Wenyan Liu1, Adrian Wong1, Lisa Au1, Jie Yang1, Zhaolu Wang1, Eric Y L Leung1, Sirong Chen1, Chi L Ho1, Vincent C T Mok2. 1. From the Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China (W.L., A.W., L.A., Z.W., V.C.T.M.); Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and Ministry of Education of China, Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China (J.Y.); and Department of Nuclear Medicine, Hong Kong Sanatorium and Hospital, Hong Kong, China (E.Y.L.L., S.C., C.L.H.). 2. From the Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China (W.L., A.W., L.A., Z.W., V.C.T.M.); Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and Ministry of Education of China, Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China (J.Y.); and Department of Nuclear Medicine, Hong Kong Sanatorium and Hospital, Hong Kong, China (E.Y.L.L., S.C., C.L.H.). vctmok@cuhk.edu.hk.
Abstract
BACKGROUND AND PURPOSE: We hypothesized that comorbid amyloid-beta (Aβ) deposition played a key role in long-term cognitive decline in subjects with stroke/transient ischemic attack. METHODS: We recruited 72 subjects with cognitive impairment after stroke/transient ischemic attack to receive Carbon-11-labeled Pittsburgh compound B positron emission tomography. We excluded subjects with known clinical Alzheimer's disease. Those with and without Alzheimer's disease-like Aβ deposition were classified as mixed vascular cognitive impairment (mVCI, n=14) and pure VCI (pVCI, n=58), respectively. We performed Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment to evaluate global cognition and cognitive domains (memory, visuospatial function, language, attention, and executive function) at 3 to 6 months (baseline) and annually for 3 years after the index event. We compared cognitive changes between mVCI and pVCI using linear mixed models and analysis of covariance adjusted for age and education. RESULTS: Over 3 years, there were significant differences between mVCI and pVCI on change of MMSE score over time (group×time interaction, P=0.007). We observed a significant decline on MMSE score (P=0.020) in the mVCI group but not in the pVCI group (P=0.208). The annual rates of decline on MMSE (P=0.023) and Montreal Cognitive Assessment score (P=0.003) were greater in the mVCI group than in the pVCI group. Memory, visuospatial, and executive function domain scores on the Montreal Cognitive Assessment were related to Aβ deposition. CONCLUSIONS: Compared with subjects without Alzheimer's disease-like Aβ deposition, those with Aβ deposition experienced a more severe and rapid cognitive decline over 3 years after stroke/transient ischemic attack. Aβ was associated with changes in multiple cognitive domains.
BACKGROUND AND PURPOSE: We hypothesized that comorbid amyloid-beta (Aβ) deposition played a key role in long-term cognitive decline in subjects with stroke/transient ischemic attack. METHODS: We recruited 72 subjects with cognitive impairment after stroke/transient ischemic attack to receive Carbon-11-labeled Pittsburgh compound B positron emission tomography. We excluded subjects with known clinical Alzheimer's disease. Those with and without Alzheimer's disease-like Aβ deposition were classified as mixed vascular cognitive impairment (mVCI, n=14) and pure VCI (pVCI, n=58), respectively. We performed Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment to evaluate global cognition and cognitive domains (memory, visuospatial function, language, attention, and executive function) at 3 to 6 months (baseline) and annually for 3 years after the index event. We compared cognitive changes between mVCI and pVCI using linear mixed models and analysis of covariance adjusted for age and education. RESULTS: Over 3 years, there were significant differences between mVCI and pVCI on change of MMSE score over time (group×time interaction, P=0.007). We observed a significant decline on MMSE score (P=0.020) in the mVCI group but not in the pVCI group (P=0.208). The annual rates of decline on MMSE (P=0.023) and Montreal Cognitive Assessment score (P=0.003) were greater in the mVCI group than in the pVCI group. Memory, visuospatial, and executive function domain scores on the Montreal Cognitive Assessment were related to Aβ deposition. CONCLUSIONS: Compared with subjects without Alzheimer's disease-like Aβ deposition, those with Aβ deposition experienced a more severe and rapid cognitive decline over 3 years after stroke/transient ischemic attack. Aβ was associated with changes in multiple cognitive domains.
Authors: Perminder S Sachdev; Jessica W Lo; John D Crawford; Lisa Mellon; Anne Hickey; David Williams; Régis Bordet; Anne-Marie Mendyk; Patrick Gelé; Dominique Deplanque; Hee-Joon Bae; Jae-Sung Lim; Amy Brodtmann; Emilio Werden; Toby Cumming; Sebastian Köhler; Frans R J Verhey; Yan-Hong Dong; Hui Hui Tan; Christopher Chen; Xu Xin; Raj N Kalaria; Louise M Allan; Rufus O Akinyemi; Adesola Ogunniyi; Aleksandra Klimkowicz-Mrowiec; Martin Dichgans; Frank A Wollenweber; Vera Zietemann; Michael Hoffmann; David W Desmond; Thomas Linden; Christian Blomstrand; Björn Fagerberg; Ingmar Skoog; Olivier Godefroy; Mélanie Barbay; Martine Roussel; Byung-Chul Lee; Kyung-Ho Yu; Joanna Wardlaw; Stephen J Makin; Fergus N Doubal; Francesca M Chappell; Velandai K Srikanth; Amanda G Thrift; Geoffrey A Donnan; Nagaendran Kandiah; Russell J Chander; Xuling Lin; Charlotte Cordonnier; Solene Moulin; Costanza Rossi; Behnam Sabayan; David J Stott; J Wouter Jukema; Susanna Melkas; Hanna Jokinen; Timo Erkinjuntti; Vincent C T Mok; Adrian Wong; Bonnie Y K Lam; Didier Leys; Hilde Hénon; Stéphanie Bombois; Darren M Lipnicki; Nicole A Kochan Journal: Alzheimers Dement (Amst) Date: 2016-11-18
Authors: Adrian Wong; Alexander Y L Lau; Jie Yang; Zhaolu Wang; Wenyan Liu; Bonnie Y K Lam; Lisa Au; Lin Shi; Defeng Wang; Winnie C W Chu; Yun-Yun Xiong; Eugene S K Lo; Lorraine S N Law; Thomas W H Leung; Linda C W Lam; Anne Y Y Chan; Yannie O Y Soo; Eric Y L Leung; Lawrence K S Wong; Vincent C T Mok Journal: PLoS One Date: 2016-09-15 Impact factor: 3.240