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June 1, 1996

Cerebral amyloid angiopathy in the brains of patients with Alzheimer's disease
The CERAD experience, part XV

June 1996 issue
46 (6) 1592-1596


We studied the frequency, severity, and clinical correlations of cerebral amyloid angiopathy (CAA) in 117 CERAD subjects with autopsy-confirmed AD. Eighty-three percent showed at least a mild degree of amyloid angiopathy. Thirty of 117 brains (25.6%) showed moderate to severe CAA affecting the cerebral vessels in one or more cortical regions. These brains also showed a significantly higher frequency of hemorrhages or ischemic lesions than those of subjects with little or no amyloid angiopathy (43.3% versus 23.0%; odds ratio = 2.6, 95% CI = 1.1 to 6.2). High CAA scores also correlated with the presence of cerebral arteriosclerosis and with older age at onset of dementia. Our findings suggest that factors contributing to non-AD-related vascular pathology (e.g., atherosclerosis) may play a role in amyloid deposition in cerebral vessels in AD.
NEUROLOGY 1996;46: 1592-1596

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Vinters HV, Gilbert JJ. Cerebral amyloid angiopathy: incidence and complications in the aging brain. II. The distribution of amyloid vascular changes. Stroke 1983;14:924-928.
Itoh Y, Yamada M, Hayakawa M, Otomo E, Miyatake T. Subpial beta/A4 peptide deposits are closely associated with amyloid angiopathy in the elderly. Neurosci Lett 1993;155:144-147.
Glenner GG, Henry JH, Fujihara S. Congophilic angiopathy in the pathogenesis of Alzheimer's degeneration. Ann Pathol 1981;1:120-129.
Joachim CL, Morris JH, Selkoe DJ. Clinically diagnosed Alzheimer's disease: autopsy results in 150 cases. Ann Neurol 1988;24:50-56.
Blondal H, Guomundssen G, Benedikz E, Johanesson G. Dementia in hereditary cystatin-c amyloidosis. Alzheimer Dis Assoc Disord 1988;2:170.
Armstrong RA, Myers D, Smith CU. The ratio of diffuse to mature beta/A4 deposits in Alzheimer's disease varies in cases with and without congophilic angiopathy. Dementia 1993;4:251-255.
Rozemuller AJ, Roos RA, Bots GT, et al. Distribution of beta/A4 protein and amyloid precursor protein in hereditary cerebral hemorrhage with amyloidosis Dutch type and Alzheimer's disease. Am J Pathol 1993;142:1449-1457.
Lippa CF, Hamos JE, Smith TW, Pulaski SD, Drachman DA. Vascular amyloid deposition in Alzheimer's disease. Neither necessary nor sufficient for the local formation of plaques or tangles. Arch Neurol 1993;50:1088-1092.
Zubenko GS, Stiffler S, Stabler S, et al. Association of the apolipoprotein E epsilon 4 allele with clinical subtypes of autopsy-confirmed Alzheimer's disease. Am J Med Genet 1994;54:199-205.
Olichney JM, Hansen L, Hofstetter CR, et al. Cerebral infarction in Alzheimer's disease is associated with severe amyloid angiopathy and hypertension. Arch Neurol 1995;52:702-708.
Ferreiro JA, Ansbacher LE, Vinters HV. Stroke related to cerebral amyloid angiopathy: the significance of systemic vascular disease. J Neurol 1989;236:267-272.
Okazaki H, Reagan TJ, Campbell RJ. Clinicopathologic studies of primary cerebral amyloid angiopathy. Mayo Clin Proc 1979;54:22-31.
Smith DB, Hitchcock M, Philpott PJ. Cerebral amyloid angiopathy presenting as transient ischemic attacks. Case report. J Neurosurg 1985;63:963-964.
Lopez O, Claassen D, Boller F. Alzheimer's disease, cerebral amyloid angiopathy, and dementia of acute onset. Aging 1991;3:171-175.
Corey-Bloom J, Galasko D, Hofstetter CR, Jackson JE, Thal LJ. Clinical features distinguishing large cohorts with possible AD, probable AD, and mixed dementia. J Am Geriatr Soc 1993;41:31-37.
Aronson MK, Ooi WL, Geva DL, et al. Dementia. Age-dependent incidence, prevalence, and mortality in the old old. Arch Intern Med 1991;151:989-992.
Mendez MF, Mastri AR, Sung JH, Frey W. Clinically diagnosed Alheimer disease: neuropathologic findings in 650 cases. Alzheimer Dis Assoc Disord 1992;6:35-43.
