Disclosure of positron emission tomography amyloid imaging results: A preliminary study of safety and tolerability

详细信息    查看全文

• 作者：Yen Ying Lim^a ; ^b ; Paul Maruff^b ; ^c ; Christine Getter^d ; Peter J. Snyder^a ; ^d ; ^{psnyder@lifespan.org" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Alzheimer disease ; Preclinical Alzheimer's disease ; Early detection ; PET imaging ; Amyloid ; Biomarkers ; Diagnosis ; Amyloid-beta protein ; Ethics ; Disclosure
• 刊名：Alzheimer's & Dementia
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：12
• 期：4
• 页码：454-458
• 全文大小：270 K

文摘

Three ¹⁸F-labeled radiopharmaceuticals have been Food and Drug Administration-approved for the identification of cortical amyloidosis in clinical settings. Although there has been strong debate among professionals as to the ethical and social consequences of disclosing such information, increasing numbers of participants are being recruited into secondary prevention trials for which they are likely to, and/or desire to, receive their positron emission tomography (PET) imaging results.

Methods

Healthy older adults (n = 63, mean age = 62 years) enrolled in a preclinical Alzheimer's disease (AD) biomarkers trial, and 11 requested disclosure of PET amyloid imaging results to their treating neurologist, per institutional review board–approved study protocol. These individuals completed a follow-up psychoeducational program and structured interviews to assess impact of disclosure on several key psychological factors.

Results

Four of 11 subjects demonstrated increased amyloid aggregation and reported that they were not surprised, particularly given their family histories and subjective memory concerns. All indicated that they had shared this information with pertinent significant others; they were satisfied with their level of social support, and the imaging results had motivated them to change their lifestyle by exercising more, changing their diet, and planning ahead. Amyloid-positive participants showed little change in levels of depressive, anxiety, and stress symptoms, subjective sense of memory impairment, or on measures of intrusion, avoidance, and hyperarousal, and reported risk of self-harm.

Discussion

Disclosure of PET amyloid status did not significantly impact mood, subjective sense of memory impairment, or perceived risk of developing AD; nor was this associated with significant emotional impact, irrespective of actual amyloid burden status. Those subjects with increased amyloid burden were more likely than those without significant amyloidosis to make positive changes to their lifestyle (e.g., engaging in more exercise and changing their diet).