|Title:||Amyloid-PET burden and regional distribution in cerebral amyloid angiopathy: A systematic review and meta-analysis of biomarker performance||Authors:||Charidimou A.
|Issue Date:||2018||Journal Volume:||89||Journal Issue:||4||Start page/Pages:||410-417||Source:||Journal of Neurology, Neurosurgery and Psychiatry||Abstract:||
Introduction We performed a meta-analysis to synthesise current evidence on amyloid-positron emission tomography (PET) burden and presumed preferential occipital distribution in sporadic cerebral amyloid angiopathy (CAA). Methods In a PubMed systematic search, we identified case-control studies with extractable data on global and occipital-to-global amyloid-PET uptake in symptomatic patients with CAA (per Boston criteria) versus control groups (healthy participants or patients with non-CAA deep intracerebral haemorrhage) and patients with Alzheimer's disease. To circumvent PET studies' methodological variation, we generated and used € fold change', that is, ratio of mean amyloid uptake (global and occipital-to-global) of CAA relative to comparison groups. Amyloid-PET uptake biomarker performance was then quantified by random-effects meta-analysis on the ratios of the means. A ratio >1 indicates that amyloid-PET uptake (global or occipital/global) is higher in CAA than comparison groups, and a ratio <1 indicates the reverse. Results Seven studies, including 106 patients with CAA (>90% with probable CAA) and 138 controls (96 healthy elderly, 42 deep intracerebral haemorrhage controls) and 72 patients with Alzheimer's disease, were included. Global amyloid-PET ratio between patients with CAA and controls was above 1, with an average effect size of 1.18 (95% CI 1.08 to 1.28; p<0.0001). Occipital-to-global amyloid-PET uptake ratio did not differ between patients with CAA versus patients with deep intracerebral haemorrhage or healthy controls. By contrast, occipital-to-global amyloid-PET uptake ratio was above 1 in patients with CAA versus those with Alzheimer's disease, with an average ratio of 1.10 (95% CI 1.03 to 1.19; p=0.009) and high statistical heterogeneity. Conclusions Our analysis provides exploratory actionable data on the overall effect sizes and strength of amyloid-PET burden and distribution in patients with CAA, useful for future larger studies. ? Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
|ISSN:||223050||DOI:||10.1136/jnnp-2017-316851||SDG/Keyword:||amyloid; 2-(4'-(methylamino)phenyl)-6-hydroxybenzothiazole; amyloid beta protein; aniline derivative; ethylene glycol derivative; florbetapir; thiazole derivative; Alzheimer disease; Article; brain hemorrhage; contrast; disease burden; evidence based medicine; human; positron emission tomography; priority journal; protein localization; protein transport; systematic review; vascular amyloidosis; diagnostic imaging; meta analysis; metabolism; positron emission tomography; vascular amyloidosis; Amyloid beta-Peptides; Aniline Compounds; Cerebral Amyloid Angiopathy; Ethylene Glycols; Humans; Positron-Emission Tomography; Thiazoles
|Appears in Collections:||醫學院附設醫院 (臺大醫院)|
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