Correction: Decreased Cerebrospinal Fluid Amyloid β 38, 40, 42, and 43 Levels in Sporadic and Hereditary Cerebral Amyloid Angiopathy

Kort, Anna M. de; Kuiperij, H. Bea; Marques, Tainá M.; Jäkel, Lieke; Berg, Elske van den; Kersten, Iris; Berckel‐Smit, Hugo E.P. van; Duering, Marco; Stoops, Erik; Abdo, Wilson F.; Rasing, Ingeborg; Voigt, Sabine; Koemans, Emma A.; Kaushik, Kanishk; Warren, Andrew; Greenberg, Steven M.; Brinkmalm, Gunnar; Terwindt, Gisela M.; Wermer, Marieke J.H.; Schreuder, Floris H.B.M.; Klijn, Catharina J.M.; Verbeek, Marcel M.

doi:10.1002/ana.26675

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“… 7 In the controls, CSF was obtained as part of a diagnostic workup during which central nervous system disorders were excluded. 12 Controls were divided into age <55 years and age ≥55 years for comparison with (pre)symptomatic D-CAA groups, respectively. This cut-off point was chosen based on the mean age of the first symptomatic ICH in D-CAA.…”

Section: Methodsmentioning

confidence: 99%

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Temporal Ordering of Biomarkers in Dutch-Type Hereditary Cerebral Amyloid Angiopathy

Koemans,

Rasing,

Voigt

et al. 2024

Stroke

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BACKGROUND: The temporal ordering of biomarkers for cerebral amyloid angiopathy (CAA) is important for their use in trials and for the understanding of the pathological cascade of CAA. We investigated the presence and abnormality of the most common biomarkers in the largest (pre)symptomatic Dutch-type hereditary CAA (D-CAA) cohort to date. METHODS: We included cross-sectional data from participants with (pre)symptomatic D-CAA and controls without CAA. We investigated CAA-related cerebral small vessel disease markers on 3T-MRI, cerebrovascular reactivity with functional 7T-MRI (fMRI) and amyloid-β 40 and amyloid-β 42 levels in cerebrospinal fluid. We calculated frequencies and plotted biomarker abnormality according to age to form scatterplots. RESULTS: We included 68 participants with D-CAA (59% presymptomatic, mean age, 50 [range, 26–75] years; 53% women), 53 controls (mean age, 51 years; 42% women) for cerebrospinal fluid analysis and 36 controls (mean age, 53 years; 100% women) for fMRI analysis. Decreased cerebrospinal fluid amyloid-β 40 and amyloid-β 42 levels were the earliest biomarkers present: all D-CAA participants had lower levels of amyloid-β 40 and amyloid-β 42 compared with controls (youngest participant 30 years). Markers of nonhemorrhagic injury (>20 enlarged perivascular spaces in the centrum semiovale and white matter hyperintensities Fazekas score, ≥2, present in 83% [n=54]) and markers of impaired cerebrovascular reactivity (abnormal BOLD amplitude, time to peak and time to baseline, present in 56% [n=38]) were present from the age of 30 years. Finally, markers of hemorrhagic injury were present in 64% (n=41) and only appeared after the age of 41 years (first microbleeds and macrobleeds followed by cortical superficial siderosis). CONCLUSIONS: Our results suggest that amyloid biomarkers in cerebrospinal fluid are the first to become abnormal in CAA, followed by MRI biomarkers for cerebrovascular reactivity and nonhemorrhagic injury and lastly hemorrhagic injury. This temporal ordering probably reflects the pathological stages of CAA and should be taken into account when future therapeutic trials targeting specific stages are designed.

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Section: Methodsmentioning

confidence: 99%

“…13 For details see the Supplemental Material. 12 With 7T-fMRI we investigated visually stimulated bloodoxygen-level-dependent (BOLD) amplitude, time to peak (TTP), and time to baseline (TTB) as measures of cerebrovascular reactivity 8 (T.W. van Harten, unpublished data, 2024).…”

Section: Csf and Mri Biomarkersmentioning

confidence: 99%