Comorbid amyloid-β pathology affects clinical and imaging features in VCD.

Introduction: To date, the clinical relevance of comorbid amyloid-beta (A beta) pathology in patients with vascular cognitive disorders (VCD) is largely unknown. Methods: We included 218 VCD patients with available cerebrospinal fluid A beta(42) levels. Patients were divided into A beta + mild-VCD (n = 84), A beta - mild-VCD (n = 68), A beta + major-VCD (n = 31), and A beta - major-VCD (n = 35). We measured depression with the Geriatric Depression Scale, cognition with a neuropsychological test battery and derived white matter hyperintensities (WMH) and gray matter atrophy from MRI. Results: A beta - patients showed more depressive symptoms than A beta +. In the major-VCD group, A beta - patients performed worse on attention (P=.02) and executive functioning (P=.008) than A beta +. We found no cognitive differences in patients with mild VCD. In the mild-VCD group, A beta - patients had more WMH than A beta + patients, whereas conversely, in the major-VCD group, A beta + patients had more WMH. Atrophy patterns did not differ between A beta + and A beta - VCD group. Discussion: Comorbid A beta pathology affects the manifestation of VCD, but effects differ by severity of VCD.