Malignant progression in parietal-dominant atrophy subtype of Alzheimer's disease occurs independent of onset age.
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.
Yonsei University College of Medicine, Seoul, Republic of Korea.
Han Kyu
HK
Na
Department of Medical Humanities & Social Medicine, Office of Biostatistics, Ajou University School of Medicine, Suwon, Republic of Korea.
Dae Ryong
DR
Kang
Yonsei University College of Medicine, Seoul, Republic of Korea.
Sungsoo
S
Kim
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea.
Sang Won
SW
Seo
Department of Neurology, University of Florida and Veterans Affairs Medical Center, Gainesville, FL, USA.
Kenneth M
KM
Heilman
Department of Neurology, Gachon University Gil Medical Center, Incheon, Republic of Korea. Electronic address: ynoh@gachon.ac.kr.
Young
Y
Noh
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea. Electronic address: dukna@skku.edu.
Duk L
DL
Na
D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000145:classification* / Q000000981:diagnostic imaging / Q000473:pathology* / Q000523:psychology; D001284:Atrophy; D002540:Cerebral Cortex / Q000473:pathology*; D003071:Cognition; D018450:Disease Progression; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging; D009483:Neuropsychological Tests; D012720:Severity of Illness Index
Alzheimer's disease; Hierarchical clustering; Magnetic resonance imaging; Neuropsychological tests; Rate of progression; Subtypes