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Distinct tau PET patterns in atrophy-defined subtypes of Alzheimer's disease

Ossenkoppele, Rik LU ; Lyoo, Chul Hyoung ; Sudre, Carole H. ; van Westen, Danielle LU ; Cho, Hanna ; Ryu, Young Hoon ; Choi, Jae Yong ; Smith, Ruben LU ; Strandberg, Olof LU and Palmqvist, Sebastian LU , et al. (2020) In Alzheimer's and Dementia 16(2). p.335-344
Abstract

Introduction: Differential patterns of brain atrophy on structural magnetic resonance imaging (MRI) revealed four reproducible subtypes of Alzheimer's disease (AD): (1) “typical”, (2) “limbic-predominant”, (3) “hippocampal-sparing”, and (4) “mild atrophy”. We examined the neurobiological characteristics and clinical progression of these atrophy-defined subtypes. Methods: The four subtypes were replicated using a clustering method on MRI data in 260 amyloid-β–positive patients with mild cognitive impairment or AD dementia, and we subsequently tested whether the subtypes differed on [18F]flortaucipir (tau) positron emission tomography, white matter hyperintensity burden, and rate of global cognitive decline. Results: Voxel-wise... (More)

Introduction: Differential patterns of brain atrophy on structural magnetic resonance imaging (MRI) revealed four reproducible subtypes of Alzheimer's disease (AD): (1) “typical”, (2) “limbic-predominant”, (3) “hippocampal-sparing”, and (4) “mild atrophy”. We examined the neurobiological characteristics and clinical progression of these atrophy-defined subtypes. Methods: The four subtypes were replicated using a clustering method on MRI data in 260 amyloid-β–positive patients with mild cognitive impairment or AD dementia, and we subsequently tested whether the subtypes differed on [18F]flortaucipir (tau) positron emission tomography, white matter hyperintensity burden, and rate of global cognitive decline. Results: Voxel-wise and region-of-interest analyses revealed the greatest neocortical tau load in hippocampal-sparing (frontoparietal-predominant) and typical (temporal-predominant) patients, while limbic-predominant patients showed particularly high entorhinal tau. Typical patients with AD had the most pronounced white matter hyperintensity load, and hippocampal-sparing patients showed the most rapid global cognitive decline. Discussion: Our data suggest that structural MRI can be used to identify biologically and clinically meaningful subtypes of AD.

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publication status
published
subject
keywords
Alzheimer's disease, Atrophy, Cognition, Dementia, Subtypes, Tau, Thickness
in
Alzheimer's and Dementia
volume
16
issue
2
pages
10 pages
publisher
Elsevier
external identifiers
  • pmid:31672482
  • scopus:85074418989
ISSN
1552-5260
DOI
10.1016/j.jalz.2019.08.201
language
English
LU publication?
yes
id
3fd4cd77-1974-4a9b-b83a-89066d9a119f
date added to LUP
2019-11-22 13:11:33
date last changed
2020-03-16 11:06:02
@article{3fd4cd77-1974-4a9b-b83a-89066d9a119f,
  abstract     = {<p>Introduction: Differential patterns of brain atrophy on structural magnetic resonance imaging (MRI) revealed four reproducible subtypes of Alzheimer's disease (AD): (1) “typical”, (2) “limbic-predominant”, (3) “hippocampal-sparing”, and (4) “mild atrophy”. We examined the neurobiological characteristics and clinical progression of these atrophy-defined subtypes. Methods: The four subtypes were replicated using a clustering method on MRI data in 260 amyloid-β–positive patients with mild cognitive impairment or AD dementia, and we subsequently tested whether the subtypes differed on [<sup>18</sup>F]flortaucipir (tau) positron emission tomography, white matter hyperintensity burden, and rate of global cognitive decline. Results: Voxel-wise and region-of-interest analyses revealed the greatest neocortical tau load in hippocampal-sparing (frontoparietal-predominant) and typical (temporal-predominant) patients, while limbic-predominant patients showed particularly high entorhinal tau. Typical patients with AD had the most pronounced white matter hyperintensity load, and hippocampal-sparing patients showed the most rapid global cognitive decline. Discussion: Our data suggest that structural MRI can be used to identify biologically and clinically meaningful subtypes of AD.</p>},
  author       = {Ossenkoppele, Rik and Lyoo, Chul Hyoung and Sudre, Carole H. and van Westen, Danielle and Cho, Hanna and Ryu, Young Hoon and Choi, Jae Yong and Smith, Ruben and Strandberg, Olof and Palmqvist, Sebastian and Westman, Erik and Tsai, Richard and Kramer, Joel and Boxer, Adam L. and Gorno-Tempini, Maria L. and La Joie, Renaud and Miller, Bruce L. and Rabinovici, Gil D. and Hansson, Oskar},
  issn         = {1552-5260},
  language     = {eng},
  number       = {2},
  pages        = {335--344},
  publisher    = {Elsevier},
  series       = {Alzheimer's and Dementia},
  title        = {Distinct tau PET patterns in atrophy-defined subtypes of Alzheimer's disease},
  url          = {http://dx.doi.org/10.1016/j.jalz.2019.08.201},
  doi          = {10.1016/j.jalz.2019.08.201},
  volume       = {16},
  year         = {2020},
}