title: Florbetapir F 18 amyloid PET and 36-month cognitive decline: a prospective multicenter study.
abstract: This study was designed to evaluate whether subjects with amyloid beta (Aβ) pathology, detected using florbetapir positron emission tomorgraphy (PET), demonstrated greater cognitive decline than subjects without Aβ pathology. Sixty-nine cognitively normal (CN) controls, 52 with recently diagnosed mild cognitive impairment (MCI) and 31 with probable Alzheimer's disease (AD) dementia were included in the study. PET images obtained in these subjects were visually rated as positive (Aβ+) or negative (Aβ-), blind to diagnosis. Fourteen percent (10/69) of CN, 37% (19/52) of MCI and 68% (21/31) of AD were Aβ+. The primary outcome was change in ADAS-Cog score in MCI subjects after 36 months; however, additional outcomes included change on measures of cognition, function and diagnostic status. Aβ+ MCI subjects demonstrated greater worsening compared with Aβ- subjects on the ADAS-Cog over 36 months (5.66 ± 1.47 vs -0.71 ± 1.09, P = 0.0014) as well as on the mini-mental state exam (MMSE), digit symbol substitution (DSS) test, and a verbal fluency test (P < 0.05). Similar to MCI subjects, Aβ+ CN subjects showed greater decline on the ADAS-Cog, digit-symbol-substitution test and verbal fluency (P<0.05), whereas Aβ+ AD patients showed greater declines in verbal fluency and the MMSE (P < 0.05). Aβ+ subjects in all diagnostic groups also showed greater decline on the CDR-SB (P<0.04), a global clinical assessment. Aβ+ subjects did not show significantly greater declines on the ADCS-ADL or Wechsler Memory Scale. Overall, these findings suggest that in CN, MCI and AD subjects, florbetapir PET Aβ+ subjects show greater cognitive and global deterioration over a 3-year follow-up than Aβ- subjects do.
authors.affiliation: Duke University Medical Center, Durham, NC, USA.
authors.forename: P M
authors.initials: PM
authors.lastname: Doraiswamy
authors.affiliation: Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Sperling
authors.affiliation: Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: K
authors.initials: K
authors.lastname: Johnson
authors.affiliation: Banner Alzheimer's Institute, Phoenix, AZ, USA.
authors.forename: E M
authors.initials: EM
authors.lastname: Reiman
authors.affiliation: Duke University Medical Center, Durham, NC, USA.
authors.forename: T Z
authors.initials: TZ
authors.lastname: Wong
authors.affiliation: Banner-Sun Health Research Institute, Sun City, AZ, USA.
authors.forename: M N
authors.initials: MN
authors.lastname: Sabbagh
authors.affiliation: Nova SE University, Ft. Lauderdale, FL, USA.
authors.forename: C H
authors.initials: CH
authors.lastname: Sadowsky
authors.affiliation: 1] Banner Alzheimer's Institute, Phoenix, AZ, USA [2] University of California, San Diego, CA, USA.
authors.forename: A S
authors.initials: AS
authors.lastname: Fleisher
authors.affiliation: Avid Radiopharmaceuticals, Philadelphia, PA, USA.
authors.forename: A
authors.initials: A
authors.lastname: Carpenter
authors.affiliation: Avid Radiopharmaceuticals, Philadelphia, PA, USA.
authors.forename: A D
authors.initials: AD
authors.lastname: Joshi
authors.affiliation: Avid Radiopharmaceuticals, Philadelphia, PA, USA.
authors.forename: M
authors.initials: M
authors.lastname: Lu
authors.affiliation: 1] University of California, San Diego, CA, USA [2] Global R&D Partners, San Diego, CA, USA.
authors.forename: M
authors.initials: M
authors.lastname: Grundman
authors.affiliation: Avid Radiopharmaceuticals, Philadelphia, PA, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Mintun
authors.affiliation: Avid Radiopharmaceuticals, Philadelphia, PA, USA.
authors.forename: D M
authors.initials: DM
authors.lastname: Skovronsky
authors.affiliation: Avid Radiopharmaceuticals, Philadelphia, PA, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Pontecorvo
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000378:metabolism; D016229:Amyloid beta-Peptides / Q000378:metabolism*; D000814:Aniline Compounds; D001921:Brain / Q000000981:diagnostic imaging* / Q000378:metabolism; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000378:metabolism; D018450:Disease Progression; D005026:Ethylene Glycols; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D018697:Nootropic Agents / Q000627:therapeutic use; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D019275:Radiopharmaceuticals
chemical_list: D016229:Amyloid beta-Peptides; D000814:Aniline Compounds; D005026:Ethylene Glycols; D018697:Nootropic Agents; D019275:Radiopharmaceuticals; C545186:florbetapir