Magazine article Clinical Psychiatry News

Occipital Region Hardest Hit by Cerebral Amyloid Angiopathy

Magazine article Clinical Psychiatry News

Occipital Region Hardest Hit by Cerebral Amyloid Angiopathy

Article excerpt

PORTO, PORTUGAL -- Cerebral amyloid angiopathy appears to disproportionately affect the occipital region, according to findings presented at the Fourth International Congress on Vascular Dementia.

In a study involving the postmortem neuropathologic evaluation of brains from 113 subjects (61% women), the incidence and severity of cerebral amyloid angiopathy (CAA) was highest in the occipital region, followed by the frontal, hippocampal, and frontobasal areas. The occipital region was significantly more frequently and more severely affected than the other regions, said Dr. Johannes Attems, of the Otto Wagner Hospital in Vienna.

Cerebral amyloid angiopathy (CAA) is defined by the deposition of amyloid-[beta] peptide in cerebral vessels and has been associated with Alzheimer's disease (AD). Despite the association with AD, CAA has been shown to be an independent risk factor for cognitive decline.

Dr. Attems and his colleagues looked at the topographical distribution of CAA in the vessels of the brain, as well as the relationship between CAA and AD. In all, 63 patients had a clinical diagnosis of dementia and 50 were nondemented. Dementia was assessed retrospectively from hospital charts based on ICD-10 criteria of a Mini-Mental State Examination score less than 20. Subjects ranged in age from 54 to 102 years at the time of death.

Neuropathologic assessment of AD was performed using Consortium to Establish a Registry for Alzheimer's Disease (CER-AD) criteria, Braak stages, and National Institute on Aging/Reagan Institute (NIA-Reagan) criteria. In this cohort, 43 subjects had high-grade AD pathology, 16 had medium-grade AD pathology, 37 had low-grade AD pathology, and had no AD pathology.

Sections were immunostained with modified Bielschowsky silver stain and a commercially available monoclonal human amyloid-[beta] antibody for the detection of amyloid-[beta] in cerebral vessels. The severity of amyloid-[beta] deposition in vessels--and CAA--was semiquantitatively assessed in the frontal, frontobasal, hippocampal, and occipital regions. The researchers used a 5-point scoring system. A grade of 0 signified no amyloid-[beta] was present, while grade 4 signified severe amyloid-[beta] deposition.

Within a region, scores were totaled separately for meningeal and cortical vessels. …

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