Cerebrospinal Fluid Anti-Amyloid-β Autoantibodies and Amyloid PET in Cerebral Amyloid Angiopathy-Related Inflammation

Article type: Short Communication

Authors: Carmona-Iragui, María^{a; b} | Fernández-Arcos, Ana^a | Alcolea, Daniel^{a; b} | Piazza, Fabrizio^{c; d} | Morenas-Rodriguez, Estrella^{a; b} | Antón-Aguirre, Sofía^{a; b} | Sala, Isabel^{a; b} | Clarimon, Jordi^{a; b} | Dols-Icardo, Oriol^{a; b} | Camacho, Valle^e | Sampedro, Frederic^f | Munuera, Josep^g | Nuñez-Marin, Fidel^f | Lleó, Alberto^{a; b} | Fortea, Juan^{a; b; *} | Gómez-Ansón, Beatriz^{f; h} | Blesa, Rafael^{a; b}

Affiliations: [a] Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain | [b] Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Spain | [c] School of Medicine and Surgery, Milan Center for Neuroscience (NeuroMi), University of Milano-Bicocca, Monza, Italy | [d] The inflammatory Cerebral Amyloid Angiopathy and Alzheimer’s disease βiomarkers International Network (iCAβ), Monza, Italy | [e] Department of Nuclear Medicine, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain | [f] Universitat Autònoma de Barcelona, Facultat de Medicina, Barcelona, Spain | [g] MRI Unit Badalona Institut de Diagnòstic per la Imatge. Hospital Germans Trias i Pujol, Badalona, Spain | [h] Neuroradiology Unit, Department of Radiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain

Correspondence: [*] Correspondence to: Juan Fortea Ormaechea, MD, PhD, Memory Unit, Department of Neurology, Hospital of Sant Pau, Sant Antoni María Claret, 167, 08025, Barcelona, Spain. Tel.: +34 935565986; Fax: +34 935565602; E-mail: jfortea@santpau.cat.

Abstract: We report a biomarker and genetic evaluation of four patients with cerebral amyloid angiopathy-related inflammation (CAA-ri) treated with corticosteroids. Patients presented with focal symptomatology and cognitive impairment. MRI revealed cortical microbleeds and asymmetrical hyperintense white matter lesions (WML). Cerebrospinal fluid (CSF) biomarker analyses showed increased anti-Aβ autoantibodies, t-Tau, and p-Tau and decreased Aβ40 and Aβ42. After treatment, focal symptomatology disappeared, and WML and anti-Aβ autoantibodies decreased. The APOE ɛ4 allele was overrepresented. Florbetapir-PET showed cortical deposition with lower retention in swollen areas. In the case of suspected CAA-ri, both CSF anti-Aβ autoantibodies levels and Florbetapir-PET could provide highly useful data to guide the correct diagnosis.

Keywords: Biomarkers, cerebral amyloid angiopathy, cerebrospinal fluid, Florbetapir-PET, inflammation

DOI: 10.3233/JAD-150614

Journal: Journal of Alzheimer's Disease, vol. 50, no. 1, pp. 1-7, 2016