Cerebral amyloid angiopathy and amyloid load distribution detected on amyloid-positron emission tomography: A systematic review and meta-analysis.

IF 4.5 3区 医学 Q1 CLINICAL NEUROLOGY
Aikaterini Theodorou, Konstantinos Melanis, Athanasia Athanasaki, Lina Palaiodimou, Maria-Ioanna Stefanou, Panagiota-Eleni Tsalouchidou, Efthimios Vassilopoulos, Anastasios Kouzoupis, Marios Themistocleous, Georgios P Paraskevas, Georgios Tsivgoulis, Elias Tzavellas
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引用次数: 0

Abstract

Introduction: There are limited data regarding the amyloid positron emission tomography (PET) imaging among patients with Cerebral Amyloid Angiopathy (CAA). We sought to assess the amyloid load distribution detected on amyloid-PET among CAA patients compared to patients with Alzheimer's Disease (AD), patients with hypertension (HTN) related hemorrhage (ICH) and healthy controls (HC).

Patients and methods: A systematic review and meta-analysis of published studies with available data on global and regional amyloid-PET uptake was conducted. Comparisons with respect to amyloid load distribution were investigated using random-effects models based on the ratio of mean (RoM) amyloid-PET uptake. RoM < 1 and RoM > 1 indicate lower and higher global or regional amyloid-PET uptake in CAA compared to another population, respectively.

Results: We identified 16 cohorts, comprising 271 CAA patients (mean age: 72 years; women: 46%) versus 130 AD patients (mean age: 73 years; women: 44%), 180 patients with HTN-related ICH (mean age: 66 years; women: 36%) and 61 HC (mean age: 71 years; women: 46%) with available data on amyloid-PET. Global amyloid PET ratio differentiated CAA from AD [RoM: 0.93; 95% CI: 0.90-0.96; p < 0.0001], HTN-related ICH [RoM: 1.25; 95% CI: 1.20-1.31; p < 0.0001], and HC [RoM: 1.26; 95% CI: 1.23-1.29; p < 0.0001]. Occipital amyloid-PET uptake [RoM: 1.20; 95% CI: 1.15-1.26; p < 0.0001] was higher in CAA compared to HTN-related ICH, and Occipital-to-global [RoM: 1.05; 95% CI: 1.03-1.07; p < 0.0001] ratio of amyloid-PET uptake differentiated also CAA from AD.

Conclusions: CAA is characterized by a distinct amyloid-PET burden and distribution compared to AD patients, patients with HTN-related ICH and HC. These findings may contribute to the design and conduct of future randomized controlled clinical trials, aiming to treat CAA at preclinical stages.

淀粉样蛋白正电子发射断层扫描检测的脑淀粉样蛋白血管病和淀粉样蛋白负荷分布:一项系统综述和荟萃分析。
简介:关于脑淀粉样血管病(CAA)患者的淀粉样正电子发射断层扫描(PET)成像数据有限。我们试图通过淀粉样蛋白pet检测评估CAA患者与阿尔茨海默病(AD)、高血压(HTN)相关出血(ICH)患者和健康对照(HC)患者的淀粉样蛋白负荷分布。患者和方法:对全球和区域淀粉样蛋白pet摄取的现有数据进行了系统回顾和荟萃分析。利用基于平均(RoM)淀粉样蛋白- pet摄取比的随机效应模型对淀粉样蛋白负载分布进行了比较。RoM 1表明,与其他人群相比,CAA中淀粉样蛋白- pet的整体或局部摄取分别较低和较高。结果:我们确定了16个队列,包括271例CAA患者(平均年龄:72岁;女性:46%)对比130例AD患者(平均年龄:73岁;女性:44%),180例htn相关性脑出血患者(平均年龄:66岁;女性:36%)和61例HC(平均年龄:71岁;女性:46%),有淀粉样蛋白pet的可用数据。总体淀粉样蛋白PET比值将CAA与AD区分开来[RoM: 0.93;结论:与AD患者、htn相关性脑出血患者和HC患者相比,CAA具有明显的淀粉样蛋白- pet负荷和分布特征。这些发现可能有助于设计和实施未来的随机对照临床试验,旨在治疗临床前阶段的CAA。
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来源期刊
CiteScore
7.50
自引率
6.60%
发文量
102
期刊介绍: Launched in 2016 the European Stroke Journal (ESJ) is the official journal of the European Stroke Organisation (ESO), a professional non-profit organization with over 1,400 individual members, and affiliations to numerous related national and international societies. ESJ covers clinical stroke research from all fields, including clinical trials, epidemiology, primary and secondary prevention, diagnosis, acute and post-acute management, guidelines, translation of experimental findings into clinical practice, rehabilitation, organisation of stroke care, and societal impact. It is open to authors from all relevant medical and health professions. Article types include review articles, original research, protocols, guidelines, editorials and letters to the Editor. Through ESJ, authors and researchers have gained a new platform for the rapid and professional publication of peer reviewed scientific material of the highest standards; publication in ESJ is highly competitive. The journal and its editorial team has developed excellent cooperation with sister organisations such as the World Stroke Organisation and the International Journal of Stroke, and the American Heart Organization/American Stroke Association and the journal Stroke. ESJ is fully peer-reviewed and is a member of the Committee on Publication Ethics (COPE). Issues are published 4 times a year (March, June, September and December) and articles are published OnlineFirst prior to issue publication.
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