Interhemispheric distribution of Alzheimer disease and vascular pathology in brain aging

Détails

Ressource 1Télécharger: 19118241_Postprint.pdf (493.25 [Ko])
Etat: Serval
Version: de l'auteur
ID Serval
serval:BIB_C16178C68A86
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Interhemispheric distribution of Alzheimer disease and vascular pathology in brain aging
Périodique
Stroke
Auteur(s)
Giannakopoulos P., Kövari E., Herrmann F.R., Hof P.R., Bouras C.
ISSN
1524-4628 ([electronic])
Statut éditorial
Publié
Date de publication
2009
Peer-reviewed
Oui
Volume
40
Numéro
3
Pages
983-986
Langue
anglais
Notes
Publication types: Letter ; Research Support, N.I.H., Extramural - Publication Status: ppublish
Résumé
BACKGROUND AND PURPOSE: Most of the neuropathological studies in brain aging were based on the assumption of a symmetrical right-left hemisphere distribution of both Alzheimer disease and vascular pathology. To explore the impact of asymmetrical lesion formation on cognition, we performed a clinicopathological analysis of 153 cases with mixed pathology except macroinfarcts. METHODS: Cognitive status was assessed prospectively using the Clinical Dementia Rating scale; neuropathological evaluation included assessment of Braak neurofibrillary tangle and Ass deposition staging, microvascular pathology, and lacunes. The right-left hemisphere differences in neuropathological scores were evaluated using the Wilcoxon signed rank test. The relationship between the interhemispheric distribution of lesions and Clinical Dementia Rating scores was assessed using ordered logistic regression. RESULTS: Unlike Braak neurofibrillary tangle and Ass deposition staging, vascular scores were significantly higher in the left hemisphere for all Clinical Dementia Rating scores. A negative relationship was found between Braak neurofibrillary tangle, but not Ass staging, and vascular scores in cases with moderate to severe dementia. In both hemispheres, Braak neurofibrillary tangle staging was the main determinant of cognitive decline followed by vascular scores and Ass deposition staging. The concomitant predominance of Alzheimer disease and vascular pathology in the right hemisphere was associated with significantly higher Clinical Dementia Rating scores. CONCLUSIONS: Our data show that the cognitive impact of Alzheimer disease and vascular lesions in mixed cases may be assessed unilaterally without major information loss. However, interhemispheric differences and, in particular, increased vascular and Alzheimer disease burden in the right hemisphere may increase the risk for dementia in this group.
Pubmed
Web of science
Open Access
Oui
Création de la notice
02/03/2009 11:35
Dernière modification de la notice
09/05/2019 0:45
Données d'usage