Purpose: The Boston criteria for cerebral amyloid angiopathy (CAA) have to be confirmed by postmortem examination. The present study investigates the incidence and the cerebrovascular impact of the severity of CAA in various neurodegenerative dementia diseases.
Material And Methods: 208 patients underwent an autopsy. They consisted of 92 brains with Alzheimer's disease (AD), 46 with frontotemporal lobar degeneration (FTLD), 24 with progressive supranuclear palsy (PSP), 21 with Lewy body dementia (LBD), 5 with corticobasal degeneration (CBD), and 20 controls. In addition to the macroscopic examination, a whole coronal section of a cerebral hemisphere, at the level of the mamillary body, was taken for semiquantitative microscopic evaluation of the small cerebrovascular lesions.
Results: CAA is present in 2/3% of the AD brains of which half of them have a severe form, grade 3. Only the latter displays more cerebrovascular lesions. CAA is present in 45% of the LBD brains. Cortical microinfarcts are only more frequent in the CAA grade 3 group. In LBD additional AD pathology is present in 41% of the CAA grade 0, 83% in grade 1-2, and 100% in grade 3. In PSP only 21% had CAA grade 1-2. In FTLD, CBD, and normal controls no CAA pathology is observed.
Conclusions: The present study shows that CAA is most frequently associated to AD but that only the severe form displays more cerebrovascular lesions. LBD is the second most frequent disease associated to CAA with a clear correlation between the incidence of the associated AD features and the increasing severity of the CAA. In PSP only 21% display mild CAA features. PSP, tau-FTLD, and CBD are part of the Pick complex diseases, who are known to have a favourable vascular profile which can explain their low incidence of cerebrovascular lesions, in contrast to AD and LBD brains.
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http://dx.doi.org/10.1155/2019/7247325 | DOI Listing |
Alzheimers Dement
December 2024
Bernard and Irene Schwartz Center for Biomedical Imaging, New York University Grossman School of Medicine, New York, NY, USA.
Background: Amyloid related imaging abnormalities (ARIA), a group of neuropathological features seen in anti-amyloid immunotherapy patients, arises partly from CAA (Aβ buildup in blood vessels). Squirrel monkeys (SQMs), developing prominent age-related CAA exceeding brain Aβ, offer a unique NHP model for ARIA study. Evaluating edema-related neurobiological defects (ARIA-E) involves preferential use of T-weighted (T-w) and flow-attenuated inversion recovery (FLAIR) MRI while T*-weighted (T*-w) MRI is better suited for investigating iron-related pathology like microbleeds, hemorrhaging, and iron-homing in plaques.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Urmia University of Medical Science, Urmia, West Azarbayjan, Iran (Islamic Republic of).
Background: Cerebral microbleeds (CMBs) are small hypointense round lesions that indicate leakage of blood products from cerebral vessels damaged by β-amyloid-40 (Aβ) and typically are detected by T2*-weighted and susceptibility weighted imaging (SWI) on MRI. They are indicators of cerebral small vessel diseases, especially cerebral amyloid angiopathy (CAA), affecting cortical small arteries. Quantitative susceptibility mapping (QSM) is an advanced MRI imaging technique used to quantify the magnetic susceptibility of tissues in the human body.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
USC Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Background: Diagnosis of cerebral amyloid angiopathy (CAA) presents a significant challenge in determining whether to propose anti-amyloid treatment plans. The identification of perivascular spaces (PVS) through MRI serves as a possible strategy to elucidate the physiopathological interconnections between the brain's clearance mechanisms and the accumulation of amyloid. This study endeavors to the association between PVS morphology and CAA pathology.
View Article and Find Full Text PDFBackground: Alzheimer's Disease (AD) has a strong spatial-temporal component to its progression, where different brain regions are affected by amyloid-beta (Aβ) plaque deposition at varying time points and in distinct cell types. Standard imaging and analysis platforms can neglect these details, as they lack the ability to pair high-yield whole-brain imaging with region-specific or high-resolution analysis. Here we describe a novel high-throughput whole-brain imaging pipeline to quantitatively track plaque progression as a function of brain region across time, while also producing indexed tissue sections for secondary staining and analysis that can be registered back to the original brain image.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Lund, Sweden.
Background: There is an urgent need for accurate and validated methods to measure plasma phosphorylated tau (p-Tau) biomarkers in Alzheimer´s disease (AD). Here we compared the performance of newly developed plasma ALZpath p-Tau217 assay to other established p-Tau assays such as Lilly p-Tau217 and Lilly p-Tau181.
Method: We included 72 participants from the Arizona Study of Aging and Neurodegenerative Disorders cohort, where we analysed antemortem collected plasma samples with ALZpath p-Tau217 as well as Lilly p-Tau217 and p-Tau181.
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