Microbleeds in atypical presentations of Alzheimer's disease: A comparison to dementia of the Alzheimer's type

Jennifer Lynn Whitwell, Kejal M Kantarci, Stephen D. Weigand, Emily S. Lundt, Jeffrey L. Gunter, Joseph R. Duffy, Edythe A. Strand, Mary Margaret Machulda, Anthony J. Spychalla, Daniel Drubach, Ronald Carl Petersen, Val Lowe, Clifford R Jr. Jack, Keith Anthony Josephs

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: Microbleeds in the brain have been shown to occur in Alzheimer's disease (AD), affecting approximately a third of subjects that present with typical dementia of the Alzheimer's type (DAT). However, little is known about the frequency or distribution of microbleeds in subjects with AD that present with atypical clinical presentations. Objective: To determine whether the frequency and regional distribution of microbleeds in atypical AD differs from that observed in subjects with DAT, and to determine whether microbleeds in atypical AD are associated with age, demographics, or cognitive impairment. Methods: Fifty-five subjects with amyloid-β deposition on Pittsburgh compound B (PiB) PET who presented with predominant language (n = 37) or visuospatial/perceptual (n = 18) deficits underwent T2∗weighted MRI. These subjects were compared to 41 PiB-positive subjects with DAT. Microbleeds were identified and assigned a lobar location. Results: The proportion of subjects with microbleeds did not differ between atypical AD (42%) and DAT (32%). However, atypical AD had larger numbers of microbleeds than DAT. In addition, the topographic distribution of microbleeds differed between atypical AD and DAT, with atypical AD showing the highest density of microbleeds in the frontal lobes. Among atypical AD, number of microbleeds was associated with age, but not gender or cognition. Microbleeds were more common in subjects with language (51%) versus visuospatial/perceptual deficits (22%). Conclusions: Microbleeds are relatively common in both DAT and atypical AD, although atypical AD subjects appear to be at particular risk for developing large numbers of microbleeds and for developing microbleeds in the frontal lobe.

Original languageEnglish (US)
Pages (from-to)1109-1117
Number of pages9
JournalJournal of Alzheimer's Disease
Volume45
Issue number4
DOIs
StatePublished - 2015

Fingerprint

Alzheimer Disease
Frontal Lobe
Language
Amyloid
Cognition

Keywords

  • Alzheimer's disease
  • amyloid-β
  • dementia of the Alzheimer's type
  • early-onset Alzheimer's disease
  • logopenic
  • magnetic resonance imaging
  • microbleeds
  • positron emission tomography
  • posterior cortical atrophy

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Geriatrics and Gerontology
  • Clinical Psychology

Cite this

Microbleeds in atypical presentations of Alzheimer's disease : A comparison to dementia of the Alzheimer's type. / Whitwell, Jennifer Lynn; Kantarci, Kejal M; Weigand, Stephen D.; Lundt, Emily S.; Gunter, Jeffrey L.; Duffy, Joseph R.; Strand, Edythe A.; Machulda, Mary Margaret; Spychalla, Anthony J.; Drubach, Daniel; Petersen, Ronald Carl; Lowe, Val; Jack, Clifford R Jr.; Josephs, Keith Anthony.

In: Journal of Alzheimer's Disease, Vol. 45, No. 4, 2015, p. 1109-1117.

Research output: Contribution to journalArticle

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title = "Microbleeds in atypical presentations of Alzheimer's disease: A comparison to dementia of the Alzheimer's type",
abstract = "Background: Microbleeds in the brain have been shown to occur in Alzheimer's disease (AD), affecting approximately a third of subjects that present with typical dementia of the Alzheimer's type (DAT). However, little is known about the frequency or distribution of microbleeds in subjects with AD that present with atypical clinical presentations. Objective: To determine whether the frequency and regional distribution of microbleeds in atypical AD differs from that observed in subjects with DAT, and to determine whether microbleeds in atypical AD are associated with age, demographics, or cognitive impairment. Methods: Fifty-five subjects with amyloid-β deposition on Pittsburgh compound B (PiB) PET who presented with predominant language (n = 37) or visuospatial/perceptual (n = 18) deficits underwent T2∗weighted MRI. These subjects were compared to 41 PiB-positive subjects with DAT. Microbleeds were identified and assigned a lobar location. Results: The proportion of subjects with microbleeds did not differ between atypical AD (42{\%}) and DAT (32{\%}). However, atypical AD had larger numbers of microbleeds than DAT. In addition, the topographic distribution of microbleeds differed between atypical AD and DAT, with atypical AD showing the highest density of microbleeds in the frontal lobes. Among atypical AD, number of microbleeds was associated with age, but not gender or cognition. Microbleeds were more common in subjects with language (51{\%}) versus visuospatial/perceptual deficits (22{\%}). Conclusions: Microbleeds are relatively common in both DAT and atypical AD, although atypical AD subjects appear to be at particular risk for developing large numbers of microbleeds and for developing microbleeds in the frontal lobe.",
keywords = "Alzheimer's disease, amyloid-β, dementia of the Alzheimer's type, early-onset Alzheimer's disease, logopenic, magnetic resonance imaging, microbleeds, positron emission tomography, posterior cortical atrophy",
author = "Whitwell, {Jennifer Lynn} and Kantarci, {Kejal M} and Weigand, {Stephen D.} and Lundt, {Emily S.} and Gunter, {Jeffrey L.} and Duffy, {Joseph R.} and Strand, {Edythe A.} and Machulda, {Mary Margaret} and Spychalla, {Anthony J.} and Daniel Drubach and Petersen, {Ronald Carl} and Val Lowe and Jack, {Clifford R Jr.} and Josephs, {Keith Anthony}",
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T1 - Microbleeds in atypical presentations of Alzheimer's disease

