18F-florbetapir Positron Emission Tomography-determined Cerebral β-Amyloid Deposition and Neurocognitive Performance after Cardiac Surgery

Rebecca Y Klinger; Olga G James; Salvador Borges-Neto; Tiffany Bisanar; Yi-Ju Li; Wenjing Qi; Miles Berger; Niccolò Terrando; Mark F Newman; P Murali Doraiswamy; Joseph P Mathew; Alzheimer’s Disease Neuroimaging Initiative (ADNI) Study Group; Neurologic Outcomes Research Group (NORG)

doi:10.1097/ALN.0000000000002103

18F-florbetapir Positron Emission Tomography-determined Cerebral β-Amyloid Deposition and Neurocognitive Performance after Cardiac Surgery

Anesthesiology. 2018 Apr;128(4):728-744. doi: 10.1097/ALN.0000000000002103.

Authors

Rebecca Y Klinger¹, Olga G James, Salvador Borges-Neto, Tiffany Bisanar, Yi-Ju Li, Wenjing Qi, Miles Berger, Niccolò Terrando, Mark F Newman, P Murali Doraiswamy, Joseph P Mathew; Alzheimer’s Disease Neuroimaging Initiative (ADNI) Study Group; Neurologic Outcomes Research Group (NORG)

Collaborators

Michael W Weiner, Paul Aisen, Michael Weiner, Paul Aisen, Ronald Petersen, Clifford R Jack Jr., William Jagust, John Q Trojanowki, Arthur W Toga, Laurel Beckett, Robert C Green, Andrew J Saykin, John Morris, Leslie M Shaw, Zaven Khachaturian, Greg Sorensen, Maria Carrillo, Lew Kuller, Marc Raichle, Steven Paul, Peter Davies, Howard Fillit, Franz Hefti, David Holtzman, M Marcel Mesulam, William Potter, Peter Snyder, Adam Schwartz, Robert C Green, Tom Montine, Ronald Petersen, Paul Aisen, Ronald G Thomas, Michael Donohue, Sarah Walter, Devon Gessert, Tamie Sather, Gus Jiminez, Archana B Balasubramanian, Jennifer Mason, Iris Sim, Laurel Beckett, Danielle Harvey, Michael Donohue, Clifford R Jack Jr., Matthew Bernstein, Nick Fox, Paul Thompson, Norbert Schuff, Charles DeCArli, Bret Borowski, Jeff Gunter, Matt Senjem, Prashanthi Vemuri, David Jones, Kejal Kantarci, Chad Ward, William Jagust, Robert A Koeppe, Norm Foster, Eric M Reiman, Kewei Chen, Chet Mathis, Susan Landau, John C Morris, Louis Nigel J Cairns, Erin Franklin, Lisa Taylor-Reinwald, Leslie M Shaw, John Q Trojanowki, Virginia Lee, Magdalena Korecka, Michal Figurski, Arthur W Toga, Karen Crawford, Scott Neu, Andrew J Saykin, Tatiana M Foroud, Steven Potkin, Li Shen, Kelley Faber, Sungeun Kim, Kwangsik Nho, Michael W Weiner, Lean Thal, Zaven Khachaturian, Leon Thal, Neil Buckholtz, Michael W Weiner, Peter J Snyder, William Potter, Steven Paul, Marilyn Albert, Richard Frank, Zaven Khachaturian, John Hsiao, Jeffrey Kaye, Joseph Quinn, Lisa Silbert, Betty Lind, Raina Carter, Sara Dolen, Lon S Schneider, Sonia Pawluczyk, Mauricio Becerra, Liberty Teodoro, Bryan M Spann, James Brewer, Helen Vanderswag, Adam Fleisher, Judith L Heidebrink, Joanne L Lord, Ronald Petersen, Sara S Mason, Colleen S Albers, David Knopman, Kris Johnson, Rachelle S Doody, Javier Villanueva-Meyer, Valory Pavlik, Victoria Shibley, Munir Chowdhury, Susan Rountree, Mimi Dang, Yaakov Stern, Lawrence S Honig, Karen L Bell, Beau Ances, John C Morris, Maria Carroll, Mary L Creech, Erin Franklin, Mark