eprintid: 10102298
rev_number: 23
eprint_status: archive
userid: 608
dir: disk0/10/10/22/98
datestamp: 2020-06-24 15:19:38
lastmod: 2024-09-23 16:48:05
status_changed: 2020-06-24 15:19:38
type: article
metadata_visibility: show
creators_name: Ebenau, JL
creators_name: Timmers, T
creators_name: Wesselman, LMP
creators_name: Verberk, IMW
creators_name: Verfaillie, SCJ
creators_name: Slot, RER
creators_name: van Harten, AC
creators_name: Teunissen, CE
creators_name: Barkhof, F
creators_name: van den Bosch, KA
creators_name: van Leeuwenstijn, M
creators_name: Tomassen, J
creators_name: Braber, AD
creators_name: Visser, PJ
creators_name: Prins, ND
creators_name: Sikkes, SAM
creators_name: Scheltens, P
creators_name: van Berckel, BNM
creators_name: van der Flier, WM
title: ATN classification and clinical progression in subjective cognitive decline
ispublished: pub
divisions: UCL
divisions: B02
divisions: C07
divisions: D07
divisions: F82
note: Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND), which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
abstract: Objective: To investigate the relationship between the ATN classification system (amyloid, tau, neurodegeneration) and risk of dementia and cognitive decline in individuals with subjective cognitive decline (SCD).
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Methods: We classified 693 participants with SCD (60 ± 9 years, 41% women, Mini-Mental State Examination score 28 ± 2) from the Amsterdam Dementia Cohort and Subjective Cognitive Impairment Cohort (SCIENCe) project according to the ATN model, as determined by amyloid PET or CSF β-amyloid (A), CSF p-tau (T), and MRI-based medial temporal lobe atrophy (N). All underwent extensive neuropsychological assessment. For 342 participants, follow-up was available (3 ± 2 years). As a control population, we included 124 participants without SCD.
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Results: Fifty-six (n = 385) participants had normal Alzheimer disease (AD) biomarkers (A–T–N–), 27% (n = 186) had non-AD pathologic change (A–T–N+, A–T+N–, A–T+N+), 18% (n = 122) fell within the Alzheimer continuum (A+T–N–, A+T–N+, A+T+N–, A+T+N+). ATN profiles were unevenly distributed, with A–T+N+, A+T–N+, and A+T+N+ containing very few participants. Cox regression showed that compared to A–T–N–, participants in A+ profiles had a higher risk of dementia with a dose–response pattern for number of biomarkers affected. Linear mixed models showed participants in A+ profiles showed a steeper decline on tests addressing memory, attention, language, and executive functions. In the control group, there was no association between ATN and cognition.
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Conclusions: Among individuals presenting with SCD at a memory clinic, those with a biomarker profile A–T+N+, A+T–N–, A+T+N–, and A+T+N+ were at increased risk of dementia, and showed steeper cognitive decline compared to A–T–N– individuals. These results suggest a future where biomarker results could be used for individualized risk profiling in cognitively normal individuals presenting at a memory clinic.
date: 2020-06-10
date_type: published
publisher: Ovid Technologies (Wolters Kluwer Health)
official_url: https://doi.org/10.1212/wnl.0000000000009724
oa_status: green
full_text_type: pub
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1791178
doi: 10.1212/wnl.0000000000009724
lyricists_name: Barkhof, Frederik
lyricists_id: FBARK32
actors_name: Flynn, Bernadette
actors_id: BFFLY94
actors_role: owner
full_text_status: public
publication: Neurology
volume: 95
number: 1
pagerange: e46-e58
issn: 0340-5354
citation:        Ebenau, JL;    Timmers, T;    Wesselman, LMP;    Verberk, IMW;    Verfaillie, SCJ;    Slot, RER;    van Harten, AC;                                                 ... van der Flier, WM; + view all <#>        Ebenau, JL;  Timmers, T;  Wesselman, LMP;  Verberk, IMW;  Verfaillie, SCJ;  Slot, RER;  van Harten, AC;  Teunissen, CE;  Barkhof, F;  van den Bosch, KA;  van Leeuwenstijn, M;  Tomassen, J;  Braber, AD;  Visser, PJ;  Prins, ND;  Sikkes, SAM;  Scheltens, P;  van Berckel, BNM;  van der Flier, WM;   - view fewer <#>    (2020)    ATN classification and clinical progression in subjective cognitive decline.                   Neurology , 95  (1)   e46-e58.    10.1212/wnl.0000000000009724 <https://doi.org/10.1212/wnl.0000000000009724>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10102298/1/Barkhof_ebenau-et-al-2020-atn-classification-and-clinical-progression-in-subjective-cognitive-decline.pdf