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Could it trigger tau pathology? Sang Won Seo, Sungkyunkwan School of Medicine, Seoul, South Korea, and colleagues scanned people with vascular cognitive impairment for neurofibrillary tau. They report that cerebrovascular disease boosts uptake of the tau tracer, and that tau accumulation in the inferior temporal cortex appears to account for cognitive impairment, independent of amyloid. The results suggest that tau could represent a common pathway for dementia triggered by both cerebrovascular and amyloid pathologies.
The work raises possibilities for treating vascular dementia, he said. If tau is also the bullet in this context, then if we counteract tau we should have benefits. That will be the next idea to test. In this condition, exacerbated by age, high blood pressure, and other factors, blood vessels deep in the brain develop atherosclerosis, and clog up or start to leak. Damage shows up on MRI as cloudy splotches or small voids in the subcortical white matter, or small hemorrhages known as microbleeds.
Symptoms include deterioration of executive function, memory loss, and other cognitive problems. They were people who had MRI evidence of significant ischemic damage, indicated by multiple white-matter hyperintensities and voids, and who had trouble in at least one aspect of language, memory, visuospatial or executive function.
The group was comprised of 72 percent women, 79 years old on average, and nearly half were amyloid-positive on florbetaben scans. About half had mild cognitive impairment, half dementia. The investigators also scanned two control groups: Compared with normal controls top row , uptake of AV increases in people with subcortical vascular cognitive impairment SVCI, second row.
The increase is apparent in people who are amyloid-negative third row or -positive fourth row , but in the latter, i. The greatest uptake occurred in the bilateral inferior temporal cortex. By comparison, people with AD had much higher tracer uptake with a wider distribution in the bilateral temporal, parietal, and frontal regions of the cortex. In contrast, amyloid positivity in the people with vessel disease correlated with AV binding in medial temporal regions, independent of CSVD status.
In addition, the pattern of cortical spread in CVSD patients differed from that normally seen in AD, with vascular disease showing a relative sparing of the parahippocampal region.
In the vascular disease group, uptake correlated with worse language function and diminished general cognitive status, as indicated by Mini Mental State Exam MMSE scores. There was no correlation between tau PET and other cognitive domains. She told Alzforum that dividing the vascular disease group into amyloid-positive or -negative does not take in to account the possible effects of subthreshold amyloid. Knowing that could, for example, clarify whether the observed tracer uptake in the inferior temporal areas in vascular impairment reflects local vascular issues that may instigate tau pathology, or a pathway dysfunction that leads to tau accumulation.
Likewise, the mismatch between vascular disease and tau did not surprise us. But this is an important point and we may look further into it. This work highlights that people with vascular disease have tau pathology and we need to think in terms of these co-pathologies. Using flortaucipir- and florbetaben-PET, Kim and colleagues observed independent contributions of amyloid and small vessel disease with regional tau pathology. These findings are consistent with animal studies noting an association between increased cerebrovascular pathology and tau formation karaoke 5 pro keygen ; crack de drivereasy 4.
It may be that additive or synergistic relationships between pathologies can be detected at different stages of the disease. Given the small sample size, the findings need to be replicated in larger cohorts. The mediation model showing that the relationship between either amyloid burden or small vessel disease on cognition is mediated by distinct patterns of tau pathology is suggestive that this may be the case, though more regions should be explored.
However, longitudinal investigations and drug interventions will be necessary to ascertain the temporal and potentially causal relationships. A rich neuropathological literature that informs us that the co-occurrence of cerebrovascular and AD pathology is quite common e.
The authors in the current article used a visual assessment to define presence of amyloid, but it would be interesting for future studies that use quantitative measurements of amyloid burden to investigate whether there is a dose-response relationship between the magnitude of small vessel disease and the threshold at which amyloid and tau pathologies impact cognition.
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Epub Sep 28 fb publisher 2. First look at tau PET in people with cerebrovascular disease. AV uptake is independent of amyloid, correlates with cognitive decline. Tau may mediate effects of vascular dysfunction to cause dementia. Annotate cars 2 the video game keygen download To make an annotation you must camtasia studio 4 keygen download crack.
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nero crack key Cerebrovascular Disease: Does Tau Mediate Cognitive Decline?
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