A Mintun, Stacy Schneider, Angela Oliver, Daniel Marson, David Geldmacher, Marissa Natelson Love, Randall Griffith, David Clark, John Brockington, Erik Roberson, Hillel Grossman, Effie Mitsis, Raj C Shah, Leyla deToledo-Morrell, Ranjan Duara, Maria T Greig-Custo, Warren Barker, Marilyn Albert, Chiadi Onyike, Daniel D'Agostino 2nd, Stephanie Kielb, Martin Sadowski, Mohammed O Sheikh, Anaztasia Ulysse, Mrunalini Gaikwad, Jeffrey R Petrella, Terence Z Wong, Edward Coleman, Steven E Arnold, Jason H Karlawish, David A Wolk, Christopher M Clark, Charles D Smith, Greg Jicha, Peter Hardy, Partha Sinha, Elizabeth Oates, Gary Conrad, Oscar L Lopez, MaryAnn Oakley, Donna M Simpson, Anton P Porsteinsson, Bonnie S Goldstein, Kim Martin, Kelly M Makino, M Saleem Ismail, Connie Brand, Steven G Potkin, Adrian Preda, Dana Nguyen, Kyle Womack, Dana Mathews, Mary Quiceno, Allan I Levey, James J Lah, Janet S Cellar, Jeffrey M Burns, Russell H Swerdlow, William M Brooks, Liana Apostolova, Kathleen Tingus, Ellen Woo, Daniel H S Silverman, Po H Lu, George Bartzokis, Neill R Graff-Radford, Francine Parfitt, Kim Poki-Walker, Martin R Farlow, Ann Marie Hake, Brandy R Matthews, Jared R Brosch, Scott Herring, Christopher H van Dyck, Richard E Carson, Martha G MacAvoy, Pradeep Varma, Howard Chertkow, Howard Bergman, Chris Hosein, Sandra Black, Bojana Stefanovic, Curtis Caldwell, Ging-Yuek, Robin Hsiung, Benita Mudge, Vesna Sossi, Howard Feldman, Michele Assaly, Elizabeth Finger, Stephen Pasternack, Irina Rachisky, Dick Trost, Andrew Kertesz, Charles Bernick, Donna Munic, Marek-Marsel Mesulam, Emily Rogalski, Kristine Lipowski, Sandra Weintraub, Borna Bonakdarpour, Diana Kerwin, Chuang-Kuo Wu, Nancy Johnson, Carl Sadowsky, Teresa Villena, Raymond Scott Turner, Kathleen Johnson, Brigid Reynolds, Reisa A Sperling, Keith A Johnson, Gad Marshall, Jerome Yesavage, Joy L Taylor, Barton Lane, Allyson Rosen, Jared Tinklenberg, Marwan N Sabbagh, Christine M Belden, Sandra A Jacobson, Sherye A Sirrel, Neil Kowall, Ronald Killiany, Andrew E Budson, Alexander Norbash, Patricia Lynn Johnson, Thomas O Obisesan, Saba Wolday, Joanne Allard, Alan Lerner, Paula Ogrocki, Curtis Tatsuoka, Parianne Fatica, Evan Fletcher, Pauline Maillard, John Olichney, Charles DeCarli, Owen Carmichael, Smita Kittur, Michael Borrie, T-Y Lee, Dr Rob Bartha, Sterling Johnson, Sanjay Asthana, Cynthia M Carlsson, Steven G Potkin, Adrian Preda, Dana Nguyen, Pierre Tariot, Anna Burke, Ann Marie Milliken, Nadira Trncic, Adam Fleisher, Stephanie Reeder, Vernice Bates, Horacio Capote, Michelle Rainka, Douglas W Scharre, Maria Kataki, Brendan Kelley, Earl A Zimmerman, Dzintra Celmins, Alice D Brown, Godfrey D Pearlson, Karen Blank, Karen Anderson, Laura A Flashman, Marc Seltzer, Mary L Hynes, Robert B Santulli, Kaycee M Sink, Leslie Gordineer, Jeff D Williamson, Pradeep Garg, Franklin Watkins, Brian R Ott, Geoffrey Tremont, Lori A Daiello, Stephen Salloway, Paul Malloy, Stephen Correia, Howard J Rosen, Bruce L Miller, David Perry, Jacobo Mintzer, Kenneth