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- W2897617828 abstract "Subcortical vascular cognitive impairment (SVCI), which is characterized by extensive cerebral small vessel disease (CSVD) is closely associated with Alzheimer's disease (AD). Previous studies showed that Aß in SVCI is shown to have impacts on brain structure and cognitive decline, and CSVD is correlated with tau uptakes, measured by AV1451 PET, which are well correlated with cognition regardless of Aß. In addition, a higher CSVD burden can lead to atrophy involving AD-like regions. These three biomarker categories – Aß (A), Tau (T), and neurodegeneration (N) – were incorporated in a new classification system called ATN, which was proposed in AD research. However, clinical significance of ATN classification in SVCI has not been investigated. In this study, therefore we applied ATN system in SVCI patients and investigated clinical significance of ATN system in SVCI patients. A total of 56 SVCI patients who underwent MRI, florbetaben PET, and AV1451 PET scans were included in this study. Neuropsychological test at enrollment and retrospective data were collected to investigate a cognitive decline. Patients were classified as abnormal Aß(A+) when florbetaben PET was positive by visual assessment, abnormal tau (T+) when AV1451 PET showed that in-vivo Braak stage using the conditional inference tree method was≥ III/IV, and abnormal neurodegeneration (N+) when the average of bilateral hippocampal volume assessed by MRI was lower than cutoff of 5.53cm3 obtained from normal controls. We investigated the effect of different groups on cognitive decline using the mixed effects model. Twenty two were categorized as A-T-N-, 7 were A-T-N+, 11 were A+T-N-, 8 were A+T-N+, 6 were A+T+N-, 1 was A-T+N-, and 1 was A-T+N+. We further categorized A-T-N- group as normal AD biomarker, A-T-N+/A-T+N-/A-T+N+ as non-AD pathophysiology, A+T-N-/A+T-N+ as Alzheimer's pathophysiology, and A+T+N/A+T+N+ as AD. SVCI with non-AD, SVCI with Alzheimer's pathophysiology and combined SVCI and AD groups showed significantly steeper cognitive decline compared with normal AD biomarker group(p<0.001). Combined SVCI and AD group had a steeper decline in cognition compared with other groups(p<0.001). However, cognitive decline in SVCI with non-AD and Alzheimer's pathophysiology group did not differ(p=0.460)." @default.
- W2897617828 created "2018-10-26" @default.
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- W2897617828 date "2018-07-01" @default.
- W2897617828 modified "2023-10-16" @default.
- W2897617828 title "IC‐P‐078: CLINICAL SIGNIFICANCE OF A/T/N SYSTEM IN SUBCORTICAL VASCULAR COGNITIVE IMPAIRMENT PATIENTS" @default.
- W2897617828 doi "https://doi.org/10.1016/j.jalz.2018.06.2142" @default.
- W2897617828 hasPublicationYear "2018" @default.
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