USE OF CSF AB1-42 AND AB1-40 IN THE CLINICAL TYPING OF ALZHEIMER’S DISEASE

USE OF CSF AB1-42 AND AB1-40 IN THE CLINICAL TYPING OF ALZHEIMER’S DISEASE

P474 Poster Presentations: Sunday, July 24, 2016 this observation remain to be elucidated and might reflect statedependent effects of LLMD on neuron...

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P474

Poster Presentations: Sunday, July 24, 2016

this observation remain to be elucidated and might reflect statedependent effects of LLMD on neuronal activity and release of Ab. P1-182

THE EFFECT OFAPOE E4 ON EPISODIC MEMORY IN PATIENTS WITH AMNESTIC MILD COGNITIVE IMPAIRMENT

Ivana Mokrisova1,2, Jan Laczo1,2, Martina Parizkova1, Kamil Vlcek3, Martin Vyhnalek1,2, Katerina Sheardova2, Vojtech Kaplan4, Vaclav Matoska4, Ross Andel5, Jakob Hort1,2, 1Memory Clinic, Department of Neurology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic; 2International Clinical Research Center, St. Anne’s University Hospital Brno, Brno, Czech Republic; 3Department of Neurophysiology of Memory, Institute of Physiology, Academy of Sciences of the Czech Republic, Prague, Czech Republic; 4Department of Clinical Biochemistry, Hematology and Immunology, Homolka Hospital, Prague, Czech Republic; 5School of Aging Studies, University of South Florida, Tampa, FL, USA. Contact e-mail: [email protected] Background: APOE ε4 genotype is associated with hippocampal at-

rophy and greater memory decline. Patients with amnestic mild cognitive impairment (aMCI) carrying the APOE ε4 allele have a similar pattern of cognitive impairment as seen in patients with dementia due to Alzheimer’s Disease (AD). The aim was to investigate the effect of APOE ε4 on episodic memory using hippocampus-dependent visual memory binding test as a specific tool for differentiating aMCI patients with higher risk for dementia. Methods: 46 aMCI patients were tested by Episodic-Like Memory Test (EMT). The subjects were classified into the following groups according to the APOE ε4 genotype––APOE ε4 non-carriers (n¼24) and APOE ε4 carriers (n¼33). We evaluated the correct position, order and the total score on EMT. Results: The groups were similar in neuropsychological profile. Controlling for age, sex and education, we found that APOE ε4 non-carriers were better than APOE ε4 carriers with respect to the total EMT score (p¼.004), the order score (p¼.006) and the position score (p¼.012). Conclusions: The aMCI ε4 carriers appear to have a more profound visual memory binding deficit than non-carriers. EMT test could be a useful tool for identifying individuals at higher risk for AD in the heterogeneous MCI population. P1-183

USE OF CSF AB1-42 AND AB1-40 IN THE CLINICAL TYPING OF ALZHEIMER’S DISEASE

Manu Vandijck1, Roger Moonen1, Nathalie Le Bastard1, Martine Dauwe1, Laura Vernoux1, Sylvie Chevalier2, Annick Barthelaix2, Els Coart3, Els Huyck4, Geert Jannes1, Vesna Kostanjevecki1, 1Fujirebio Europe, Gent, Belgium; 2Neurobiology Laboratory CHU Angers, Angers, France; 3IDDI, Louvain-la-Neuve, Belgium; 4Fujirebio Europe N.V., Gent, Belgium. Contact e-mail: [email protected] Background: Over recent years, the use of cerebrospinal fluid (CSF)

b-amyloid1-40 (Ab1-40) levels for diagnosing Alzheimer’s disease (AD) and distinguishing AD from other dementias has increased. Especially the ratio of Ab1-42/Ab1-40 is currently gaining interest. In this study we evaluated the diagnostic impact of adding Ab1-40 to the measurements of INNOTEST b-AMYLOID(1-42) obtained according to the classical (precision-based) and modified (accuracy-based) test procedure. Methods: A set of 145 CSF samples of individuals characterized according to the NIA-AA criteria (58 AD and 87 non-AD) was analyzed at Fujirebio Europe with the INNOTEST b-AMYLOID(1-42) (cat # 81576) and the INNOTEST b-AMYLOID(1-40) (cat # 80462). For both assays, tests were performed both according to the procedure described in the product’s package insert, and to a modified procedure for Ab1-42 (e.g. longer

