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

*Corresponding author for this work
  • Great Ormond St Hospital for Children NHS Trust
  • Academic Center for Evidence-Based Sports Medicine (ACES), Amsterdam UMC, Amsterdam, the Netherlands
  • Lund University
  • VU University Medical Hospital
  • Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
  • Pompeu Fabra University
  • Hospital del Mar
  • University of Brescia
  • CHU de Toulouse
  • Toulouse Neuro Imaging Center
  • Département de Génétique et Cytogénétique
  • UIC Barcelona
  • CIBER - Center for Biomedical Research Network
  • Karolinska Institutet
  • Karolinska University Hospital
  • University College London and Essex Partnership University NHS Foundation Trust
  • University of Gothenburg
  • Sahlgrenska University Hospital
  • University College London
  • IXICO plc
  • GmbH
  • GE Healthcare
  • Université catholique de Louvain
  • Brigham and Women’s Hospital
  • WEL Research Institute
  • University of Limburg
  • KU Leuven
  • University Hospital of Cologne
  • Jülich Research Centre
  • University of Bonn and German Center for Neurodegenerative Diseases (DZNE)
  • University of Groningen
  • London South Bank University

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

INTRODUCTION: To 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. METHODS: A 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. RESULTS: Reliable 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. DISCUSSION: Our results support a 12–20 CL window for inclusion into early secondary prevention studies. Reliable accumulation definition warrants further investigations.
Original languageEnglish
Pages (from-to)3429-3441
Number of pages13
JournalAlzheimer's and Dementia
Volume20
Issue number5
Early online date2024
DOIs
Publication statusPublished - May 2024

Keywords

  • Alzheimer's
  • Centiloid
  • amyloid
  • longitudinal PET
  • quantification
  • reliable accumulation

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