Document Detail

Predicting sites of new hemorrhage with amyloid imaging in cerebral amyloid angiopathy.
MedLine Citation:
PMID:  22786597     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: We aimed to determine whether amyloid imaging can help predict the location and number of future hemorrhages in cerebral amyloid angiopathy (CAA).
METHODS: We performed a longitudinal cohort study of 11 patients with CAA without dementia who underwent serial brain MRIs after baseline amyloid imaging with Pittsburgh compound B (PiB). Mean distribution volume ratio (DVR) of PiB was determined at the sites of new micro/macrobleeds identified on follow-up MRI and compared with PiB retention at "simulated" hemorrhages, randomly placed in the same subjects using a probability distribution map of CAA-hemorrhage location. Mean PiB retention at the sites of observed new bleeds was also compared to that in shells concentrically surrounding the bleeds. Finally the association between number of incident bleeds and 3 regional amyloid measures were obtained.
RESULTS: Nine of 11 subjects had at least one new microbleed on follow-up MRI (median 4, interquartile range [IQR] 1-9) and 2 had 5 new intracerebral hemorrhages. Mean DVR was greater at the sites of incident bleeds (1.34, 95% confidence interval [CI] 1.23-1.46) than simulated lesions (1.14, 95% CI 1.07-1.22, p < 0.0001) in multivariable models. PiB retention decreased with increasing distance from sites of observed bleeds (p < 0.0001). Mean DVR in a superior frontal/parasagittal region of interest correlated independently with number of future hemorrhages after adjustment for relevant covariates (p = 0.003).
CONCLUSIONS: Our results provide direct evidence that new CAA-related hemorrhages occur preferentially at sites of increased amyloid deposition and suggest that PiB-PET imaging may be a useful tool in prediction of incident hemorrhages in patients with CAA.
M Edip Gurol; Gregory Dierksen; Rebecca Betensky; Christopher Gidicsin; Amy Halpin; Alex Becker; Jeremy Carmasin; Alison Ayres; Kristin Schwab; Anand Viswanathan; David Salat; Jonathan Rosand; Keith A Johnson; Steven M Greenberg
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-07-11
Journal Detail:
Title:  Neurology     Volume:  79     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-07-24     Completed Date:  2012-10-24     Revised Date:  2014-04-03    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  320-6     Citation Subset:  AIM; IM    
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MeSH Terms
Aged, 80 and over
Amyloid / metabolism*
Brain / metabolism,  pathology*,  radionuclide imaging
Brain Mapping
Cerebral Amyloid Angiopathy / metabolism,  pathology*,  radionuclide imaging
Image Processing, Computer-Assisted
Intracranial Hemorrhages / metabolism,  pathology*,  radionuclide imaging
Magnetic Resonance Imaging
Middle Aged
Predictive Value of Tests
Prospective Studies
Grant Support
5R01NS070834-01/02/NS/NINDS NIH HHS; P50 AG005134/AG/NIA NIH HHS; R01 AG026484/AG/NIA NIH HHS; R01AG026484/AG/NIA NIH HHS; T32 NS048005/NS/NINDS NIH HHS; T32NS048005/NS/NINDS NIH HHS
Reg. No./Substance:

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