Spicer, David Bachman, Elizabeth Finger, Stephen Pasternak, Irina Rachinsky, John Rogers, Andrew Kertesz, Dick Drost, Nunzio Pomara, Raymundo Hernando, Antero Sarrael, Susan K Schultz, Karen Ekstam Smith, Hristina Koleva, Ki Won Nam, Hyungsub Shim, Norman Relkin, Gloria Chiang, Michael Lin, Lisa Ravdin, Amanda Smith, Balebail Ashok Raj, Kristin Fargher, Michael W Weiner, Paul Aisen, Michael Weiner, Paul Aisen, Ronald Petersen, Robert C Green, Danielle Harvey, Clifford R Jack Jr., William Jagust, John C Morris, Andrew J Saykin, Leslie M Shaw, Arthur W Toga, John Q Trojanowki, Thomas Neylan, Jordan Grafman, Jordan Grafman, Robert C Green, Tom Montine, Michael Weiner, Ronald Petersen, Paul Aisen, Ronald G Thomas, Michael Donohue, Devon Gessert, Tamie Sather, Melissa Davis, Rosemary Morrison, Gus Jiminez, Thomas Neylan, Jacqueline Hayes, Shannon Finely, Danielle Harvey, Michael Donohue, Clifford R Jack Jr., Matthew Bernstein, Bret Borowski, Jeff Gunter, Matt Senjem, Kejal Kantarci, Chad Ward, William Jagust, Robert A Koeppe, Norm Foster, Eric M Reiman, Kewei Chen, Susan Landau, John C Morris, Nigel J Cairns, Erin Householder, Leslie M Shaw, John Q Trojanowki, Virginia Lee, Magdalena Korecka, Michal Figurski, Arthur W Toga, Karen Crawford, Scott Neu, Andrew J Saykin, Tatiana M Foroud, Steven Potkin, Li Shen, Kelley Faber, Sungeun Kim, Kwangsik Nho, Michael W Weiner, Karl Friedl, Lon S Schneider, Sonia Pawluczyk, Mauricio Becerra, James Brewer, Helen Vanderswag, Yaakov Stern, Lawrence S Honig, Karen L Bell, Debra Fleischman, Konstantinos Arfanakis, Raj C Shah, Ranjan Duara, Daniel Varon, Maria T Greig, Jeffrey R Petrella, Anton P Porsteinsson, Bonnie Goldstein, Kimberly S Martin, Steven G Potkin, Adrian Preda, Dana Nguyen, Jacobo Mintzer, Dino Massoglia, Olga Brawman-Mintzer, Carl Sadowsky, Walter Martinez, Teresa Villena, William Jagust, Susan Landau, Howard Rosen, David Perry, Raymond Scott Turner, Kelly Behan, Brigid Reynolds, Reisa A Sperling, Keith A Johnson, Gad Marshall, Marwan N Sabbagh, Sandra A Jacobson, Sherye A Sirrel, Thomas O Obisesan, Saba Wolday, Joanne Allard, Sterling C Johnson, J Jay Fruehling, Sandra Harding, Elaine R Peskind, Eric C Petrie, Gail Li, Jerome A Yesavage, Joy L Taylor, Ansgar J Furst, Steven Chao, Norman Relkin, Gloria Chiang, Lisa Ravdin, James A Blumenthal, Jorn A Karhausen, Miklos D Kertai, Mihai V Podgoreanu, Mark Stafford-Smith, Madhav Swaminathan, David S Warner, Bonita L Funk, Narai Balajonda, Rachele Brassard, Mary Cooter, Yanne Toulgoat-Dubois, Peter Waweru, Michael A Babyak, James A Blumenthal, Jeffrey N Browndyke, Kathleen A Welsh-Bohmer, Michael H Sketch Jr., Ellen R Bennett, Carmelo Graffagnino, Daniel T Laskowitz, Warren J Strittmatter, Kevin Collins, Greg Smigla, Ian Shearer, Thomas A D'Amico, Mani A Daneshmand, R Jeffrey G Gaca, Donald D Glower, Jack Haney, R David Harpole, Mathew G Hartwig, G Chad Hughes, Jacob A Klapper, Shu S Lin, Andrew J Lodge, Carmelo A Milano, Ryan P Plichta, Jacob N Schroeder, Peter K Smith, Betty C Tong

