Neuroimaging analyses from a randomized, controlled study to evaluate plasma exchange with albumin replacement in mild-to-moderate Alzheimer's disease

This study was designed to detect structural and functional brain changes in Alzheimer's disease (AD) patients treated with therapeutic plasma exchange (PE) with albumin replacement, as part of the recent AMBAR phase 2b/3 clinical trial. Mild-to-moderate AD patients were randomized into four ar...

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Autores: Cuberas-Borrós, Gemma|||0000-0001-5276-8212, Roca Bielsa, María Isabel, Castell-Conesa, Joan|||0000-0002-6449-9731, Núñez, Laura, Boada, Mercè|||0000-0003-2617-3009, López, Oscar L., Grifols, Carlota, Barceló Torns, Miquel|||0000-0002-6205-8000, Pareto, Deborah|||0000-0001-7356-3769, Páez, Antonio
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:268536
Acceso en línea:https://ddd.uab.cat/record/268536
https://dx.doi.org/urn:doi:10.1007/s00259-022-05915-5
Access Level:acceso abierto
Palabra clave:Alzheimer's disease
Plasmapheresis
Plasma exchange
Albumin
Intravenous immunoglobulin
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spelling Neuroimaging analyses from a randomized, controlled study to evaluate plasma exchange with albumin replacement in mild-to-moderate Alzheimer's diseaseadditional results from the AMBAR studyCuberas-Borrós, Gemma|||0000-0001-5276-8212Roca Bielsa, María IsabelCastell-Conesa, Joan|||0000-0002-6449-9731Núñez, LauraBoada, Mercè|||0000-0003-2617-3009López, Oscar L.Grifols, CarlotaBarceló Torns, Miquel|||0000-0002-6205-8000Pareto, Deborah|||0000-0001-7356-3769Páez, AntonioAlzheimer's diseasePlasmapheresisPlasma exchangeAlbuminIntravenous immunoglobulinThis study was designed to detect structural and functional brain changes in Alzheimer's disease (AD) patients treated with therapeutic plasma exchange (PE) with albumin replacement, as part of the recent AMBAR phase 2b/3 clinical trial. Mild-to-moderate AD patients were randomized into four arms: three arms receiving PE with albumin (one with low-dose albumin, and two with low/high doses of albumin alternated with IVIG), and a placebo (sham PE) arm. All arms underwent 6 weeks of weekly conventional PE followed by 12 months of monthly low-volume PE. Magnetic resonance imaging (MRI) volumetric analyses and regional and statistical parametric mapping (SPM) analysis on 18 F-fluorodeoxyglucose positron emission tomography (18 FDG-PET) were performed. MRI analyses (n = 198 patients) of selected subcortical structures showed fewer volume changes from baseline to final visit in the high albumin + IVIG treatment group (p < 0.05 in 3 structures vs. 4 to 9 in other groups). The high albumin + IVIG group showed no statistically significant reduction of right hippocampus. SPM 18 FDG-PET analyses (n = 213 patients) showed a worsening of metabolic activity in the specific areas affected in AD (posterior cingulate, precuneus, and parieto-temporal regions). The high-albumin + IVIG treatment group showed the greatest metabolic stability over the course of the study, i.e., the smallest percent decline in metabolism (MaskAD), and least progression of defect compared to placebo. PE with albumin replacement was associated with fewer deleterious changes in subcortical structures and less metabolic decline compared to the typical of the progression of AD. This effect was more marked in the group treated with high albumin + IVIG. (AMBAR trial registration: EudraCT#: 2011-001,598-25; ClinicalTrials.gov ID: NCT01561053). The online version contains supplementary material available at 10.1007/s00259-022-05915-5.Universitat Autònoma de Barcelona 22022-01-0120222022-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/268536https://dx.doi.org/urn:doi:10.1007/s00259-022-05915-5reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest 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, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:2685362026-06-06T12:50:31Z
dc.title.none.fl_str_mv Neuroimaging analyses from a randomized, controlled study to evaluate plasma exchange with albumin replacement in mild-to-moderate Alzheimer's disease
additional results from the AMBAR study
title Neuroimaging analyses from a randomized, controlled study to evaluate plasma exchange with albumin replacement in mild-to-moderate Alzheimer's disease
spellingShingle Neuroimaging analyses from a randomized, controlled study to evaluate plasma exchange with albumin replacement in mild-to-moderate Alzheimer's disease
Cuberas-Borrós, Gemma|||0000-0001-5276-8212
Alzheimer's disease
Plasmapheresis
Plasma exchange
Albumin
Intravenous immunoglobulin
title_short Neuroimaging analyses from a randomized, controlled study to evaluate plasma exchange with albumin replacement in mild-to-moderate Alzheimer's disease
title_full Neuroimaging analyses from a randomized, controlled study to evaluate plasma exchange with albumin replacement in mild-to-moderate Alzheimer's disease
title_fullStr Neuroimaging analyses from a randomized, controlled study to evaluate plasma exchange with albumin replacement in mild-to-moderate Alzheimer's disease
title_full_unstemmed Neuroimaging analyses from a randomized, controlled study to evaluate plasma exchange with albumin replacement in mild-to-moderate Alzheimer's disease
title_sort Neuroimaging analyses from a randomized, controlled study to evaluate plasma exchange with albumin replacement in mild-to-moderate Alzheimer's disease
dc.creator.none.fl_str_mv Cuberas-Borrós, Gemma|||0000-0001-5276-8212
Roca Bielsa, María Isabel
Castell-Conesa, Joan|||0000-0002-6449-9731
Núñez, Laura
Boada, Mercè|||0000-0003-2617-3009
López, Oscar L.
