Alakbarzade Vafa, French Jonathan Mr, Howlett David R, Attems Johannes, Francis Paul T, Stratton Sarah, Clark Camilla N, Pereira Anthony C, Hainsworth Atticus H
St George's University Hospitals London UK.
King's College London London UK.
Alzheimers Dement (N Y). 2021 Feb 16;7(1):e12145. doi: 10.1002/trc2.12145. eCollection 2021.
Radiolabeled ligands for fibrillar amyloid beta (Aβ) peptides are used in positron emission tomography (PET) for dementia diagnosis. Current ligands do not discriminate parenchymal amyloid plaques from cerebral amyloid angiopathy (CAA).
We undertook neuropathological examination of 65 older people (81.6 ± 7.96 (mean ± SD) years, 27F/38M): 15 with neuropathological diagnosis of AD, 25 with neuropathological diagnosis of other neurodegenerative dementias (Lewy body dementia and Parkinson disease dementia), and 25 without significant neurodegenerative pathology.
We observed CAA in non-Alzheimer's dementia (non-AD dementia) and control brains, of comparable extent to those with neuropathologically confirmed AD. Aβ-positive vessel density did not differ significantly between non-AD dementia and control groups. Across all subjects there was a highly significant correlation between vessel Aβ40 density and vessel Aβ42 density (Spearman rho = 0.855, < .001). CAA was absent or sparse in subcortical white matter across all patient groups.
Our data indicate that CAA can be abundant in non-AD brains and raise a cautionary note regarding interpretation of amyloid PET imaging.
用于检测纤维状淀粉样β（Aβ）肽的放射性标记配体被用于正电子发射断层扫描（PET）以诊断痴呆症。目前的配体无法区分脑实质淀粉样斑块和脑淀粉样血管病（CAA）。
我们对65名老年人（年龄81.6±7.96（均值±标准差）岁，27名女性/38名男性）进行了神经病理学检查：15例经神经病理学诊断为阿尔茨海默病（AD），25例经神经病理学诊断为其他神经退行性痴呆（路易体痴呆和帕金森病痴呆），25例无明显神经退行性病变。
我们在非阿尔茨海默病痴呆（非AD痴呆）和对照脑中观察到CAA，其程度与经神经病理学证实为AD的患者相当。非AD痴呆组和对照组之间的Aβ阳性血管密度无显著差异。在所有受试者中，血管Aβ40密度和血管Aβ42密度之间存在高度显著的相关性（斯皮尔曼相关系数rho = 0.855，P <.001）。在所有患者组的皮质下白质中，CAA不存在或稀少。
我们的数据表明，CAA在非AD脑中可能大量存在，并对淀粉样PET成像的解读提出了警示。
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