Affiliation

¹ From the Department of Anesthesiology (R.Y.K., T.B., M.B., N.T., M.F.N., J.P.M.), Department of Radiology (O.G.J., S.B.-N.), Department of Biostatistics and Bioinformatics (Y.-J.L., W.Q.), and the Department of Psychiatry and Behavioral Science (P.M.D.), Duke University, Durham, North Carolina. University of California, San Francisco University of Southern California University of California, San Francisco University of Southern California Mayo Clinic, Rochester Mayo Clinic, Rochester University of California, Berkeley University of Pennsylvania University of Southern California University of California, Davis Brigham and Women's Hospital/Harvard Medical School Indiana University Washington University St. Louis University of Pennsylvania Prevent Alzheimer's Disease 2020 (Chair) Siemens Alzheimer's Association University of Pittsburgh Washington University St. Louis Cornell University Albert Einstein College of Medicine of Yeshiva University AD Drug Discovery Foundation Acumen Pharmaceuticals Washington University St. Louis Northwestern University National Institute of Mental Health Brown University Eli Lilly (Chair) BWH/HMS (Chair) University of Washington (Chair) Mayo Clinic, Rochester (Core Principal Investigator) University of Southern California University of California, San Diego University of California, San Diego University of California, San Diego University of California, San Diego University of California, San Diego University of California, San Diego University of California, San Diego University of California, San Diego University of California, San Diego University of California, Davis (Core Principal Investigator) University of California, Davis University of California, San Diego Mayo Clinic, Rochester (Core Principal Investigator) Mayo Clinic, Rochester University of London University of California, Los Angeles School of Medicine University of California, San Francisco Magnetic Resonance Imaging University of California, Davis Mayo Clinic Mayo Clinic Mayo Clinic Mayo Clinic Mayo Clinic Mayo Clinic Mayo Clinic University of California, Berkeley (Core Principal Investigator) University of Michigan University of Utah Banner Alzheimer's Institute Banner Alzheimer's Institute University of Pittsburgh University of California, Berkeley Washington University St. Louis Washington University St. Louis Washington University St. Louis Washington University St. Louis (ASCP) - Past Investigator University of Pennsylvania School of Medicine University of Pennsylvania School of Medicine University of Pennsylvania School of Medicine University of Pennsylvania School of Medicine University of Pennsylvania School of Medicine University of Southern California (Core Principal Investigator) University of Southern California University of Southern California Indiana University Indiana University University of California, Irvine Indiana University Indiana University Indiana University Indiana University University of California, San Francisco University of California, San Diego Prevent Alzheimer's Disease 2020 University of California, San Diego National Institute on Aging University of California, San Francisco Brown University National Institute of Mental Health Cornell University Johns Hopkins University Richard Frank Consulting Prevent Alzheimer's Disease 2020 National Institute on Aging Oregon Health & Science University Oregon Health & Science University Oregon Health & Science University Oregon Health & Science University Oregon Health & Science University Oregon Health & Science University University of Southern California University of Southern California University of Southern California University of Southern California University of Southern California University of California, San Diego University of California, San Diego University of California, San Diego University of Michigan University of Michigan Mayo Clinic, Rochester Mayo Clinic, Rochester Mayo Clinic, Rochester Mayo Clinic, Rochester Mayo Clinic, Rochester Baylor College of Medicine Baylor College of Medicine Baylor College of Medicine Baylor College of Medicine Baylor College of Medicine Baylor College of Medicine Baylor College of Medicine Columbia University Medical Center Columbia University Medical Center Columbia University Medical Center Washington University, St. Louis Washington University, St. Louis Washington University, St. Louis Washington University, St. Louis Washington University, St. Louis Washington University, St. Louis Washington University, St. Louis Washington University, St. Louis University of Alabama - Birmingham University of Alabama - Birmingham University of Alabama - Birmingham University of Alabama - Birmingham University of Alabama - Birmingham University of Alabama - Birmingham University of Alabama - Birmingham Mount Sinai School of Medicine Mount Sinai School of Medicine Rush University Medical Center Rush University Medical Center Wien Center Wien Center Wien Center Johns Hopkins University Johns Hopkins University Johns Hopkins University Johns Hopkins University New York University New York University New York University New York University Duke University Medical Center Duke University Medical Center Duke University Medical Center University of Pennsylvania University of Pennsylvania University of Pennsylvania University of Pennsylvania University of Kentucky University of Kentucky University of Kentucky University of Kentucky University of Kentucky University of Kentucky University of Pittsburgh University of Pittsburgh University of Pittsburgh University of Rochester Medical Center University of Rochester Medical Center University of Rochester Medical Center University of Rochester Medical Center University of Rochester Medical Center University of Rochester Medical Center University of California, Irvine University of California, Irvine University of California, Irvine University of Texas Southwestern Medical School University of Texas Southwestern Medical School University of Texas Southwestern Medical School Emory University Emory University Emory University University of Kansas, Medical Center University of Kansas, Medical Center University of Kansas, Medical Center University of California, Los Angeles University of California, Los Angeles University of 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Joseph's, Ontario Cognitive Neurology - St. Joseph's, Ontario Cognitive Neurology - St. Joseph's, Ontario Cognitive Neurology - St. Joseph's, Ontario Cleveland Clinic Lou Ruvo Center for Brain Health Cleveland Clinic Lou Ruvo Center for Brain Health Northwestern University Northwestern University Northwestern University Northwestern University Northwestern University Northwestern University Northwestern University Northwestern University Premiere Research Inst (Palm Beach Neurology) Premiere Research Inst (Palm Beach Neurology) Georgetown University Medical Center Georgetown University Medical Center Georgetown University Medical Center Brigham and Women's Hospital Brigham and Women's Hospital Brigham and Women's Hospital Stanford University Stanford University Stanford University Stanford University Stanford University Banner Sun Health Research Institute Banner Sun Health Research Institute Banner Sun Health Research Institute Banner Sun Health Research Institute Boston University 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Abstract