sample incubation time, 10 mL sample volume). The clinical performance of the Ab1-42 measurements alone and in a ratio with Ab1-40 was compared with empirical ROC analysis. Results: The AUC for the classical INNOTEST b-AMYLOID(1-42) measurements was 0.89 (95% CI: [0.84 – 0.95]), whereas the use of modified INNOTEST b-AMYLOID(1-42) resulted in an AUC of 0.81 (95% CI: [0.75 – 0.88]). The clinical performance of Ab1-42 with the accuracybased assay was significantly reduced compared to the classical INNOTEST b-AMYLOID(1-42) (p < 0.0001). When calculating the ratio with Ab1-40 for both Ab1-42 measurements, the AUC for the classical procedure increases slightly but not significantly to 0.93 (95% CI: [0.88 – 0.97], p ¼ 0.2533), whereas for the modified procedure the ratio increased significantly (p ¼ 0.0005) to 0.93 (95% CI: [0.89 – 0.97]). The AUCs of the Ab1-42 / Ab1-40 ratios calculated with the modified and classical Ab1-42 are not significantly different (p ¼ 0.4466). Conclusions: Improving the analytical performance of the INNOTEST b-AMYLOID(1-42) by use of a modified test procedure decreased its clinical performance. Using these accuracybased Ab1-42 measurements in a ratio with Ab1-40 resolved this issue. The parallel quantification of Ab1-40can be a significant aid and will become more important in the diagnosis of AD and distinguishing AD from other dementias, especially in cases where the classical CSF biomarker profile is inconclusive. P1-184

ADNI: ARGENTINEAN COHORT — ONE-YEAR FOLLOW-UP

Patricio Alexis Chrem Mendez, Ismael Luis Calandri, Federico Nahas, Jorge Campos, Ezequiel Surace, Silvia Vazquez, Gustavo Sevlever, Allegri Ricardo, FLENI, Buenos Aires, Argentina. Contact e-mail: [email protected] Background: Alzheimer Disease Neuroimaging Initiative (ADNI) is a worldwide standardized observational study which analyzes longitudinal changes in neuropsychological battery test, brain MRI, PET-PIB and FDG and AD biomarkers in CSF in patients who meet criteria for Mild Cognitive Impairment (MCI) or Alzheimer Disease (AD) compared with Normal Controls (NC). Our Center is the only center in Latin- American. Herein, we show preliminary data on neuropsychological testing between those with positive and negative AD biomarkers. We aim to assess the neuropsychological variations of a cohort of patients in different stages of Alzheimers disease with AD biomarkers. Methods: We included a total of 50 participants who had met the criteria of MCI (n¼24) and AD (12) and also 14 NC to compare with. Initially we performed a complete neuropsychological battery test which included: MMSE, MoCA, ADAS cog, RALVT, Trail A and B, Weschler Logical Memory paragraph 1, Clock design, Semantic Fluency, Boston Naming Test, CDR, GDS, NPI and FAQ. Participants underwent to brain MRI, PET-PIB, PET-FDG and AD biomarkers in CSF. After one year participants repeated the same neuropsychological testing. One-way ANOVA was performed on the variations found in the neuropsychological testing after one year of follow-up (baseline - 12 months) between each group and between AD biomarker status. Results: We found only significant decline in ADAS-cog (p¼0.01), Logical Memory delayed (p¼0.01), Trail A (p¼0.01), Boston (p¼0.03) and CDR (p<0.01) between clinical groups after one-year follow-up. But importantly, post hoc analysis only showed differences in Boston and CDR between MCI and AD. When we compared variances between those who had at least one AD biomarker with those with negative AD biomarkers (regardless of the clinical diagnosis), positive group showed significant decline on the exact same test. Conclusions: In this preliminary analysis,