Brain Vascular Disease in Aging and Dementia
| Status: | Enrolling by invitation |
|---|---|
| Conditions: | Alzheimer Disease, Healthy Studies, Neurology |
| Therapuetic Areas: | Neurology, Other |
| Healthy: | No |
| Age Range: | 60 - Any |
| Updated: | 1/13/2019 |
| Start Date: | May 23, 2017 |
| End Date: | November 2019 |
White Matter Hyperintensities in Aging and Dementia
This study examines the factors that may drive the relationship between vascular disease and
Alzheimer's Disease (AD) in a large, longitudinal, multi-ethnic community-based cohort study
of older adults in northern Manhattan, New York. In past research, the investigators
demonstrated that accumulation of brain vascular disease is associated with risk for
development of AD. The study now extends the research to examine how brain vascular disease
and AD interact. In this pilot study, the investigators will obtain positron emission
tomography (PET) scans to measure amyloid (one of the protein pathological markers of AD)
from participants in an ongoing community-based study of aging and dementia (WHICAP). The
study will include subjects who are already enrolled in the parent project and already
evaluated at baseline with PET scans. The study plans to obtain 20 amyloid PET scans after a
5-year interval on the cohort of participants established at baseline. The investigators will
also conduct transcranial Doppler studies to measure blood flow in the participants with
amyloid PET scans. The potential benefits to society should be considerable if this study
reveals new information about risk factors for or contributions to AD.
Alzheimer's Disease (AD) in a large, longitudinal, multi-ethnic community-based cohort study
of older adults in northern Manhattan, New York. In past research, the investigators
demonstrated that accumulation of brain vascular disease is associated with risk for
development of AD. The study now extends the research to examine how brain vascular disease
and AD interact. In this pilot study, the investigators will obtain positron emission
tomography (PET) scans to measure amyloid (one of the protein pathological markers of AD)
from participants in an ongoing community-based study of aging and dementia (WHICAP). The
study will include subjects who are already enrolled in the parent project and already
evaluated at baseline with PET scans. The study plans to obtain 20 amyloid PET scans after a
5-year interval on the cohort of participants established at baseline. The investigators will
also conduct transcranial Doppler studies to measure blood flow in the participants with
amyloid PET scans. The potential benefits to society should be considerable if this study
reveals new information about risk factors for or contributions to AD.
Alzheimer's disease (AD) is one of the most devastating international public health
epidemics. There are currently no effective disease-modifying or preventative strategies.
Current pathogenic models emphasize a single pathway of disease pathogenesis, but
underestimate the contribution of small vessel cerebrovascular disease, which manifests
primarily as white matter hyperintensities (WMH) on T2-weighted magnetic resonance imaging
(MRI). Understanding of the factors that drive the relationship between vascular disease and
AD remains elusive; vascular factors may be independent sources of dysfunction that
contribute additively to clinical expression, they may interact mechanistically with AD
pathology, and/or they may relate to each other because of a shared association with a third
set of factors. These issues are particularly relevant among ethnic/racial minorities, who
are at much greater risk for clinical AD, have more severe cerebrovascular disease, but
appear to have similar levels of AD pathology compared with Whites.
The proposed research examines these factors in a large, longitudinal, multi-ethnic
community-based cohort study of older adults in northern Manhattan, New York. The
investigators demonstrated that accumulation of WMH, particularly in parietal lobes, predicts
incident AD, and is associated with the presence of cerebral microbleeds, an indicator of
cerebral amyloid angiopathy. The investigators extend the research to examine mechanistic
interactions between cerebrovascular disease and AD. The preliminary data suggest that
individuals with evidence of fibrillar amyloidosis have increased parietal lobe WMH and that
hemodynamic markers of autoregulatory dysfunction are associated with both WMH and amyloid
deposition, which in turn interact to promote the clinical expression of AD. These findings
are buffered by new data that establish WMH as a core feature in autosomal dominant forms of
AD. In this pilot study, the investigators propose to obtain longitudinal MRI and amyloid PET
data from participants in WHICAP.
epidemics. There are currently no effective disease-modifying or preventative strategies.
Current pathogenic models emphasize a single pathway of disease pathogenesis, but
underestimate the contribution of small vessel cerebrovascular disease, which manifests
primarily as white matter hyperintensities (WMH) on T2-weighted magnetic resonance imaging
(MRI). Understanding of the factors that drive the relationship between vascular disease and
AD remains elusive; vascular factors may be independent sources of dysfunction that
contribute additively to clinical expression, they may interact mechanistically with AD
pathology, and/or they may relate to each other because of a shared association with a third
set of factors. These issues are particularly relevant among ethnic/racial minorities, who
are at much greater risk for clinical AD, have more severe cerebrovascular disease, but
appear to have similar levels of AD pathology compared with Whites.
The proposed research examines these factors in a large, longitudinal, multi-ethnic
community-based cohort study of older adults in northern Manhattan, New York. The
investigators demonstrated that accumulation of WMH, particularly in parietal lobes, predicts
incident AD, and is associated with the presence of cerebral microbleeds, an indicator of
cerebral amyloid angiopathy. The investigators extend the research to examine mechanistic
interactions between cerebrovascular disease and AD. The preliminary data suggest that
individuals with evidence of fibrillar amyloidosis have increased parietal lobe WMH and that
hemodynamic markers of autoregulatory dysfunction are associated with both WMH and amyloid
deposition, which in turn interact to promote the clinical expression of AD. These findings
are buffered by new data that establish WMH as a core feature in autosomal dominant forms of
AD. In this pilot study, the investigators propose to obtain longitudinal MRI and amyloid PET
data from participants in WHICAP.
Inclusion Criteria:
- current participant in WHICAP (Washington Heights/Inwood Columbia Aging Project)
- subject previously participated in baseline MRI and PET imaging sub-study
- post-menopausal
Exclusion Criteria:
- allergic to Florbetaben
- claustrophobic
- kidney/liver problems
- history of epilepsy/seizures
- history of stroke/heart attack
- serious medical conditions
We found this trial at
1
site
630 W 168th St
New York, New York
New York, New York
212-305-2862
Phone: 646-317-4072
Columbia University Medical Center Situated on a 20-acre campus in Northern Manhattan and accounting for...
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