Associations between Neuropsychiatric Symptoms and Cerebral Amyloid Deposition in Cognitively Impaired Elderly People

Article type: Research Article

Authors: Bensamoun, David^{a; *} | Guignard, Renaud^b | Furst, Ansgar J.^c | Derreumaux, Alexandre^a | Manera, Valeria^a | Darcourt, Jacques^d | Benoit, Michel^e | Robert, Philippe H.^a | David, Renaud^a | for the Alzheimer’s Disease Neuroimaging Initiative¹

Affiliations: [a] Centre Memoire de Ressources et de Recherche, Institut Claude Pompidou, EA CoBTek, University of Nice Sophia Antipolis, Nice, France | [b] Department of Nuclear Medicine, Hôpital de La Tour, Meyrin, GE, Switzerland | [c] 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 | [d] Nuclear Medicine Department, Antoine Lacassagne Center, Nice, France | [e] Department of Psychiatry, University Hospital of Nice, France

Correspondence: [*] Correspondence to: David Bensamoun, MD, MSc, Centre mémoire de ressources et de recherche, Institut Claude Pompidou, 10 rue Molière, 06100, Nice, France. Tel.: +33 4 92034770; Fax: +33 4 93529257; E-mail: d.bensamoun@gmx.com

Note: [1] Data used in preparation of this article were obtained from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database (http://adni.loni.usc.edu). As such, the investigators within the ADNI contributed to the design and implementation of ADNI and/or provided data but did not participate in analysis or writing of this report. A complete listing of ADNI investigators can be found at: http://adni.loni.usc.edu/wp-content/uploads/how_to_apply/ADNI_Acknowledgement_List.pdf.

Abstract: 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). Conclusion:Anxiety and irritability are associated with greater amyloid deposition in the neurodegenerative process leading to AD.

Keywords: ADNI, Alzheimer’s disease, amyloid, anxiety, behavioral and psychological symptoms of dementia, dementia, cingulate, frontal, irritability, neuroimaging, neuropsychiatric symptoms

DOI: 10.3233/JAD-150181

Journal: Journal of Alzheimer's Disease, vol. 49, no. 2, pp. 387-398, 2016