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Principal Investigator  
Principal Investigator's Name: Hyung-Ji Kim
Institution: Uijeongbu Eulji Medical Center
Department: Neurology
Country:
Proposed Analysis: The impact of Subthreshold levels of amyloid deposition on conversion to dementia in patient with amyloid-negative amnestic mild cognitive impairment  Purpose of study We investigated the risk factors that influence progression to dementia in patients with amyloid negative amnestic mild cognitive impairment (aMCI).  Background of study Amyloid PET scan allows for the assessment of beta amyloid status in the brain, distinguishing true Alzheimer’s disease from Alzheimer’s mimicking conditions. 15 to 20% of patients with clinically probable Alzheimer’s disease (AD) have been shown to have no significant Alzheimer’s pathology on amyloid PET. Fewer studies, however, have been done about this subpopulation in terms of clinical progression  Method 1) Inclusion criteria - All enrolled subjects from ADNI go to ADNI 3 - Over age 50 - Follow up period more than 36 months - Both brain MRI and amyloid PET were performed - Diagnosed with mild cognitive impairment by cognitive battery 2) Exclusion criteria - Structural lesion which could rapidly aggravate cognitive function intracranial hemorrhage, subdural/subarachinoid hemorrhage acute cerebral infarction brain tumor (malignant) 3) Control group - Amyloid PET negative findings - Stationary at MCI state more than 36 months  Clinical information - Demographic data age(onset, diagnosed), Sex, education years, socio-economic state race, familial history of dementia or other neurodegenerative disorder baseline disease (DM, HTN, Hepatitis, Thyroid disease, dyslipidemia) - Physical and neurologic examination - Cognitive evaluations ADAS-cog 13, Logical Memory test I and II, MMSE, and MoCA - Global, functional, and behavioral evaluation CDR scale, ADL, Functional Assessment Questionnaire(FAQ) Neuropsychiatric Inventory or Neuropsychiatric Inventory Q - Clinical laboratory evaluation complete blood count, chemistry battery with lipid profiles, ESR vitamin B 12 , folate, homocysteine, thyroid function test magnesium, total calcium with ionized calcium level - Biofluid CSF : Aβ 1-42 , t-tau, and p-tau 181 Serum Genetics and genomic analysis (like ApoE gene) - Neuroimaging Structural : Brain MRI scan Functional neuroimaging : FDG-PET, amyloid PET, AV-1451 PET(tau PET)  Statistical analysis - The statistical analysis were performed using SPSS (version 21.0m IBM Corp) - To figure out the pattern distribution of data : Kolmogorov-Smirnov tests normal distribution : independent samples T test did not confirm normal distribution : Kruskal-Wallis test - Test for independency of sex, diabetes, hypertension, and dyslipidemia Pearson’s chi-square test - Analysis of covariance was also used need of the age-adjusted comparison - Imaging analysis : using SPM-12 (Matlab). freesurfer other technic same as above  Follow up survey - The prognosis of patients with amyloid negative amnestic MCI can be predicted. - A follow-up survey can be conducted to confirm the association with emerging biomarkers in Alzheimer’s disease
Additional Investigators  
Investigator's Name: Jae-Hong Lee
Proposed Analysis:  Purpose of study We investigated the risk factors that influence progression to dementia in patients with amyloid negative amnestic mild cognitive impairment (aMCI).  Background of study Amyloid PET scan allows for the assessment of beta amyloid status in the brain, distinguishing true Alzheimer’s disease from Alzheimer’s mimicking conditions. 15 to 20% of patients with clinically probable Alzheimer’s disease (AD) have been shown to have no significant Alzheimer’s pathology on amyloid PET. Fewer studies, however, have been done about this subpopulation in terms of clinical progression  Method 1) Inclusion criteria - All enrolled subjects from ADNI go to ADNI 3 - Over age 50 - Follow up period more than 36 months - Both brain MRI and amyloid PET were performed - Diagnosed with mild cognitive impairment by cognitive battery 2) Exclusion criteria - Structural lesion which could rapidly aggravate cognitive function intracranial hemorrhage, subdural/subarachinoid hemorrhage acute cerebral infarction brain tumor (malignant) 3) Control group - Amyloid PET negative findings - Stationary at MCI state more than 36 months  Clinical information - Demographic data age(onset, diagnosed), Sex, education years, socio-economic state race, familial history of dementia or other neurodegenerative disorder baseline disease (DM, HTN, Hepatitis, Thyroid disease, dyslipidemia) - Physical and neurologic examination - Cognitive evaluations ADAS-cog 13, Logical Memory test I and II, MMSE, and MoCA - Global, functional, and behavioral evaluation CDR scale, ADL, Functional Assessment Questionnaire(FAQ) Neuropsychiatric Inventory or Neuropsychiatric Inventory Q - Clinical laboratory evaluation complete blood count, chemistry battery with lipid profiles, ESR vitamin B 12 , folate, homocysteine, thyroid function test magnesium, total calcium with ionized calcium level - Biofluid CSF : Aβ 1-42 , t-tau, and p-tau 181 Serum Genetics and genomic analysis (like ApoE gene) - Neuroimaging Structural : Brain MRI scan Functional neuroimaging : FDG-PET, amyloid PET, AV-1451 PET(tau PET)  Statistical analysis - The statistical analysis were performed using SPSS (version 21.0m IBM Corp) - To figure out the pattern distribution of data : Kolmogorov-Smirnov tests normal distribution : independent samples T test did not confirm normal distribution : Kruskal-Wallis test - Test for independency of sex, diabetes, hypertension, and dyslipidemia Pearson’s chi-square test - Analysis of covariance was also used need of the age-adjusted comparison - Imaging analysis : using SPM-12 (Matlab). freesurfer other technic same as above  Follow up survey - The prognosis of patients with amyloid negative amnestic MCI can be predicted. - A follow-up survey can be conducted to confirm the association with emerging biomarkers in Alzheimer’s disease