Occipital Amyloid Deposition Is Associated with Rapid Cognitive Decline in the Alzheimer’s Disease Continuum

Article type: Research Article

Authors: Jeong, Seong Ho^{a; b; 1} | Cha, Jungho^{c; 1} | Jung, Jin Ho^d | Yun, Mijin^e | Sohn, Young H.^b | Chung, Seok Jong^{b; f; g; 2; *} | Lee, Phil Hyu^{b; 2; *}

Affiliations: [a] Department of Neurology, Inje University Sanggye Paik Hospital, Seoul, South Korea | [b] Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea | [c] Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA | [d] Department of Neurology, Inje University Busan Paik Hospital, Busan, South Korea | [e] Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, South Korea | [f] Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea | [g] YONSEI BEYOND LAB, Yongin, South Korea

Correspondence: [*] Correspondence to: Phil Hyu Lee, MD, PhD, Professor, Department of Neurology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 30722, South Korea. Tel.: +82 2 2228 1608; Fax: +82 2 393 0705; E-mail: phlee@yuhs.ac and Seok Jong Chung, MD, PhD, Assistant Professor, Department of Neurology, Yongin Severance Hospital, 363 Dongbaekjukjeon-daero, Giheung-gu, Yongin-si, Gyeonggi-do, 16995, South Korea. Tel.: +82 31 5189 8175; Fax: +82 31 5189 8565; E-mail: sjchung@yuhs.ac.

Note: [1] These authors contributed equally to this work.

Note: [2] These authors contributed equally as co-senior authors.

Abstract: Background:Clinical significance of additional occipital amyloid-β (Aβ) plaques in Alzheimer’s disease (AD) remains unclear. Objective:In this study, we investigated the effect of regional Aβ deposition on cognition in patients on the AD continuum, especially in the occipital region. Methods:We retrospectively reviewed the medical record of 208 patients with AD across the cognitive continuum (non-dementia and dementia). Multivariable linear regression analyses were performed to determine the effect of regional Aβ deposition on cognitive function. A linear mixed model was used to assess the effect of regional deposition on longitudinal changes in Mini-Mental State Examination (MMSE) scores. Additionally, the patients were dichotomized according to the occipital-to-global Aβ deposition ratio (ratio ≤1, Aβ-OCC– group; ratio >1, Aβ-OCC+ group), and the same statistical analyses were applied for between-group comparisons. Results:Regional Aβ burden itself was not associated with baseline cognitive function. In terms of Aβ-OCC group effect, the Aβ-OCC+ group exhibited a poorer cognitive performance on language function compared to the Aβ-OCC– group. High Aβ retention in each region was associated with a rapid decline in MMSE scores, only in the dementia subgroup. Additionally, Aβ-OCC+ individuals exhibited a faster annual decline in MMSE scores than Aβ-OCC– individuals in the non-dementia subgroup (β= –0.77, standard error [SE] = 0.31, p = 0.013). Conclusion:The present study demonstrated that additional occipital Aβ deposition was associated with poor baseline language function and rapid cognitive deterioration in patients on the AD continuum.

Keywords: Alzheimer’s disease, amyloid, cognition, occipital lobe, prognosis

DOI: 10.3233/JAD-230187

Journal: Journal of Alzheimer's Disease, vol. 94, no. 3, pp. 1133-1144, 2023