T2 - A comparison to dementia of the Alzheimer's type

AU - Whitwell, Jennifer Lynn

AU - Kantarci, Kejal M

AU - Weigand, Stephen D.

AU - Lundt, Emily S.

AU - Gunter, Jeffrey L.

AU - Duffy, Joseph R.

AU - Strand, Edythe A.

AU - Machulda, Mary Margaret

AU - Spychalla, Anthony J.

AU - Drubach, Daniel

AU - Petersen, Ronald Carl

AU - Lowe, Val

AU - Jack, Clifford R Jr.

AU - Josephs, Keith Anthony

PY - 2015

Y1 - 2015

N2 - Background: Microbleeds in the brain have been shown to occur in Alzheimer's disease (AD), affecting approximately a third of subjects that present with typical dementia of the Alzheimer's type (DAT). However, little is known about the frequency or distribution of microbleeds in subjects with AD that present with atypical clinical presentations. Objective: To determine whether the frequency and regional distribution of microbleeds in atypical AD differs from that observed in subjects with DAT, and to determine whether microbleeds in atypical AD are associated with age, demographics, or cognitive impairment. Methods: Fifty-five subjects with amyloid-β deposition on Pittsburgh compound B (PiB) PET who presented with predominant language (n = 37) or visuospatial/perceptual (n = 18) deficits underwent T2∗weighted MRI. These subjects were compared to 41 PiB-positive subjects with DAT. Microbleeds were identified and assigned a lobar location. Results: The proportion of subjects with microbleeds did not differ between atypical AD (42%) and DAT (32%). However, atypical AD had larger numbers of microbleeds than DAT. In addition, the topographic distribution of microbleeds differed between atypical AD and DAT, with atypical AD showing the highest density of microbleeds in the frontal lobes. Among atypical AD, number of microbleeds was associated with age, but not gender or cognition. Microbleeds were more common in subjects with language (51%) versus visuospatial/perceptual deficits (22%). Conclusions: Microbleeds are relatively common in both DAT and atypical AD, although atypical AD subjects appear to be at particular risk for developing large numbers of microbleeds and for developing microbleeds in the frontal lobe.

AB - Background: Microbleeds in the brain have been shown to occur in Alzheimer's disease (AD), affecting approximately a third of subjects that present with typical dementia of the Alzheimer's type (DAT). However, little is known about the frequency or distribution of microbleeds in subjects with AD that present with atypical clinical presentations. Objective: To determine whether the frequency and regional distribution of microbleeds in atypical AD differs from that observed in subjects with DAT, and to determine whether microbleeds in atypical AD are associated with age, demographics, or cognitive impairment. Methods: Fifty-five subjects with amyloid-β deposition on Pittsburgh compound B (PiB) PET who presented with predominant language (n = 37) or visuospatial/perceptual (n = 18) deficits underwent T2∗weighted MRI. These subjects were compared to 41 PiB-positive subjects with DAT. Microbleeds were identified and assigned a lobar location. Results: The proportion of subjects with microbleeds did not differ between atypical AD (42%) and DAT (32%). However, atypical AD had larger numbers of microbleeds than DAT. In addition, the topographic distribution of microbleeds differed between atypical AD and DAT, with atypical AD showing the highest density of microbleeds in the frontal lobes. Among atypical AD, number of microbleeds was associated with age, but not gender or cognition. Microbleeds were more common in subjects with language (51%) versus visuospatial/perceptual deficits (22%). Conclusions: Microbleeds are relatively common in both DAT and atypical AD, although atypical AD subjects appear to be at particular risk for developing large numbers of microbleeds and for developing microbleeds in the frontal lobe.

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KW - dementia of the Alzheimer's type

KW - early-onset Alzheimer's disease

KW - logopenic

KW - magnetic resonance imaging

KW - microbleeds

KW - positron emission tomography

KW - posterior cortical atrophy

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