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Brain Sciences
Volume 9
Issue 8
10.3390/brainsci9080187
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Article

A Multimodal Approach to Stratification of Patients with Dementia: Selection of Mixed Dementia Patients Prior to Autopsy

by
Gary A. Rosenberg
*,
Jillian Prestopnik
,
Janice Knoefel
,
John C. Adair
,
Jeffrey Thompson
, and
Arvind Caprihan
Department of Neurology, University of New Mexico Health Sciences Center and the MIND Research Network, Albuquerque, NM 87131, USA
*
Author to whom correspondence should be addressed.
Brain Sci. 2019, 9(8), 187; https://doi.org/10.3390/brainsci9080187
Received: 3 July 2019 / Revised: 21 July 2019 / Accepted: 29 July 2019 / Published: 1 August 2019
(This article belongs to the Special Issue Vascular Cognitive Impairment and Dementia Focused on Subcortical Small Vessel Disease)
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Abstract

Alzheimer’s disease (AD) and vascular cognitive impairment and dementia (VCID) are major causes of dementia, and when combined lead to accelerated cognitive loss. We hypothesized that biomarkers of neurodegeneration and neuroinflammation could be used to stratify patients into diagnostic groups. Diagnosis of AD can be made biologically with detection of amyloid and tau proteins in the cerebrospinal fluid (CSF) and vascular disease can be identified with diffusion tensor imaging (DTI). We recruited patients with cognitive complaints and made an initial clinical diagnosis. After one year of follow-up we made a biological diagnosis based on the use of biomarkers obtained from DTI, CSF AD, and inflammatory proteins, and neuropsychological testing. Patients with AD had primarily findings of neurodegeneration (CSF showing increased tau and reduced amyloid), while patients with neuroinflammation had abnormal DTI mean diffusion (MD) in the white matter. Using the biological biomarkers resulted in many of the clinically diagnosed AD patients moving into mixed dementia (MX). Biomarkers of inflammation tended to be higher in the MX than in either the AD or VCID, suggesting dual pathology leads to increased inflammation, which could explain accelerated cognitive decline in that group. View Full-Text
Keywords: vascular cognitive impairment; Alzheimer’s disease; mixed dementia; biomarkers; cerebrospinal fluid; diffusion tensor imaging; neurodegeneration; neuroinflammation vascular cognitive impairment; Alzheimer’s disease; mixed dementia; biomarkers; cerebrospinal fluid; diffusion tensor imaging; neurodegeneration; neuroinflammation
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
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MDPI and ACS Style

Rosenberg, G.A.; Prestopnik, J.; Knoefel, J.; Adair, J.C.; Thompson, J.; Raja, R.; Caprihan, A. A Multimodal Approach to Stratification of Patients with Dementia: Selection of Mixed Dementia Patients Prior to Autopsy. Brain Sci. 2019, 9, 187. https://doi.org/10.3390/brainsci9080187

AMA Style

Rosenberg GA, Prestopnik J, Knoefel J, Adair JC, Thompson J, Raja R, Caprihan A. A Multimodal Approach to Stratification of Patients with Dementia: Selection of Mixed Dementia Patients Prior to Autopsy. Brain Sciences. 2019; 9(8):187. https://doi.org/10.3390/brainsci9080187

Chicago/Turabian Style

Rosenberg, Gary A., Jillian Prestopnik, Janice Knoefel, John C. Adair, Jeffrey Thompson, Rajikha Raja, and Arvind Caprihan. 2019. "A Multimodal Approach to Stratification of Patients with Dementia: Selection of Mixed Dementia Patients Prior to Autopsy" Brain Sciences 9, no. 8: 187. https://doi.org/10.3390/brainsci9080187

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