title: Seoul criteria for PiB(-) subcortical vascular dementia based on clinical and MRI variables.
abstract: OBJECTIVE
  The purpose of this study was to propose new criteria for differentiating Pittsburgh compound B (PiB)-negative from PiB-positive subcortical vascular dementia (SVaD) using clinical and MRI variables.
  
  
  METHODS
  We measured brain amyloid deposition using PiB-PET in 77 patients with SVaD. All patients met DSM-IV criteria for vascular dementia and had severe white matter hyperintensities on MRI, defined as a cap or band ≥ 10 mm as well as a deep white matter lesion ≥ 25 mm. Eleven models were considered to differentiate PiB(-) from PiB(+) SVaD using 4 variables, including age, number of lacunes, medial temporal atrophy (MTA), and APOE ε4. The ideal cutoff values in each of the 11 models were selected using the highest Youden index.
  
  
  RESULTS
  A total of 49 of 77 patients (63.6%) tested negative for PiB retention, while 28 (36.4%) tested positive for PiB retention. The ideal model for differentiating PiB(-) from PiB(+) SVaD was as follows: age ≤ 75 years, ≥ 5 lacunes, and MTA ≤ 3, which together yielded an accuracy of 67.5%.
  
  
  CONCLUSIONS
  When patients meet the DSM-IV criteria for vascular dementia and also have severe white matter hyperintensities, younger age, greater number of lacunes, and lesser MTA, these are predictive of a PiB(-) scan in patients with SVaD.
  
  
  METHODS
  This study provides Class II evidence that the combination of younger age, greater number of lacunes, and lesser MTA identifies patients with SVaD at lower risk of Alzheimer disease pathology.
authors.affiliation: From the Department of Neurology (G.H.K., J.H.J.), Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul; Departments of Neurology (J.H.L.) and Nuclear Medicine (S.J.O., J.S.K.), Asan Medical Center, University of Ulsan College of Medicine, Seoul; Departments of Neurology (S.W.S., B.S.Y., H.C., H.J.K., J.H.C., D.L.N.), Nuclear Medicine (Y.S.C., K.H.L.), and Radiology (S.T.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Department of Neurology (Y.N.), Gachon University Gil Medical Center, Incheon; and Department of Neurology (C.W.Y.), Inha University Hospital, Inha University School of Medicine, Incheon, Korea.
authors.forename: Geon Ha
authors.initials: GH
authors.lastname: Kim
authors.forename: Jae Hong
authors.initials: JH
authors.lastname: Lee
authors.forename: Sang Won
authors.initials: SW
authors.lastname: Seo
authors.forename: Byoung Seok
authors.initials: BS
authors.lastname: Ye
authors.forename: Hanna
authors.initials: H
authors.lastname: Cho
authors.forename: Hee Jin
authors.initials: HJ
authors.lastname: Kim
authors.forename: Young
authors.initials: Y
authors.lastname: Noh
authors.forename: Cindy W
authors.initials: CW
authors.lastname: Yoon
authors.forename: Ju Hee
authors.initials: JH
authors.lastname: Chin
authors.forename: Seung Jun
authors.initials: SJ
authors.lastname: Oh
authors.forename: Jae Seung
authors.initials: JS
authors.lastname: Kim
authors.forename: Yearn Seong
authors.initials: YS
authors.lastname: Choe
authors.forename: Kyung Han
authors.initials: KH
authors.lastname: Lee
authors.forename: Sung Tae
authors.initials: ST
authors.lastname: Kim
authors.forename: Jee Hyang
authors.initials: JH
authors.lastname: Jeong
authors.forename: Duk L
authors.initials: DL
authors.lastname: Na
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001284:Atrophy / Q000175:diagnosis / Q000209:etiology; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology*; D015140:Dementia, Vascular / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000175:diagnosis / Q000209:etiology; D056784:Leukoencephalopathies / Q000175:diagnosis / Q000209:etiology; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000592:standards; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000592:standards; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D056910:Republic of Korea; D059409:Stroke, Lacunar / Q000175:diagnosis / Q000209:etiology; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology