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Abstract
Background: Subcortical vascular dementia (SVaD) is considered the most common type of vascular dementia and often follows a slowly progressive course, simulating Alzheimer disease (AD). Whether the progressive cognitive decline is associated with pure SVaD or concomitant AD remains unknown. The purpose of this study was to determine what proportion of patients with SVaD lack abnormal amyloid imaging, and to examine differences in the clinical or MRI features between subjects with SVaD with cortical amyloid deposition and those without.
Methods: We measured brain amyloid deposition using 11C-Pittsburgh compound B (PiB) PET in 45 patients (men: women = 19:26; mean age 74.2 ± 7.6 years) with SVaD. They all met DSM-IV criteria for vascular dementia and had severe white matter high signal intensities without territorial infarction or macrohemorrhage on MRI.
Results: Thirty-one (68.9%) of 45 patients with SVaD were negative for cortical PiB binding. There was significant difference between 11C-PiB-positive and 11C-PiB-negative groups in terms of age (79.5 vs 71.9 years), Mini-Mental State Examination score (18.6 vs 22.6), the number of lacunes (3.9 vs 9.0), and the visual rating scale of hippocampal atrophy (3.1 vs 2.3). The neuropsychological assessments revealed that patients with 11C-PiB-negative SVaD performed better on the delayed recall of both the verbal and visual memory test than did those with 11C-PiB-positive scan.
Conclusion: SVaD without abnormal amyloid imaging was more common than expected. Patients with SVaD with and without abnormal amyloid imaging differed in clinical and MRI features, although there was considerable overlap.
Footnotes
Study funding: Supported by the Korea Healthcare Technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea (A050079), the Asan Institute for Life Sciences (2006-159), and the Converging Research Center Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2010K001054).
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Editorial, page 12
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Supplemental data at www.neurology.org
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- Aβ=
- β-amyloid;
- AD=
- Alzheimer disease;
- AMPETIS=
- Amyloid PET Imaging for Subcortical Vascular Dementia study;
- CAA=
- cerebral amyloid angiopathy;
- CREDOS=
- Clinical Research Center for Dementia of South Korea;
- CVD=
- cerebrovascular disorder;
- DSM-IV=
- Diagnostic and Statistical Manual of Mental Disorders, 4th edition;
- FFE=
- fast field echo;
- FLAIR=
- fluid-attenuated inversion recovery;
- MMSE=
- Mini-Mental State Examination;
- MTA=
- medial temporal lobe atrophy;
- NINCDS-ADRDA=
- National Institute of Neurological and Communicative Disorders and Stroke–Alzheimer's Disease and Related Disorders Association;
- PEPS=
- Pyramidal and Extrapyramidal Scale;
- PiB=
- Pittsburgh compound B;
- ROI=
- region of interest;
- SPM=
- statistical parametric mapping;
- SVaD=
- subcortical vascular dementia;
- WMHS=
- white matter high signal intensities.
- Received September 24, 2010.
- Accepted December 22, 2010.
- Copyright © 2011 by AAN Enterprises, Inc.
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