Multi-disciplinary research

Topographical distribution of cerebral amyloid angiopathy and its effect on cognitive decline are influenced by Alzheimer disease pathology (2007)

Author(s): Attems J, Quass M, Jellinger KA, Lintner F

    Abstract: Cerebral amyloid angiopathy (CAA) is defined by beta-amyloid peptide (Abeta) depositions in cerebral vessels and is associated with Alzheimer disease (AD). It has been suggested that severe CAA is an independent risk factor for cognitive decline. 171 autopsy brains underwent standardized neuropathological assessment, the patients age ranged from 54 to 104 years (mean age: 83.9 years, +/-9.2, 59.6% female, 56.1% clinically demented). Using immunohistochemistry, the severity of Abeta depositions in vessels was assessed semiquantitatively in the frontal, frontobasal, hippocampal, and occipital region, respectively. CAA was present in 117 cases (68.4%), with the occipital region being affected significantly stronger than other regions. The overall incidence of CAA was significantly higher in cases with high grade neuritic AD pathology (ADP) compared to those with low grade or no ADP. The severity of CAA significantly increased with increasing ADP, with CAA in the occipital region increasing significantly stronger than that in other regions. The association of CAA and clinical dementia failed to remain statistically significant when adjusting for concomitant ADP. However, in cases devoid of any ADP CAA was significantly associated with the presence of clinical dementia. These results indicate a strong association of AD with CAA, but do not unequivocally support reports suggesting CAA to be an independent risk factor for cognitive decline, except for a subgroup of demented patients lacking any ADP.

    Notes: Research Support, Non-U.S. Gov't

      • Date: 15-02-2007
      • Journal: Journal of the Neurological Sciences
      • Volume: 257
      • Issue: 1-2
      • Pages: 49-55
      • Publisher: Elsevier BV
      • Publication type: Article
      • Bibliographic status: Published

      Keywords: Aged Aged, 80 and over Alzheimer Disease/*pathology/physiopathology/psychology Cerebral Amyloid Angiopathy/*pathology/physiopathology/psychology Cerebral Arteries/*pathology/physiopathology Cognition Disorders/etiology/*pathology/physiopathology Cohort Studies Disease Progression Female Humans Immunohistochemistry Male Microcirculation/pathology/physiopathology Middle Aged Occipital Lobe/blood supply/pathology/physiopathology Risk Factors Senile Plaques/metabolism/pathology Telencephalon/blood supply/*pathology/physiopathology


      Professor Johannes Attems
      Professor of Neuropathology, Honorary Consultant Pathologist