Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Plaques detected in brain scans forecast cognitive impairment

11.03.2014

Brain imaging using radioactive dye can detect early evidence of Alzheimer's disease that may predict future cognitive decline among adults with mild or no cognitive impairment, according to a 36-month follow-up study led by Duke Medicine.

The national, multicenter study confirms earlier findings suggesting that identifying silent beta-amyloid plaque build-up in the brain could help guide care and treatment decisions for patients at risk for Alzheimer's. The findings appeared online March 11, 2014, in Molecular Psychiatry, a Nature Publishing Group journal.

"Our research found that healthy adults and those with mild memory loss who have a positive scan for these plaques have a much faster rate of decline on memory, language and reasoning over three years," said lead author P. Murali Doraiswamy, M.D., professor of psychiatry and director of the neurocognitive disorders program at Duke.

Alzheimer's disease – which currently has no cure – afflicts an estimated five million U.S. adults, and is the sixth-leading cause of death among adults, according to the Centers for Disease Control and Prevention. Prior studies have found that changes in the brain begin years, and possibly decades, before cognitive symptoms emerge.

... more about:
»Alzheimer's »PET »Plaques »cognitive »scans

A biomarker that could accurately identify those at greatest risk for cognitive decline could help clinicians better evaluate and treat patients, while also accelerating the testing of drugs to treat the disease.

The current study, which enrolled 152 adults ages 50 and older, was designed to assess whether silent pathological changes in the brain associated with Alzheimer's and detected with positron emission tomography (PET) can predict cognitive decline. Of the participants, 69 had normal cognitive function at the start of the study, 52 had been recently diagnosed with mild cognitive impairment, and 31 were diagnosed with Alzheimer's disease.

Subjects completed cognitive tests and underwent PET scans of their brains. This type of imaging uses a radioactive tracer to look for chemical signs of disease in specific tissues.

The radioactive dye used, florbetapir (Amyvid), was approved by the U.S. Food and Drug Administration in 2012 for PET imaging of the brain to estimate beta-amyloid plaque density in patients being evaluated for cognitive impairment. It binds to the beta-amyloid plaques that characterize Alzheimer's disease, helping to measure the extent to which plaques have formed in different brain regions. Using this information, the researchers rated the PET scans as positive or negative.

After 36 months, the researchers repeated the same cognitive exams to reassess participants. They found that those with mild or no cognitive impairment who had evidence of plaques at the trial's start worsened to a greater degree on cognitive tests than those with negative scans.

Thirty-five percent of plaque-positive participants who started with mild cognitive impairment progressed to Alzheimer's, compared to 10 percent without plaque. In addition, plaque-positive participants with mild impairment were more than twice as likely to be started on cognitive-enhancing medication than those without plaque.

Conversely, those with negative scans experienced much less decline: 90 percent of participants with mild cognitive impairment but no plaque did not progress to Alzheimer's. This finding supports the negative predictive value of using PET imaging to identify patients unlikely to decline, which has important implications for both clinical research and treatment.

"Having a negative scan could reassure people that they are not likely to be at risk for progression in the near future," Doraiswamy said.

Doraiswamy cautioned that florbetapir is currently not approved to predict the development of dementia and is not used as a screening tool in cognitively normal people. Future longitudinal studies are needed to further clarify the prognostic role of beta-amyloid plaque PET imaging in a clinical setting.

"Even though our study suggests the test has predictive value in normal adults, we still need additional evidence," Doraiswamy said. "We need longer-term studies to look at the consequences of silent brain plaque build-up, given that it affects 15 to 30 percent of normal older people."

Doraiswamy added that the findings provide support for planned and ongoing multicenter clinical trials of asymptomatic older adults with plaque-positive scans. The research also has implications for other conditions where amyloid might play a role, such as traumatic brain injury (from sports or combat).

###

In addition to Doraiswamy, study authors include Terence Z. Wong of Duke (currently at the University of North Carolina at Chapel Hill); Reisa A. Sperling and Keith Johnson of Massachusetts General Hospital, Harvard Medical School; Eric M. Reiman of Banner Alzheimer's Institute; Marwan N. Sabbagh of Banner-Sun Health Research Institute; Carl H. Sadowsky of Nova SE University; Michael Grundman of Global R&D Partners and the University of California, San Diego; Adam S. Fleisher of Banner Alzheimer's Institute and the University of California, San Diego; and Alan Carpenter, Abhinay D. Joshi, Ming Lu, Mark A. Mintun, Daniel M. Skovronsky and Michael J. Pontecorvo of Avid Radiopharmaceuticals.

