Background:The overlap between cerebral amyloid angiopathy (CAA) and Alzheimer’s disease (AD) is frequent and relevant for patients with cognitive impairment. Objective:To assess the role of the diagnosis of CAA on the phenotype of amyloid-β (Aβ) positive patients from a university-hospital memoryclinic. Methods:Consecutive patients referred for suspected cognitive impairment, screened for Aβ pathological changes in cerebrospinal fluid (CSF), with available MRI and neuropsychological results were included. We determined the association between probable CAA and clinical, neuropsychological (at presentation and after a mean follow-up of 17 months in a sub-sample) and MRI (atrophy, white matter hyperintensities, perivascular spaces) characteristics. Results:Of 218 amyloid-positive patients, 8.3% fulfilled criteria for probable CAA. A multivariable logistic regression showed an independent association of probable CAA with lower Aβ1–42 (adjusted odds ratio [aOR] = 0.94, 95% confidence interval [95%CI] = 0.90–0.98, p = 0.003), and Aβ1–40 (aOR = 0.98, 95% CI=0.97–0.99 p = 0.017) levels in CSF, and presence of severe burden of enlarged perivascular spaces (EPVS) in the centrum semiovale (aOR = 3.67, 95% CI = 1.21–11.15, p = 0.022). Linear mixed-model analysis showed that both groups significantly deteriorated in global clinical severity, executive function and memory. Nevertheless, the presence of probable CAA did not differently affect the rate of cognitive decline. Conclusion:The presence of probable CAA in Aβ positive patients was associated with lower Aβ1–42 and Aβ1–40 CSF levels and increased centrum semiovale EPVS burden, but did not independently influence clinical phenotype nor the rate of cognitive decline within our follow-up time window.

中文翻译：

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来自记忆临床队列的淀粉样蛋白阳性患者的脑淀粉样蛋白血管病

背景：脑淀粉样血管病 (CAA) 和阿尔茨海默病 (AD) 之间的重叠很常见，并且与认知障碍患者相关。目的：评估CAA的诊断对来自大学-医院记忆诊所的淀粉样蛋白-β（Aβ）阳性患者表型的影响。方法：连续纳入疑似认知障碍转诊、脑脊液（CSF）Aβ病理改变、可用MRI和神经心理学结果的患者。我们确定了可能的 CAA 与临床、神经心理学（就诊时和子样本中平均随访 17 个月后）和 MRI（萎缩、白质高信号、血管周围间隙）特征之间的关联。结果：在 218 名淀粉样蛋白阳性患者中，8.3% 符合可能 CAA 的标准。多变量逻辑回归显示可能的 CAA 与较低的 Aβ1-42（调整优势比 [aOR] = 0.94，95% 置信区间 [95%CI] = 0.90-0.98，p = 0.003）和 Aβ1-40（ aOR = 0.98, 95% CI = 0.97–0.99 p = 0.017) CSF 水平，半卵圆中央存在严重的血管周围间隙扩大 (EPVS) 负担（aOR = 3.67，95% CI = 1.21–11.15，p = 0.022）。线性混合模型分析显示，两组的整体临床严重程度、执行功能和记忆力均显着恶化。尽管如此，可能的 CAA 的存在对认知能力下降的速度没有不同的影响。结论：Aβ 阳性患者可能存在 CAA 与较低的 Aβ1-42 和 Aβ1-40 CSF 水平和半卵圆中心 EPVS 负荷增加有关，