Malignant progression in parietal-dominant atrophy subtype of Alzheimer's disease occurs independent of onset age

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• 作者：Han Kyu Na^a ; ¹ ; Dae Ryong Kang^b ; ¹ ; Sungsoo Kim^a ; Sang Won Seo^c ; ^d ; Kenneth M. Heilman^e ; Young Noh^f ; ^{ynoh@gachon.ac.kr" class="auth_mail" title="E-mail the corresponding author} ; Duk L. Na^c ; ^d ; ^{dukna@skku.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Alzheimer's disease ; Subtypes ; Magnetic resonance imaging ; Neuropsychological tests ; Hierarchical clustering ; Rate of progression
• 刊名：Neurobiology of Aging
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：47
• 期：Complete
• 页码：149-156
• 全文大小：1395 K

文摘

Recently, we reported that earlier stages of Alzheimer's disease (AD) can be categorized into 3 following anatomical subtypes using a hierarchical cluster analysis of cortical thickness across the entire brain: medial temporal-dominant (MT), parietal-dominant (P), and diffuse atrophy (D). The goal of this study was to investigate the rates of cognitive decline in these anatomical subtypes. Of the patients included in the prior study, 100 AD patients (MT, n = 36; P, n = 20; D, n = 44) who underwent follow-up neuropsychological assessments over a 3-year period were included. A linear mixed model analysis was performed to compare the longitudinal changes in neuropsychological test scores. The P subtype exhibited the most rapid cognitive decline in attention, language, visuospatial, memory, and frontal executive function, whereas MT and D subtypes did not differ in their longitudinal decline. When repeating the analyses with early-onset AD, which is known to progress faster than late-onset AD, only the P subtype showed such rapid progression. The P subtype appears to be a unique subtype of AD characterized by an aggressive rate of progression.