Investigating reliable amyloid accumulation in Centiloids: Results from the AMYPAD Prognostic and Natural History Study

Author:

Bollack Ariane1ORCID,Collij Lyduine E.234ORCID,García David Vállez2ORCID,Shekari Mahnaz567ORCID,Altomare Daniele8ORCID,Payoux Pierre910,Dubois Bruno11,Grau‐Rivera Oriol5,Boada Mercè1213ORCID,Marquié Marta1213ORCID,Nordberg Agneta1415,Walker Zuzana1617ORCID,Scheltens Philip18,Schöll Michael192021,Wolz Robin22,Schott Jonathan M.23,Gismondi Rossella24,Stephens Andrew24ORCID,Buckley Christopher25,Frisoni Giovanni B.8,Hanseeuw Bernard262728ORCID,Visser Pieter Jelle21429,Vandenberghe Rik30,Drzezga Alexander313233,Yaqub Maqsood2,Boellaard Ronald234,Gispert Juan Domingo5635ORCID,Markiewicz Pawel136ORCID,Cash David M.3738ORCID,Farrar Gill25,Barkhof Frederik1237ORCID,

Affiliation:

1. Centre for Medical Image Computing (CMIC) Department of Medical Physics and Bioengineering University College London London London UK

2. Department of Radiology and Nuclear Medicine Amsterdam UMC Amsterdam The Netherlands

3. Clinical Memory Research Unit Department of Clinical Sciences Lund University Malmö Sweden

4. Amsterdam Neuroscience, Brain Imaging VU University Amsterdam Amsterdam The Netherlands

5. Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation Barcelona Spain

6. Universitat Pompeu Fabra Barcelona Spain

7. Instituto de investigaciones médicas Hospital del Mar (IMIM) Barcelona Spain

8. Neurology Unit Department of Clinical and Experimental Sciences University of Brescia Brescia Italy

9. Department of Nuclear Medicine Imaging Pole Toulouse University Hospital Toulouse France

10. Toulouse NeuroImaging Center Université de Toulouse Inserm UPS CHU Purpan Pavillon Baudot Place du Docteur Joseph Baylac Toulouse France

11. Department of Neurology Salpêtrière Hospital AP‐HP Sorbonne University Paris France

12. Ace Alzheimer Center Barcelona – Universitat Internacional de Catalunya Barcelona Spain

13. CIBERNED Network Center for Biomedical Research in Neurodegenerative Diseases National Institute of Health Carlos III Madrid Spain

14. Department of Neurobiology Care Sciences and Society, Center for Alzheimer Research, Division of Clinical Geriatrics, Karolinska Institutet Stockholm Sweden

15. Theme Inflammation and Aging, Karolinska University Hospital, Karolinska Institutet Stockholm Sweden

16. Division of Psychiatry University College London London UK

17. Essex Partnership University NHS Foundation Trust, The Lodge Wickford UK

18. Alzheimer Center and Department of Neurology Amsterdam Neuroscience, VU University Medical Center, Alzheimercentrum Amsterdam Amsterdam The Netherlands

19. Wallenberg Centre for Molecular and Translational Medicine, The University of Gothenburg Gothenburg Sweden

20. Department of Psychiatry and Neurochemistry Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital Gothenburg Sweden

21. Department of Neurodegenerative Disease UCL Institute of Neurology London UK

22. IXICO Plc London UK

23. Dementia Research Centre, UCL Queen Square Institute of Neurology London UK

24. Life Molecular Imaging, GmbH Berlin Germany

25. GE HealthCare Buckinghamshire UK

26. Department of Neurology Institute of Neuroscience, Université Catholique de Louvain, Cliniques Universitaires Saint‐Luc Brussels Belgium

27. Gordon Center for Medical Imaging Department of Radiology Massachusetts General Hospital Boston Massachusetts USA

28. WELBIO Department WEL Research Institute Wavre Belgium

29. Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University Maastricht The Netherlands

30. Laboratory for Cognitive Neurology, LBI – KU Leuven Brain Institute Leuven Belgium

31. Department of Nuclear Medicine University Hospital Cologne, Universitätsklinikums Köln Köln Germany

32. Molecular Organization of the Brain, Institute for Neuroscience and Medicine, INM‐2), Forschungszentrum Jülich GmbH Jülich Germany

33. German Center for Neurodegenerative Diseases (DZNE) Bonn Germany

34. Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen Groningen The Netherlands

35. Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III Madrid Spain

36. Computer Science and Informatics, School of Engineering, London South Bank University London UK

37. Queen Square Institute of Neurology, University College London London UK

38. UK Dementia Research Institute at University College London London UK

Abstract

AbstractINTRODUCTIONTo support clinical trial designs focused on early interventions, our study determined reliable early amyloid‐β (Aβ) accumulation based on Centiloids (CL) in pre‐dementia populations.METHODSA total of 1032 participants from the Amyloid Imaging to Prevent Alzheimer's Disease–Prognostic and Natural History Study (AMYPAD‐PNHS) and Insight46 who underwent [18F]flutemetamol, [18F]florbetaben or [18F]florbetapir amyloid‐PET were included. A normative strategy was used to define reliable accumulation by estimating the 95th percentile of longitudinal measurements in sub‐populations (NPNHS = 101/750, NInsight46 = 35/382) expected to remain stable over time. The baseline CL threshold that optimally predicts future accumulation was investigated using precision‐recall analyses. Accumulation rates were examined using linear mixed‐effect models.RESULTSReliable accumulation in the PNHS was estimated to occur at >3.0 CL/year. Baseline CL of 16 [12,19] best predicted future Aβ‐accumulators. Rates of amyloid accumulation were tracer‐independent, lower for APOE ε4 non‐carriers, and for subjects with higher levels of education.DISCUSSIONOur results support a 12–20 CL window for inclusion into early secondary prevention studies. Reliable accumulation definition warrants further investigations.

Publisher

Wiley

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