The study was funded by Eli Lilly/Avid Radiopharmaceuticals, which markets florbetapir, and was conducted by Avid and the AV45-A11 study group, a consortium of Alzheimer's clinical research centers. Doraiswamy receives advisory and speaker fees from Lilly/Avid, as well as other companies. A full list of author disclosures can be found in the manuscript.

Rachel Harrison | EurekAlert!
Further information:
http://www.dukemednews.org/

Further reports about: Alzheimer's PET Plaques cognitive scans

More articles from Health and Medicine:

nachricht Mobile phone test can reveal vision problems in time
11.02.2016 | University of Gothenburg

nachricht Proteomics and precision medicine
08.02.2016 | University of Iowa Health Care

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Production of an AIDS vaccine in algae

Today, plants and microorganisms are heavily used for the production of medicinal products. The production of biopharmaceuticals in plants, also referred to as “Molecular Pharming”, represents a continuously growing field of plant biotechnology. Preferred host organisms include yeast and crop plants, such as maize and potato – plants with high demands. With the help of a special algal strain, the research team of Prof. Ralph Bock at the Max Planck Institute of Molecular Plant Physiology in Potsdam strives to develop a more efficient and resource-saving system for the production of medicines and vaccines. They tested its practicality by synthesizing a component of a potential AIDS vaccine.

The use of plants and microorganisms to produce pharmaceuticals is nothing new. In 1982, bacteria were genetically modified to produce human insulin, a drug...

Im Focus: The most accurate optical single-ion clock worldwide

Atomic clock experts from the Physikalisch-Technische Bundesanstalt (PTB) are the first research group in the world to have built an optical single-ion clock which attains an accuracy which had only been predicted theoretically so far. Their optical ytterbium clock achieved a relative systematic measurement uncertainty of 3 E-18. The results have been published in the current issue of the scientific journal "Physical Review Letters".

Atomic clock experts from the Physikalisch-Technische Bundesanstalt (PTB) are the first research group in the world to have built an optical single-ion clock...

Im Focus: Goodbye ground control: autonomous nanosatellites

The University of Würzburg has two new space projects in the pipeline which are concerned with the observation of planets and autonomous fault correction aboard satellites. The German Federal Ministry of Economic Affairs and Energy funds the projects with around 1.6 million euros.

Detecting tornadoes that sweep across Mars. Discovering meteors that fall to Earth. Investigating strange lightning that flashes from Earth's atmosphere into...

Im Focus: Flow phenomena on solid surfaces: Physicists highlight key role played by boundary layer velocity

Physicists from Saarland University and the ESPCI in Paris have shown how liquids on solid surfaces can be made to slide over the surface a bit like a bobsleigh on ice. The key is to apply a coating at the boundary between the liquid and the surface that induces the liquid to slip. This results in an increase in the average flow velocity of the liquid and its throughput. This was demonstrated by studying the behaviour of droplets on surfaces with different coatings as they evolved into the equilibrium state. The results could prove useful in optimizing industrial processes, such as the extrusion of plastics.

The study has been published in the respected academic journal PNAS (Proceedings of the National Academy of Sciences of the United States of America).

Im Focus: New study: How stable is the West Antarctic Ice Sheet?

Exceeding critical temperature limits in the Southern Ocean may cause the collapse of ice sheets and a sharp rise in sea levels

A future warming of the Southern Ocean caused by rising greenhouse gas concentrations in the atmosphere may severely disrupt the stability of the West...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Travel grants available: Meet the world’s most proficient mathematicians and computer scientists

09.02.2016 | Event News

AKL’16: Experience Laser Technology Live in Europe´s Largest Laser Application Center!

02.02.2016 | Event News

From intelligent knee braces to anti-theft backpacks

26.01.2016 | Event News

 
Latest News

Scientists take nanoparticle snapshots

11.02.2016 | Physics and Astronomy

NASA sees development of Tropical Storm 11P in Southwestern Pacific

11.02.2016 | Earth Sciences

Scientists from MIPT gain insights into 'forbidden' chemistry

11.02.2016 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>