Longitudinal Neuroimaging Analysis in Mild-Moderate Alzheimer's Disease Patients Treated with Plasma Exchange with 5% Human Albumin
Cuberas-Borrós, Gemma (Hospital Universitari Vall d'Hebron)
Roca Bielsa, María Isabel (Hospital Universitari Vall d'Hebron)
Boada, Mercè (Hospital Universitari Vall d'Hebron)
Tárraga, Lluís (Institut Català de Neurociènces Aplicades)
Hernández, Isabel (Institut Català de Neurociènces Aplicades)
Buendía, Mar (Institut Català de Neurociènces Aplicades)
Rubio, Lourdes (Gammagrafía Corachan, Barcelona)
Torres, Gustavo (Gammagrafía Corachan, Barcelona)
Bittini, Ángel (Hospital General Universitario Gregorio Marañón)
Guzmán-de-Villoria, Juan A. (Hospital General Universitario Gregorio Marañón)
Pujadas, Francesc (Hospital Universitari Vall d'Hebron)
Torres, Mireia (Grupo Grifols)
Núñez, Laura (Grupo Grifols)
Castell-Conesa, Joan (Hospital Universitari Vall d'Hebron)
Páez, Antonio (Grupo Grifols)
Universitat Autònoma de Barcelona

Fecha:	2017
Resumen:	Recently, modifications of Aβ levels in CSF and plasma associated with improvement in memory and language functions have been observed in patients with mild-moderate Alzheimer's disease (AD) treated with plasma exchange (PE) with albumin replacement. To detect structural and functional brain changes in PE-treated AD patients as part of a Phase II clinical trial. Patients received between 3 and 18 PE with albumin (Albutein ® 5%, Grifols) or sham-PE (controls) for 21 weeks (divided in one intensive and two maintenance periods) followed by 6-month follow-up. Brain perfusion assessed by SPECT scans using an automated software (NeuroGam ®) and brain structural changes assessed by MRI were performed at weeks 0 (baseline), 21, and 44 (with additional SPECT at weeks 9 and 33). Statistical parametric mapping (voxel-based analysis, SPM) and Z-scores calculations were applied to investigate changes to baseline. 42 patients were recruited (39 evaluable; 37 analyzed: 18 PE-treated; 19 controls). There was a trend toward decreasing hippocampi and total intracranial volume for both patient groups during the study (p < 0. 05). After six months, PE-treated patients had less cerebral perfusion loss than controls in frontal, temporal, and parietal areas, and perfusion stabilization in Brodmann area BA38-R during the PE-treatment period (p < 0. 05). SPM analysis showed stabilization or absence of progression of perfusion loss in PE-treated patients until week 21, not observed in controls. Mild-moderate AD patients showed decreased brain volume and impairment of brain perfusion as expected for the progression of the disease. PE-treatment with albumin replacement favored the stabilization of perfusion.
Nota:	Altres ajuts: This study was funded by Grifols. [...] James T. Becker (Department of Psychiatry, Neurology and Psychology. University of Pittsburgh, Pittsburgh PA, USA) read and commented on an earlier draft of the manuscript. Jordi Bozzo PhD, CMPP (Grifols) is acknowledged for medical writing and editorial assistance in the preparation of the manuscript.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Albumin ; Alzheimer's disease ; Magnetic resonance imaging ; Plasma exchange ; Single-photon emission computed tomography
Publicado en:	Journal of Alzheimer's disease, Vol. 61 (november 2017) , p. 321-332, ISSN 1875-8908

DOI: 10.3233/JAD-170693
PMID: 29154283

12 p, 1000.7 KB

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