Grifols, Carlota
Barceló Torns, Miquel|||0000-0002-6205-8000
Pareto, Deborah|||0000-0001-7356-3769
Páez, Antonio
author Cuberas-Borrós, Gemma|||0000-0001-5276-8212
author_facet Cuberas-Borrós, Gemma|||0000-0001-5276-8212
Roca Bielsa, María Isabel
Castell-Conesa, Joan|||0000-0002-6449-9731
Núñez, Laura
Boada, Mercè|||0000-0003-2617-3009
López, Oscar L.
Grifols, Carlota
Barceló Torns, Miquel|||0000-0002-6205-8000
Pareto, Deborah|||0000-0001-7356-3769
Páez, Antonio
author_role author
author2 Roca Bielsa, María Isabel
Castell-Conesa, Joan|||0000-0002-6449-9731
Núñez, Laura
Boada, Mercè|||0000-0003-2617-3009
López, Oscar L.
Grifols, Carlota
Barceló Torns, Miquel|||0000-0002-6205-8000
Pareto, Deborah|||0000-0001-7356-3769
Páez, Antonio
author2_role author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona
dc.subject.none.fl_str_mv Alzheimer's disease
Plasmapheresis
Plasma exchange
Albumin
Intravenous immunoglobulin
topic Alzheimer's disease
Plasmapheresis
Plasma exchange
Albumin
Intravenous immunoglobulin
description This study was designed to detect structural and functional brain changes in Alzheimer's disease (AD) patients treated with therapeutic plasma exchange (PE) with albumin replacement, as part of the recent AMBAR phase 2b/3 clinical trial. Mild-to-moderate AD patients were randomized into four arms: three arms receiving PE with albumin (one with low-dose albumin, and two with low/high doses of albumin alternated with IVIG), and a placebo (sham PE) arm. All arms underwent 6 weeks of weekly conventional PE followed by 12 months of monthly low-volume PE. Magnetic resonance imaging (MRI) volumetric analyses and regional and statistical parametric mapping (SPM) analysis on 18 F-fluorodeoxyglucose positron emission tomography (18 FDG-PET) were performed. MRI analyses (n = 198 patients) of selected subcortical structures showed fewer volume changes from baseline to final visit in the high albumin + IVIG treatment group (p < 0.05 in 3 structures vs. 4 to 9 in other groups). The high albumin + IVIG group showed no statistically significant reduction of right hippocampus. SPM 18 FDG-PET analyses (n = 213 patients) showed a worsening of metabolic activity in the specific areas affected in AD (posterior cingulate, precuneus, and parieto-temporal regions). The high-albumin + IVIG treatment group showed the greatest metabolic stability over the course of the study, i.e., the smallest percent decline in metabolism (MaskAD), and least progression of defect compared to placebo. PE with albumin replacement was associated with fewer deleterious changes in subcortical structures and less metabolic decline compared to the typical of the progression of AD. This effect was more marked in the group treated with high albumin + IVIG. (AMBAR trial registration: EudraCT#: 2011-001,598-25; ClinicalTrials.gov ID: NCT01561053). The online version contains supplementary material available at 10.1007/s00259-022-05915-5.
publishDate 2022
dc.date.none.fl_str_mv 2
2022-01-01
2022
2022-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/268536
https://dx.doi.org/urn:doi:10.1007/s00259-022-05915-5
url https://ddd.uab.cat/record/268536
https://dx.doi.org/urn:doi:10.1007/s00259-022-05915-5
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
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