Gilbert JJ, Vinters HV. Cerebral amyloid angiopathy: incidence and complications in the aging brain. I. Cerebral hemorrhage. Stroke 1983;14:915-923.
Mandybur TI. Cerebral amyloid angiopathy: the vascular pathology and complications. J Neuropathol Exp Neurol 1986;45:79-90.
Greenberg SM, Vonsattel JP, Stakes JW, Gruber M, Finkelstein SP. The clinical spectrum of cerebral amyloid angiopathy: presentations without lobar hemorrhage. Neurology 1993;43:2073-2079.
Hendriks L, Van DC, Cras P, et al. Presenile dementia and cerebral haemorrhage linked to a mutation at codon 692 of the beta-amyloid precursor protein gene. Nature Genet 1992;1:218-221.
Morris JC, Heyman A, Mohs RC, et al. The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part I. Clinical and neurological assessment of Alzheimer's disease. Neurology 1989;39:1159-1165.
Mirra SS, Heyman A, McKeel D, et al. The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part II. Standardization of the neuropathologic assessment of Alzheimer's disease. Neurology 1991;41:479-486.
Esiri MM, Wilcock GK. Cerebral amyloid angiopathy in dementia and old age. J Neurosurg Psychiatry 1986;49:1221-1226.
Ishihara T, Takahashi M, Yokota T, et al. The significance of cerebral vascular amyloid in the aetiology of superficial (lobar) cerebral haemorrhage and its incidence in the elderly population. J Pathol 1991;165:229-234.
Vonsattel JP, Myers RH, Hedley-White ET, et al. Cerebral amyloid angiopathy without and with cerebral hemorrhages: a comparative histological study. Ann Neurol 1991;30:637-649.
Yamada M, Tsukagoshi H, Otomo E, Hayakawa M. Cerebral amyloid angiopathy in the aged. J Neurol 1987;234:371-376.
Joachim CL, Duffy LK, Morris JH, Selkoe DJ. Protein chemical and immunocytochemical studies of meningovascular beta amyloid protein in Alzheimer's disease and normal aging. Brain Res 1988;474:100-111.
Roher AE, Palmer KC, Yurewicz EC, Ball MJ, Greenberg BD. Morphological and biochemical analyses of amyloid plaque core proteins purified from Alzheimer disease brain tissue. J Neurochem 1993;61:1916-1926.
Roher AE, Lowenson JD, Clarke S, et al. Beta-amyloid-(1-42) is a major component of cerebrovascular amyloid deposits: implications for the pathology of Alzheimer disease. Proc Natl Acad Sci USA 1993;90:10836-10840.
Suzuki N, Iwatsubo T, Odaka A, Ishibashi Y, Kitada C, Ihara Y. High tissue content of soluble beta 1-40 is linked to cerebral amyloid angiopathy. Am J Pathol 1994;145:452-460.
Wisniewski HM, Wegiel J. Beta-amyloid formation by myocytes of amyloid vessels. Acta Neuropathol 1994;87:233-241.
Kawai M, Kalaria RN, Cras P, et al. Degeneration of vascular muscle cells in cerebral amyloid angiopathy of Alzheimer's disease. Brain Res 1993;63:142-146.

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Published In

Volume 46Number 6June 1996
Pages: 1592-1596
PubMed: 8649554

Publication History

Published online: June 1, 1996
Published in print: June 1996


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Affiliations & Disclosures

From the University of California-San Diego and VA Medical Center, Department of Neurosciences (Drs. Ellis, Olichney, and Thal), San Diego, CA; VA Medical Center and Emory University School of Medicine, Department of Pathology and Laboratory Medicine (Dr. Mirra), Atlanta, GA; Department of Neurology (Dr. Morris), Washington University School of Medicine, St. Louis, MO; Department of Biostatistics (Dr. Beekly), University of Washington, Seattle, WA; and Duke University Medical Center, Division of Neurology (Dr. Heyman), Durham, NC.
Supported in part by a Fellowship in Geriatric Neurology from the Department of Veteran's Affairs and by National Institute on Aging Grants AG06790 and AG05131.
Received September 7, 1995. Accepted in final form October 2, 1995.
Address correspondence and reprint requests to Dr. Ronald J. Ellis, Alzheimer's Disease Research Center (0948), University of California (San Diego), La Jolla, CA 92093.

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