Posterior Cortical Atrophy (PCA) Clinical Trial
Official title:
Amyloid-related Imaging Abnormalities (Microbleeds) in Atypical AD
The study is designed to assess the demographic, clinical and imaging associations with the presence of microbleeds in atypical Alzheimer's disease. The primary hypothesis is that cognitive and functional performance will be poorer in atypical Alzheimer's subjects with microbleeds compared to those without microbleeds.
Alzheimer's disease (AD) is associated with amyloid-related imaging abnormalities (ARIA).
Microbleeds (MBs) represent part of the spectrum of ARIA and can be identified as small
hypointense lesions on gradient-recalled echo (GRE) T2*-weighted MRI. They are thought to
represent hemosiderin deposits (and hence have been classified as ARIA-H1) and occur as a
consequence of leakage of blood products out of vessels that have been damaged by deposition
of the protein β-amyloid in cerebral vessels; cerebral amyloid angiopathy (CAA). However, it
is also possible that cerebrovascular disease could contribute to the presence of MBs in AD.
Subjects with MBs are at a greater risk of bleeds which could impact the use of
anti-coagulation treatment approaches.
The presence of CAA has been particularly associated with AD and studies have demonstrated
that MBs occur in 12-33% of subjects with typical Alzheimer's dementia, with a large
proportion of subjects showing multiple MBs. The presence of MBs has been associated with
older age and a greater degree of white matter hyperintensities (WMH) in Alzheimer's
dementia. The association between MBs and WMH, a marker of cerebrovascular disease, suggests
cerebrovascular disease may also play a role in the etiology of MBs in AD. However,
approximately 16% of AD subjects do not present with episodic memory loss, but instead
display language problems such as poor naming and impaired sentence repetition, or
visuospatial and visual perceptual deficits, and are referred to as atypical AD. Since AD is
associated with CAA, one would assume that CAA and hence MBs, would also occur in atypical
AD, although no studies have assessed MBs in atypical AD.
Amyloid-binding ligands, such as Pittsburgh Compound B (PiB), that can be detected using PET
scanning have now been developed and provide an invaluable biomarker to infer the presence
of β-amyloid. The presence of CAA has been shown to be associated with elevated PiB uptake,
and hence the assessment of PiB-PET in subjects with MBs will provide important information
on the association of MBs and β-amyloid deposition in AD.
The goal of the study is to assess the associations between MBs and demographic/clinical
features, assess the associations between MBs and imaging features as well as a possible
correlate to the number of MBs a subject has in atypical AD.
Patients found to be eligible and willing to enroll in this study will be asked to undergo a
Neurologic Examination, Neuropsychometric testing, an MRI scan, and a PiB PET scan of the
brain. This will be done over a period of two days at the Mayo Clinic in Rochester,
Minnesota.
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Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Diagnostic
| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Completed |
NCT02289118 -
Tau Imaging in Young Onset Dementia
|
||
| Recruiting |
NCT02740634 -
Molecular and Structural Imaging in Alzheimer's Disease: A Longitudinal Study
|
N/A |