eprintid: 10084779 rev_number: 23 eprint_status: archive userid: 608 dir: disk0/10/08/47/79 datestamp: 2019-11-05 10:46:17 lastmod: 2021-09-17 22:32:35 status_changed: 2019-11-05 10:46:17 type: article metadata_visibility: show creators_name: Altomare, D creators_name: de Wilde, A creators_name: Ossenkoppele, R creators_name: Pelkmans, W creators_name: Bouwman, F creators_name: Groot, C creators_name: van Maurik, I creators_name: Zwan, M creators_name: Yaqub, M creators_name: Barkhof, F creators_name: van Berckel, BN creators_name: Teunissen, CE creators_name: Frisoni, GB creators_name: Scheltens, P creators_name: van der Flier, WM title: Applying the ATN scheme in a memory clinic population: The ABIDE project ispublished: pub divisions: UCL divisions: B02 divisions: C07 divisions: D07 divisions: F82 note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. abstract: Objective To apply the ATN scheme to memory clinic patients, to assess whether it discriminates patient populations with specific features. Methods We included 305 memory clinic patients (33% subjective cognitive decline [SCD]: 60 ± 9 years, 61% M; 19% mild cognitive impairment [MCI]: 68 ± 9 years, 68% M; 48% dementia: 66 ± 10 years, 58% M) classified for positivity (±) of amyloid (A) ([18F]Florbetaben PET), tau (T) (CSF p-tau), and neurodegeneration (N) (medial temporal lobe atrophy). We assessed ATN profiles' demographic, clinical, and cognitive features at baseline, and cognitive decline over time. Results The proportion of A+T+N+ patients increased with syndrome severity (from 1% in SCD to 14% in MCI and 35% in dementia), while the opposite was true for A−T−N− (from 48% to 19% and 6%). Compared to A−T−N−, patients with the Alzheimer disease profiles (A+T+N− and A+T+N+) were older (both p < 0.05) and had a higher prevalence of APOE ε4 (both p < 0.05) and lower Mini-Mental State Examination (MMSE) (both p < 0.05), memory (both p < 0.05), and visuospatial abilities (both p < 0.05) at baseline. Non-Alzheimer profiles A−T−N+ and A-T+N+ showed more severe white matter hyperintensities (both p < 0.05) and worse language performance (both p < 0.05) than A−T−N−. A linear mixed model showed faster decline on MMSE over time in A+T+N− and A+T+N+ (p = 0.059 and p < 0.001 vs A−T−N−), attributable mainly to patients without dementia. Conclusions The ATN scheme identified different biomarker profiles with overlapping baseline features and patterns of cognitive decline. The large number of profiles, which may have different implications in patients with vs without dementia, poses a challenge to the application of the ATN scheme. date: 2019-10-22 date_type: published official_url: https://doi.org/10.1212/WNL.0000000000008361 full_text_type: other language: eng verified: verified_manual elements_id: 1706115 doi: 10.1212/WNL.0000000000008361 pii: WNL.0000000000008361 lyricists_name: Barkhof, Frederik lyricists_id: FBARK32 actors_name: Austen, Jennifer actors_id: JAUST66 actors_role: owner full_text_status: restricted publication: Neurology volume: 93 number: 17 pagerange: e1635-e1646 event_location: United States issn: 1526-632X citation: Altomare, D; de Wilde, A; Ossenkoppele, R; Pelkmans, W; Bouwman, F; Groot, C; van Maurik, I; ... van der Flier, WM; + view all <#> Altomare, D; de Wilde, A; Ossenkoppele, R; Pelkmans, W; Bouwman, F; Groot, C; van Maurik, I; Zwan, M; Yaqub, M; Barkhof, F; van Berckel, BN; Teunissen, CE; Frisoni, GB; Scheltens, P; van der Flier, WM; - view fewer <#> (2019) Applying the ATN scheme in a memory clinic population: The ABIDE project. Neurology , 93 (17) e1635-e1646. 10.1212/WNL.0000000000008361 <https://doi.org/10.1212/WNL.0000000000008361>. document_url: https://discovery.ucl.ac.uk/id/eprint/10084779/3/Barkhof%20Altomare_ATN%20stage%20in%20ABIDE_Neurology_R2_Manuscript_Clean.pdf