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The Relationship between Amyloid Deposition, Neurodegeneration, and Cognitive Decline in Dementia

  • Neuroimaging (DJ Brooks, Section Editor)
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Abstract

Amyloid imaging has been clinically approved for measuring β amyloid plaque load in patients being evaluated for Alzheimer's disease or other causes of cognitive decline. Here we explore a multidimensional approach to cognitive decline, where we situate amyloid plaque burden among a number of other relevant dimensions, such as aging, volume loss, other proteinopathies such as TDP43 and Lewy bodies, and functional reorganisation of cognitive brain systems. The multidimensional model incorporates a 'pure AD' trajectory, corresponding to e.g. monogenic Alzheimer's disease, but leaves room for other combinations of biomarker abnormalities (e.g. volume loss without amyloid positivity) and other trajectories. More tools will become available in the future that allow one to carve out a causal-mechanistic space for explaing cognitive decline in a personalized manner, enhancing progress towards more efficacious interventions.

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Acknowledgements

Supported by FWO grants G.0076.02 (R.V.), KU Leuven Research grants OT/08/056, OT/12/097 (R.V.), Federaal Wetenschapsbeleid belspo Inter-University Attraction Pole P6/29 and P7/11, Stichting Alzheimer Onderzoek grant 11020, Vlaams Initiatief voor Netwerken voor Dementie Onderzoek (IWT) and Transformationeel Geneeskundig Onderzoek BioAdaptAD (IWT). R.V. is a senior clinical investigator of the Fund for Scientific Research, Flanders, Belgium (FWO). I thank Katarzyna Adamczuk for helpful comments.

Compliance with Ethics Guidelines

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Conflict of Interest

Rik Vandenberghe has received consultancy fees from GE Healthcare (Consultancy agreement with GEHC from 24 May 2013 to 24 May 2014). Clinical trial agreement between GEHC and my institution (UZ Leuven) for the phase 1 and 2 18 F-flutemetamol trial (PI Rik Vandenberghe).

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Laboratory for Cognitive Neurology, Department of Neurosciences, University of Leuven, Leuven, Belgium

    Rik Vandenberghe

  2. Neurology Department, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium

    Rik Vandenberghe

  3. Alzheimer Research Centre KU Leuven, Leuven Institute of Neuroscience and Disease, University of Leuven, Leuven, Belgium

    Rik Vandenberghe

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  1. Rik Vandenberghe
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Correspondence to Rik Vandenberghe.

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This article is part of the Topical Collection on Neuroimaging

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Vandenberghe, R. The Relationship between Amyloid Deposition, Neurodegeneration, and Cognitive Decline in Dementia. Curr Neurol Neurosci Rep 14, 498 (2014). https://doi.org/10.1007/s11910-014-0498-9

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  • DOI: https://doi.org/10.1007/s11910-014-0498-9

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