Beta amyloid deposition is not associated with cognitive impairment in Parkinson's disease

Type of content
Journal Article
Thesis discipline
Degree name
Publisher
Frontiers Media SA
Journal Title
Journal ISSN
Volume Title
Language
eng
Date
2019
Authors
Melzer TR
Stark MR
Keenan RJ
Myall DJ
MacAskill MR
Pitcher TL
Livingston L
Grenfell S
Horne KL
Young BN
Abstract

The extent to which Alzheimer neuropathology, particularly the accumulation of misfolded beta-amyloid, contributes to cognitive decline and dementia in Parkinson's disease (PD) is unresolved. Here, we used Florbetaben PET imaging to test for any association between cerebral amyloid deposition and cognitive impairment in PD, in a sample enriched for cases with mild cognitive impairment. This cross-sectional study used Movement Disorders Society level II criteria to classify 115 participants with PD as having normal cognition (PDN, n = 23), mild cognitive impairment (PD-MCI, n = 76), or dementia (PDD, n = 16). We acquired 18F-Florbetaben (FBB) amyloid PET and structural MRI. Amyloid deposition was assessed between the three cognitive groups, and also across the whole sample using continuous measures of both global cognitive status and average performance in memory domain tests. Outcomes were cortical FBB uptake, expressed in centiloids and as standardized uptake value ratios (SUVR) using the Centiloid Project whole cerebellum region as a reference, and regional SUVR measurements. FBB binding was higher in PDD, but this difference did not survive adjustment for the older age of the PDD group. We established a suitable centiloid cut-off for amyloid positivity in Parkinson's disease (31.3), but there was no association of FBB binding with global cognitive or memory scores. The failure to find an association between PET amyloid deposition and cognitive impairment in a moderately large sample, particularly given that it was enriched with PD-MCI patients at risk of dementia, suggests that amyloid pathology is not the primary driver of cognitive impairment and dementia in most patients with PD.

Description
Citation
Melzer TR, Stark MR, Keenan RJ, Myall DJ, MacAskill MR, Pitcher TL, Livingston L, Grenfell S, Horne KL, Young BN, Pascoe MJ, Almuqbel MM, Wang J, Marsh SH, Miller DH, Dalrymple-Alford JC, Anderson TJ (2019). Beta amyloid deposition is not associated with cognitive impairment in Parkinson's disease. Frontiers in Neurology. 10(APR). 391-.
Keywords
Parkinson's disease, amyloid PET, Florbetaben, dementia, centiloid, mild cognitive impairment
Ngā upoko tukutuku/Māori subject headings
ANZSRC fields of research
1103 Clinical Sciences
1109 Neurosciences
1701 Psychology
Fields of Research::32 - Biomedical and clinical sciences::3209 - Neurosciences::320905 - Neurology and neuromuscular diseases
Fields of Research::32 - Biomedical and clinical sciences::3202 - Clinical sciences::320206 - Diagnostic radiography
Fields of Research::52 - Psychology::5202 - Biological psychology::520203 - Cognitive neuroscience
Fields of Research::52 - Psychology::5202 - Biological psychology::520206 - Psychophysiology
Rights
Copyright © 2019 Melzer, Stark, Keenan, Myall, MacAskill, Pitcher, Livingston, Grenfell, Horne, Young, Pascoe, Almuqbel, Wang, Marsh, Miller, Dalrymple- Alford and Anderson. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.