Defining the Lowest Threshold for Amyloid-PET to Predict Future Cognitive Decline and Amyloid Accumulation

  • M.E. Farrell
  • , S. Jiang
  • , A.P. Schultz
  • , M.J. Properzi
  • , J.C. Price
  • , J.A. Becker
  • , H.I.L. Jacobs
  • , B.J. Hanseeuw
  • , D.M. Rentz
  • , V.L. Villemagne
  • , K.V. Papp
  • , E.C. Mormino
  • , R.A. Betensky
  • , K.A. Johnson
  • , R.A. Sperling
  • , R.F. Buckley*
  • , Alzheimer's Disease Neuroimaging Initiative (ADNI)
  • *Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

IntroductionAs clinical trials move toward earlier intervention, we sought to redefine the beta-amyloid (A beta)-PET threshold based on the lowest point in a baseline distribution that robustly predicts future A beta accumulation and cognitive decline in 3 independent samples of clinically normal individuals.MethodsSequential A beta cutoffs were tested to identify the lowest cutoff associated with future change in cognition (Preclinical Alzheimer Cognitive Composite [PACC]) and A beta-PET in clinically normal participants from the Harvard Aging Brain Study (n = 342), Australian Imaging, Biomarker and Lifestyle study of aging (n = 157), and Alzheimer's Disease Neuroimaging Initiative (n = 356).ResultsWithin samples, cutoffs derived from future A beta-PET accumulation and PACC decline converged on the same inflection point, beyond which trajectories diverged from normal. Across samples, optimal cutoffs fell within a short range (Centiloid 15-18.5).DiscussionThese optimized thresholds can help to inform future research and clinical trials targeting early A beta. Threshold convergence raises the possibility of contemporaneous early changes in A beta and cognition.
Original languageEnglish
Pages (from-to)E619-E631
Number of pages13
JournalNeurology
Volume96
Issue number4
DOIs
Publication statusPublished - 26 Jan 2021

Keywords

  • ALZHEIMERS-DISEASE
  • APOE EPSILON-4
  • BETA
  • NEURODEGENERATION
  • ASSOCIATION
  • BIOMARKERS
  • DEPOSITION
  • PROGRESS
  • CORE

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