Associations between Neuropsychiatric Symptoms and Cerebral Amyloid Deposition in Cognitively Impaired Elderly People.
BACKGROUND
Neuropsychiatric symptoms, also known as behavioral and psychological symptoms of dementia (BPSD), affect the majority of patients with dementia, and result in a greater cognitive and functional impairment.


OBJECTIVE
To investigate associations between BPSD and amyloid cerebral deposition as measured by 18F-Florbetapir-PET quantitative uptake in elderly subjects with and without cognitive impairment.


METHODS
Participants with cognitive impairment [mild cognitive impairment (MCI) or Alzheimer's disease (AD)] and healthy controls (HC) from the ADNI cohort (Alzheimer Disease Neuroimaging Initiative) who underwent an 18F-florbetapir PET scan between May 2010 and March 2014 were included. Clinical assessments included the Clinical Dementia Rating, the Mini-Mental State Examination (MMSE), and the Neuropsychiatric Inventory. Freesurfer software was used to extract PET counts based on T1-based structural ROI (frontal, cingulate, parietal, and temporal). Spearman's partial correlation scores between BPSD severity and regional amyloid uptake were calculated.


RESULTS
Data for 657 participants [age = 72.6 (7.19); MMSE = 27.4 (2.67)] were analyzed, including 230 HC [age = 73.1 (6.02); MMSE = 29 (1.21)], 308 MCI [age = 71.5 (7.44); MMSE = 28.0 (1.75)], and 119 AD subjects [age = 74.7 (8.05); MMSE = 23.1 (2.08)]. Considering all diagnostic groups together, positive significant correlations were found between anxiety and 18F-florbetapir uptake in the frontal (r = 0.102; p = 0.009), cingulate (r = 0.083; p = 0.034), and global cerebral uptake (r = 0.099; p = 0.011); between irritability and frontal (r = 0.089; p = 0.023), cingulate (r = 0.085; p = 0.030), parietal (r = 0.087; p = 0.025), and global cerebral uptake (r = 0.093; p = 0.017); in the MCI subgroup, between anxiety and frontal (r = 0.126; p = 0.03) and global uptake (r = 0.14; p = 0.013); in the AD subgroup, between irritability and parietal uptake (r = 0.201; p = 0.03).


CONCLUSIONS
Anxiety and irritability are associated with greater amyloid deposition in the neurodegenerative process leading to AD.
Centre Memoire de Ressources et de Recherche, Institut Claude Pompidou, EA CoBTek, University of Nice Sophia Antipolis, Nice, France.
David
D
Bensamoun
Department of Nuclear Medicine, Hôpital de La Tour, Meyrin, GE, Switzerland.
Renaud
R
Guignard
Department of Psychiatry and Behavioral Sciences, Department of Neurology and Neurological Sciences, Stanford University, Stanford, USA; War Related Illness and Injury Study Center, VA Palo Alto, Palo Alto, USA.
Ansgar J
AJ
Furst
Centre Memoire de Ressources et de Recherche, Institut Claude Pompidou, EA CoBTek, University of Nice Sophia Antipolis, Nice, France.
Alexandre
A
Derreumaux
Centre Memoire de Ressources et de Recherche, Institut Claude Pompidou, EA CoBTek, University of Nice Sophia Antipolis, Nice, France.
Valeria
V
Manera
Nuclear Medicine Department, Antoine Lacassagne Center, Nice, France.
Jacques
J
Darcourt
Department of Psychiatry, University Hospital of Nice, France.
Michel
M
Benoit
Centre Memoire de Ressources et de Recherche, Institut Claude Pompidou, EA CoBTek, University of Nice Sophia Antipolis, Nice, France.
Philippe H
PH
Robert
Centre Memoire de Ressources et de Recherche, Institut Claude Pompidou, EA CoBTek, University of Nice Sophia Antipolis, Nice, France.
Renaud
R
David
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000378:metabolism*; D058227:Amyloidogenic Proteins / Q000378:metabolism*; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D003072:Cognition Disorders / Q000150:complications / Q000000981:diagnostic imaging / Q000378:metabolism*; D015331:Cohort Studies; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D019964:Mood Disorders / Q000209:etiology / Q000378:metabolism*; D009483:Neuropsychological Tests; D049268:Positron-Emission Tomography
D058227:Amyloidogenic Proteins; D019788:Fluorodeoxyglucose F18
ADNI; Alzheimer’s disease; amyloid; anxiety; behavioral and psychological symptoms of dementia; cingulate; dementia; frontal; irritability; neuroimaging; neuropsychiatric symptoms