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). / 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. / 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. / 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