The role of the hippocampus in mediating cognitive impairment in cerebral amyloid angiopathy. (1st February 2022)

• Record Type: Journal Article
• Authors: Perosa, Valentina; Zotin, Maria Clara Zanon; Schoemaker, Dorothee; Sveikata, Lukas; Etherton, Mark; Charidimou, Andreas; Greenberg, Steven M.; Viswanathan, Anand
• Is Part Of: Alzheimer's & dementia. Volume 17(2021)Supplement 4
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-02-01
• Subjects: Alzheimer's disease -- Periodicals; Alzheimer Disease -- Periodicals; Dementia -- Periodicals; Démence; Maladie d'Alzheimer; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.83
• DOI: 10.1002/alz.054515
• Languages: English
• ISSNs: 1552-5260

Abstract

Abstract: Background: The interplay between cerebrovascular and Alzheimer's pathology has an important role in the development of cognitive impairment 1 . Vascular risk factors and neuroimaging markers of cerebral small vessel disease (CSVD), have well been characterized in patients with Alzheimer's disease (AD) in the past years 2, 3 . Conversely, few studies asked how hippocampal neurodegeneration, a benchmark of AD, relates to cognition in CSVD patients 4 . Method: We set out to investigate the relation between hippocampal neurodegeneration and cognition in a memory clinic cohort of 101 (75.8 ± 6.7 y, 58 F) patients with possible and probable cerebral amyloid angiopathy (CAA), a common CSVD form with defined diagnostic criteria. Linear regression models were used to assess the associations between the volume of hippocampal subfields and cognitive measures. Neuroimaging markers of CSVD were subsequently included in the analyses, to evaluate how they mediate the relation between cognition and hippocampal neurodegeneration. Result: We found a significant positive association between CA1 volume and cognitive domains (memory: b =0.14, p =0.008; processing speed: b =0.15, p =0.03; language: b =0.14, p =0.03; executive function: b =0.20, p =0.01). CA1 volume was significantly related to memory and executive function, even when accounting for neuroimaging markers of CSVD. Furthermore, presence of cortical superficial siderosis and peak width of skeletonized mean diffusivity (PSMD), a measure of white matter (WM) integrity, were negatively associated with hippocampal and subfields' volumes. Conclusion: These results suggest that neurodegeneration of CA1 is related to cognitive impairment in CAA patients, and may further support established links between vascular pathology and loss of CA1 integrity and/or overlap of AD pathology in these patients 5‐7 . Moreover, further studies exploring the relationship between WM and hippocampal integrity may be warranted.