Background: Amyloid deposition is a potential contributor to postoperative cognitive dysfunction. The authors hypothesized that 6-week global cortical amyloid burden, determined by F-florbetapir positron emission tomography, would be greater in those patients manifesting cognitive dysfunction at 6 weeks postoperatively.

Methods: Amyloid deposition was evaluated in cardiac surgical patients at 6 weeks (n = 40) and 1 yr (n = 12); neurocognitive function was assessed at baseline (n = 40), 6 weeks (n = 37), 1 yr (n = 13), and 3 yr (n = 9). The association of 6-week amyloid deposition with cognitive dysfunction was assessed by multivariable regression, accounting for age, years of education, and baseline cognition. Differences between the surgical cohort with cognitive deficit and the Alzheimer's Disease Neuroimaging Initiative cohorts (normal and early/late mild cognitive impairment) was assessed, adjusting for age, education, and apolipoprotein E4 genotype.

Results: The authors found that 6-week abnormal global cortical amyloid deposition was not associated with cognitive dysfunction (13 of 37, 35%) at 6 weeks postoperatively (median standard uptake value ratio [interquartile range]: cognitive dysfunction 0.92 [0.89 to 1.07] vs. 0.98 [0.93 to 1.05]; P = 0.455). In post hoc analyses, global cortical amyloid was also not associated with cognitive dysfunction at 1 or 3 yr postoperatively. Amyloid deposition at 6 weeks in the surgical cohort was not different from that in normal Alzheimer's Disease Neuroimaging Initiative subjects, but increased over 1 yr in many areas at a rate greater than in controls.

Conclusions: In this study, postoperative cognitive dysfunction was not associated with 6-week cortical amyloid deposition. The relationship between cognitive dysfunction and regional amyloid burden and the rate of postoperative amyloid deposition merit further investigation.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Aged
Amyloid beta-Peptides* / metabolism
Aniline Compounds*
Brain / diagnostic imaging*
Brain / metabolism
Cardiac Surgical Procedures / adverse effects
Cardiac Surgical Procedures / trends*
Cognitive Dysfunction / diagnostic imaging*
Cognitive Dysfunction / metabolism
Cognitive Dysfunction / psychology
Ethylene Glycols*
Female
Fluorine Radioisotopes*
Humans
Male
Mental Status and Dementia Tests
Middle Aged
Positron-Emission Tomography / methods*
Postoperative Complications / diagnostic imaging
Postoperative Complications / metabolism
Postoperative Complications / psychology
Prospective Studies

Substances

Amyloid beta-Peptides
Aniline Compounds
Ethylene Glycols
Fluorine Radioisotopes
florbetapir
Fluorine-18

Abstract

Publication types

MeSH terms

Substances

Grants and funding