Antipolis, Nice, France.
2
Department of Nuclear Medicine, Hôpital de La Tour, Meyrin, GE, Switzerland.
3
Department of Psychiatry and Behavioral Sciences, Department of Neurology and Neurological Sciences, Stanford University, Stanford, USA; War Related Illness and Injury Study Center, VA Palo Alto, Palo Alto, USA.
4
Nuclear Medicine Department, Antoine Lacassagne Center, Nice, France.
5
Department of Psychiatry, University Hospital of Nice, France.

Abstract

BACKGROUND:

Neuropsychiatric symptoms, also known as behavioral and psychological symptoms of dementia (BPSD), affect the majority of patients with dementia, and result in a greater cognitive and functional impairment.

OBJECTIVE:

To investigate associations between BPSD and amyloid cerebral deposition as measured by 18F-Florbetapir-PET quantitative uptake in elderly subjects with and without cognitive impairment.

METHODS:

Participants with cognitive impairment [mild cognitive impairment (MCI) or Alzheimer's disease (AD)] and healthy controls (HC) from the ADNI cohort (Alzheimer Disease Neuroimaging Initiative) who underwent an 18F-florbetapir PET scan between May 2010 and March 2014 were included. Clinical assessments included the Clinical Dementia Rating, the Mini-Mental State Examination (MMSE), and the Neuropsychiatric Inventory. Freesurfer software was used to extract PET counts based on T1-based structural ROI (frontal, cingulate, parietal, and temporal). Spearman's partial correlation scores between BPSD severity and regional amyloid uptake were calculated.

RESULTS:

Data for 657 participants [age = 72.6 (7.19); MMSE = 27.4 (2.67)] were analyzed, including 230 HC [age = 73.1 (6.02); MMSE = 29 (1.21)], 308 MCI [age = 71.5 (7.44); MMSE = 28.0 (1.75)], and 119 AD subjects [age = 74.7 (8.05); MMSE = 23.1 (2.08)]. Considering all diagnostic groups together, positive significant correlations were found between anxiety and 18F-florbetapir uptake in the frontal (r = 0.102; p = 0.009), cingulate (r = 0.083; p = 0.034), and global cerebral uptake (r = 0.099; p = 0.011); between irritability and frontal (r = 0.089; p = 0.023), cingulate (r = 0.085; p = 0.030), parietal (r = 0.087; p = 0.025), and global cerebral uptake (r = 0.093; p = 0.017); in the MCI subgroup, between anxiety and frontal (r = 0.126; p = 0.03) and global uptake (r = 0.14; p = 0.013); in the AD subgroup, between irritability and parietal uptake (r = 0.201; p = 0.03).

CONCLUSION:

Anxiety and irritability are associated with greater amyloid deposition in the neurodegenerative process leading to AD.

KEYWORDS:

ADNI; Alzheimer’s disease; amyloid; anxiety; behavioral and psychological symptoms of dementia; cingulate; dementia; frontal; irritability; neuroimaging; neuropsychiatric symptoms

PMID:
26484900
DOI:
10.3233/JAD-150181
[Indexed for MEDLINE]

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