Cerebral amyloid deposition predicts long‐term cognitive decline in hemorrhagic small vessel disease

• Published in: Brain and behavior Vol. 13; no. 10; pp. e3189 - n/a
• Main Authors: Tsai, Ya‐Chin, Tsai, Hsin‐Hsi, Liu, Chia‐Ju, Lin, Sheng‐Sian, Chen, Ya‐Fang, Jeng, Jiann‐Shing, Tsai, Li‐Kai, Yen, Ruoh‐Fang
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.10.2023; John Wiley and Sons Inc; Wiley
• Subjects: Cognitive ability; cognitive impairment; Cohort analysis; Dementia; intracerebral hemorrhage; Ischemia; Medical imaging; Neuroimaging; Original; Patients; Pittsburgh compound B; small vessel disease; intracerebral hemorrhage; small vessel disease; dementia; cognitive impairment; Pittsburgh compound B
• ISSN: 2162-3279; 2162-3279
• DOI: 10.1002/brb3.3189

To investigate the association between cerebral amyloid deposition and long-term cognitive outcomes in patients with hemorrhagic small vessel disease (SVD) and survivors of intracerebral hemorrhage (ICH). Patients experiencing an ICH without overt dementia were prospectively recruited (n = 68) for brain MRI and Pittsburgh compound B (PiB) positron emission tomography scans at baseline. Cognitive function was assessed using the mini-mental status examination (MMSE) and clinical dementia rating after an overall median follow-up of 3.8 years. A positive amyloid scan was defined as a global PiB standardized uptake value ratio >1.2. Associations between follow-up cognitive outcomes and neuroimaging markers were explored using multivariable Cox regression models. PiB(+) patients were older (72.1 ± 7.8 vs. 59.9 ± 11.7, p = .002) and more frequently had cerebral amyloid angiopathy (CAA) (63.6% vs. 15.8%, p = .002) than PiB(-) patients. PiB(+) was associated with a higher risk of dementia conversion (32.9 vs. 4.0 per 100-person-years, hazard ratio [HR] = 15.7 [3.0-80.7], p = .001) and MMSE score decline (58.8 vs. 9.9 per 100-person-years, HR = 6.2 [1.9-20.0], p = .002). In the non-CAA subgroup (n = 52), PiB(+) remained an independent predictor of dementia conversion, p = .04). In the Cox models, PiB(+) was an independent predictor of dementia conversion (HR = 15.8 [2.6-95.4], p = .003) and MMSE score decline (HR = 5.7 [1.6-20.3], p = .008) after adjusting for confounders. Cerebral amyloid deposition potentially contributes to long-term cognitive decline in SVD-related ICH.