Abstract

Case Report

Focal Ab-amyloid deposition precedes cerebral microbleeds and Superficial siderosis: a case report

Parnesh Raniga, Patricia Desmond, Paul Yates, Olivier Salvado, Pierrick Bourgeat, Jurgen Fripp, Svetlana Pejoska, Michael Woodward, Colin L Masters, Christopher C Rowe and Victor L Villemagne*

Published: 13 October, 2017 | Volume 1 - Issue 1 | Pages: 039-044

This case report presents in-vivo findings on the spatial and temporal relationship between focal Ab-amyloid deposition, cerebral micro-haemorrhages and superficial siderosis. A 65-year-old woman underwent 11C-PiB PET scans that revealed an atypical focal and asymmetrical pattern of Ab-amyloid deposition and MRI scans that revealed cerebral micro-haemorrhages and superficial siderosis. Almost all micro-haemorrhages were associated with focal Ab-amyloid deposition. Follow-up 11C-PiB PET and MRI scans showed progression of the disease. We speculate that Abamyloid deposition affects the structural integrity of arterioles, thereby predisposing them to micro haemorrhages. In support of this hypothesis, progression of MRI lesions was observed only in areas associated with Ab-amyloid deposition.

Read Full Article HTML DOI: 10.29328/journal.jnnd.1001007 Cite this Article Read Full Article PDF

Keywords:

Brain imaging; Alzheimer’s disease; Ab-amyloid; PiB; cerebral amyloid angiopathy

References

 

  1. Jellinger KA, Attems J. Prevalence and pathogenic role of cerebrovascular lesions in Alzheimer disease. J Neurol Sci. 2005; 229-230: 37-41. Ref.: https://goo.gl/ro46Px
  2. Smith DC, Woodward M, Merory J, Tochon-Danguy H, O’Keefe G, et al. Imaging beta-amyloid burden in aging and dementia. Neurology. 2007; 68: 1718-1725. Ref.: https://goo.gl/XYWWFB
  3. Knudsen KA, Rosand J, Karluk D, Greenberg SM. Clinical diagnosis of cerebral amyloid angiopathy: Validation of the Boston Criteria. Neurology. 2001; 56: 537-539. Ref.: https://goo.gl/7VzhiH
  4. Feldman HH, Maia LF, Mackenzie IRA, Forster BB, Martzke J, et al. Superficial Siderosis: A Potential Diagnostic Marker of Cerebral Amyloid Angiopathy in Alzheimer Disease. Stroke. 2008; 39: 2894-2897. Ref.: https://goo.gl/YzysMy
  5. Linn J, Halpin A, Demaerel P, Ruhland J, Giese AD, Prevalence of superficial siderosis in patients with cerebral amyloid angiopathy. Neurology 2010; 74: 1346-1350. Ref.: https://goo.gl/xgoRSu
  6. Dhollander I, Nelissen N, Van Laere K, Peeters D, Demaerel P, et al. In vivo amyloid imaging in cortical superficial siderosis. J Neurol Neurosurg Psychiatr. 2011; 82: 469-471. Ref.: https://goo.gl/taca5n
  7. Pike KE, Savage G, Villemagne VL, Ng S, Moss SA, et al. β-amyloid imaging and memory in non-demented individuals: evidence for preclinical Alzheimer’s disease. Brain. 2007; 130: 2837-2844. Ref.: https://goo.gl/n7uZ61
  8. Ng S, Villemagne VL, Berlangieri S, Lee S-T, Cherk M, et al. Visual Assessment Versus Quantitative Assessment of 11C-PIB PET and 18F-FDG PET for Detection of Alzheimer’s Disease. J Nucl Med. 2007; 48: 547-552. Ref.: https://goo.gl/Chr5pR
  9. Ellis KA, Bush AI, Darby D, De Fazio D, Foster J, et al. The Australian Imaging, Biomarkers and Lifestyle (AIBL) study of aging: methodology and baseline characteristics of 1112 individuals recruited for a longitudinal study of Alzheimer’s disease. Int Psychogeriatr. 2009; 21: 672-687. Ref.: https://goo.gl/QGkr7F
  10. Dierksen GA, Skehan ME, Khan MA, Jeng J, Nandigam RNK, et al. Spatial relation between microbleeds and amyloid deposits in amyloid angiopathy. Ann Neurol. 2010; 68: 545-548. Ref.: https://goo.gl/k5XJau
  11. Yates PA, Sirisriro R, Villemagne VL, Farquharson S, Masters CL, et al. For the AIBL Research Group Cerebral microhemorrhage and brain β-amyloid in aging and Alzheimer disease. Neurology. 2011; 77: 48 -54. Ref.: https://goo.gl/GNpjEa
  12. Weller RO, Preston SD, Subash M, Carare RO. Cerebral amyloid angiopathy in the aetiology and immunotherapy of Alzheimer disease. Alzheimers Res Ther. 2009; 1: 6. Ref.: https://goo.gl/BG4MFa
  13. Holland CM, Smith EE, Csapo I, Gurol ME, Brylka DA, et al. Spatial distribution of white-matter hyperintensities in Alzheimer disease, cerebral amyloid angiopathy, and healthy aging. Stroke 2008; 39: 1127-1133. Ref.: https://goo.gl/wFnkzm
  14. Smith EE. Leukoaraiosis and Stroke. Stroke. 2010; 41: S139-143. Ref.: https://goo.gl/BC7A9C
  15. Thal DR, Capetillo-Zarate E, Larionov S, Staufenbiel M, Zurbruegg S, et al. Capillary cerebral amyloid angiopathy is associated with vessel occlusion and cerebral blood flow disturbances. Neurobiol. Aging. 2009; 30: 1936-1948. Ref.: https://goo.gl/7PM88E
  16. Villemagne VL, Pike KE, Chételat G, Ellis KA, Mulligan RS, et al. Longitudinal assessment of Aβ and cognition in aging and Alzheimer disease. Ann Neurol. 2011; 69: 181-192. Ref.: https://goo.gl/rLdZf1
  17. Rinne JO, Brooks DJ, Rossor MN, Fox NC, Bullock R, et al. 11C-PiB PET assessment of change in fibrillar amyloid-β load in patients with Alzheimer’s disease treated with bapineuzumab: a phase 2, double-blind, placebo-controlled, ascending-dose study. Lancet Neurol. 2010; 9: 363-372. Ref.: https://goo.gl/gEJoWh
  18. Jack CR, Lowe VJ, Senjem ML, Weigand SD, Kemp BJ, et al. 11C PiB and structural MRI provide complementary information in imaging of Alzheimer’s disease and amnestic mild cognitive impairment. Brain. 2008; 131: 665-680. Ref.: https://goo.gl/LZQGez

Figures:

Figure 1

Figure 1

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More