title: Influence of Amyloid-β on Cognitive Decline After Stroke/Transient Ischemic Attack: Three-Year Longitudinal Study.
abstract: OBJECTIVE
  We hypothesized that comorbid amyloid-beta (Aβ) deposition played a key role in long-term cognitive decline in subjects with stroke/transient ischemic attack.
  
  
  METHODS
  We recruited 72 subjects with cognitive impairment after stroke/transient ischemic attack to receive Carbon-11-labeled Pittsburgh compound B positron emission tomography. We excluded subjects with known clinical Alzheimer's disease. Those with and without Alzheimer's disease-like Aβ deposition were classified as mixed vascular cognitive impairment (mVCI, n=14) and pure VCI (pVCI, n=58), respectively. We performed Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment to evaluate global cognition and cognitive domains (memory, visuospatial function, language, attention, and executive function) at 3 to 6 months (baseline) and annually for 3 years after the index event. We compared cognitive changes between mVCI and pVCI using linear mixed models and analysis of covariance adjusted for age and education.
  
  
  RESULTS
  Over 3 years, there were significant differences between mVCI and pVCI on change of MMSE score over time (group×time interaction, P=0.007). We observed a significant decline on MMSE score (P=0.020) in the mVCI group but not in the pVCI group (P=0.208). The annual rates of decline on MMSE (P=0.023) and Montreal Cognitive Assessment score (P=0.003) were greater in the mVCI group than in the pVCI group. Memory, visuospatial, and executive function domain scores on the Montreal Cognitive Assessment were related to Aβ deposition.
  
  
  CONCLUSIONS
  Compared with subjects without Alzheimer's disease-like Aβ deposition, those with Aβ deposition experienced a more severe and rapid cognitive decline over 3 years after stroke/transient ischemic attack. Aβ was associated with changes in multiple cognitive domains.
authors.affiliation: From the Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China (W.L., A.W., L.A., Z.W., V.C.T.M.); Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and Ministry of Education of China, Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China (J.Y.); and Department of Nuclear Medicine, Hong Kong Sanatorium and Hospital, Hong Kong, China (E.Y.L.L., S.C., C.L.H.).
authors.forename: Wenyan
authors.initials: W
authors.lastname: Liu
authors.affiliation: From the Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China (W.L., A.W., L.A., Z.W., V.C.T.M.); Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and Ministry of Education of China, Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China (J.Y.); and Department of Nuclear Medicine, Hong Kong Sanatorium and Hospital, Hong Kong, China (E.Y.L.L., S.C., C.L.H.).
authors.forename: Adrian
authors.initials: A
authors.lastname: Wong
authors.affiliation: From the Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China (W.L., A.W., L.A., Z.W., V.C.T.M.); Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and Ministry of Education of China, Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China (J.Y.); and Department of Nuclear Medicine, Hong Kong Sanatorium and Hospital, Hong Kong, China (E.Y.L.L., S.C., C.L.H.).
authors.forename: Lisa
authors.initials: L
authors.lastname: Au
authors.affiliation: From the Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China (W.L., A.W., L.A., Z.W., V.C.T.M.); Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and Ministry of Education of China, Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China (J.Y.); and Department of Nuclear Medicine, Hong Kong Sanatorium and Hospital, Hong Kong, China (E.Y.L.L., S.C., C.L.H.).
authors.forename: Jie
authors.initials: J
authors.lastname: Yang
authors.affiliation: From the Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China (W.L., A.W., L.A., Z.W., V.C.T.M.); Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and Ministry of Education of China, Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China (J.Y.); and Department of Nuclear Medicine, Hong Kong Sanatorium and Hospital, Hong Kong, China (E.Y.L.L., S.C., C.L.H.).
authors.forename: Zhaolu
authors.initials: Z
authors.lastname: Wang
authors.affiliation: From the Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China (W.L., A.W., L.A., Z.W., V.C.T.M.); Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and Ministry of Education of China, Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China (J.Y.); and Department of Nuclear Medicine, Hong Kong Sanatorium and Hospital, Hong Kong, China (E.Y.L.L., S.C., C.L.H.).
authors.forename: Eric Y L
authors.initials: EY
authors.lastname: Leung
authors.affiliation: From the Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China (W.L., A.W., L.A., Z.W., V.C.T.M.); Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and Ministry of Education of China, Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China (J.Y.); and Department of Nuclear Medicine, Hong Kong Sanatorium and Hospital, Hong Kong, China (E.Y.L.L., S.C., C.L.H.).
authors.forename: Sirong
authors.initials: S
authors.lastname: Chen
authors.affiliation: From the Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China (W.L., A.W., L.A., Z.W., V.C.T.M.); Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and Ministry of Education of China, Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China (J.Y.); and Department of Nuclear Medicine, Hong Kong Sanatorium and Hospital, Hong Kong, China (E.Y.L.L., S.C., C.L.H.).
authors.forename: Chi L
authors.initials: CL
authors.lastname: Ho
authors.affiliation: From the Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China (W.L., A.W., L.A., Z.W., V.C.T.M.); Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and Ministry of Education of China, Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China (J.Y.); and Department of Nuclear Medicine, Hong Kong Sanatorium and Hospital, Hong Kong, China (E.Y.L.L., S.C., C.L.H.). vctmok@cuhk.edu.hk.
authors.forename: Vincent C T
authors.initials: VC
authors.lastname: Mok
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000523:psychology; D016229:Amyloid beta-Peptides; D000814:Aniline Compounds; D002250:Carbon Radioisotopes; D003072:Cognition Disorders / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002546:Ischemic Attack, Transient / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000523:psychology; D008137:Longitudinal Studies; D008297:Male; D049268:Positron-Emission Tomography / Q000639:trends; D012042:Registries; D020521:Stroke / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000523:psychology; D013844:Thiazoles; D013997:Time Factors
chemical_list: C475519:2-(4'-(methylamino)phenyl)-6-hydroxybenzothiazole; D016229:Amyloid beta-Peptides; D000814:Aniline Compounds; D002250:Carbon Radioisotopes; D013844:Thiazoles
keywords: Alzheimer’s disease; ischemic attack, transient; mild cognitive impairment; positron-emission tomography; stroke