Cerebral amyloid angiopathy: diagnosis and potential therapies

Stewart A. Weber, Ranish K. Patel, Helmi Lutsep

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Introduction: Cerebral amyloid angiopathy (CAA) is characterized by the pathologic deposition of amyloid-beta within cortical and leptomeningeal arteries, arterioles, capillaries and, in rare cases, the venules of the brain. It is often associated with the development of lobar intracerebral hemorrhages (ICHs) but may cause other neurologic symptoms or be asymptomatic. Magnetic resonance imaging characteristics, such as lobar microbleeds, support a diagnosis of CAA and assist with hemorrhage risk assessments. Immunosuppressants are used to treat rarer inflammatory forms of CAA. For the more common forms of CAA, the use of antihypertensive medications can prevent ICH recurrence while the use of antithrombotics may increase hemorrhage risk. Anti-amyloid approaches to treatment have not yet been investigated in phase 3 trials. Areas covered: A literature search was conducted using MEDLINE on the topics of imaging, biomarkers, ICH prevention and treatment trials in CAA, focusing on its current diagnosis and management and opportunities for future therapeutic approaches. Expert commentary: There is likely a significant unrecognized burden of CAA in the elderly population. Continued research efforts to discover biomarkers that allow the early diagnosis of CAA will enhance the opportunity to develop treatment interventions.

Original languageEnglish (US)
Pages (from-to)503-513
Number of pages11
JournalExpert Review of Neurotherapeutics
Volume18
Issue number6
DOIs
StatePublished - Jun 3 2018

Fingerprint

Cerebral Amyloid Angiopathy
Cerebral Hemorrhage
Amyloid
Therapeutics
Biomarkers
Hemorrhage
Venules
Arterioles
Immunosuppressive Agents
Neurologic Manifestations
MEDLINE
Antihypertensive Agents
Early Diagnosis
Arteries
Magnetic Resonance Imaging
Recurrence
Brain

Keywords

  • CAA-related inflammation
  • Cerebral amyloid angiopathy
  • lobar hemorrhage
  • microbleed
  • β-amyloid-related angiitis

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology
  • Pharmacology (medical)

Cite this

Cerebral amyloid angiopathy : diagnosis and potential therapies. / Weber, Stewart A.; Patel, Ranish K.; Lutsep, Helmi.

In: Expert Review of Neurotherapeutics, Vol. 18, No. 6, 03.06.2018, p. 503-513.

Research output: Contribution to journalReview article

Weber, Stewart A. ; Patel, Ranish K. ; Lutsep, Helmi. / Cerebral amyloid angiopathy : diagnosis and potential therapies. In: Expert Review of Neurotherapeutics. 2018 ; Vol. 18, No. 6. pp. 503-513.
@article{ff2a2adca71b4e748ddcb7b07c399fd0,
title = "Cerebral amyloid angiopathy: diagnosis and potential therapies",
abstract = "Introduction: Cerebral amyloid angiopathy (CAA) is characterized by the pathologic deposition of amyloid-beta within cortical and leptomeningeal arteries, arterioles, capillaries and, in rare cases, the venules of the brain. It is often associated with the development of lobar intracerebral hemorrhages (ICHs) but may cause other neurologic symptoms or be asymptomatic. Magnetic resonance imaging characteristics, such as lobar microbleeds, support a diagnosis of CAA and assist with hemorrhage risk assessments. Immunosuppressants are used to treat rarer inflammatory forms of CAA. For the more common forms of CAA, the use of antihypertensive medications can prevent ICH recurrence while the use of antithrombotics may increase hemorrhage risk. Anti-amyloid approaches to treatment have not yet been investigated in phase 3 trials. Areas covered: A literature search was conducted using MEDLINE on the topics of imaging, biomarkers, ICH prevention and treatment trials in CAA, focusing on its current diagnosis and management and opportunities for future therapeutic approaches. Expert commentary: There is likely a significant unrecognized burden of CAA in the elderly population. Continued research efforts to discover biomarkers that allow the early diagnosis of CAA will enhance the opportunity to develop treatment interventions.",
keywords = "CAA-related inflammation, Cerebral amyloid angiopathy, lobar hemorrhage, microbleed, β-amyloid-related angiitis",
author = "Weber, {Stewart A.} and Patel, {Ranish K.} and Helmi Lutsep",
year = "2018",
month = "6",
day = "3",
doi = "10.1080/14737175.2018.1480938",
language = "English (US)",
volume = "18",
pages = "503--513",
journal = "Expert Review of Neurotherapeutics",
issn = "1473-7175",
publisher = "Expert Reviews Ltd.",
number = "6",

}

TY - JOUR

T1 - Cerebral amyloid angiopathy

T2 - diagnosis and potential therapies

AU - Weber, Stewart A.

AU - Patel, Ranish K.

AU - Lutsep, Helmi

PY - 2018/6/3

Y1 - 2018/6/3

N2 - Introduction: Cerebral amyloid angiopathy (CAA) is characterized by the pathologic deposition of amyloid-beta within cortical and leptomeningeal arteries, arterioles, capillaries and, in rare cases, the venules of the brain. It is often associated with the development of lobar intracerebral hemorrhages (ICHs) but may cause other neurologic symptoms or be asymptomatic. Magnetic resonance imaging characteristics, such as lobar microbleeds, support a diagnosis of CAA and assist with hemorrhage risk assessments. Immunosuppressants are used to treat rarer inflammatory forms of CAA. For the more common forms of CAA, the use of antihypertensive medications can prevent ICH recurrence while the use of antithrombotics may increase hemorrhage risk. Anti-amyloid approaches to treatment have not yet been investigated in phase 3 trials. Areas covered: A literature search was conducted using MEDLINE on the topics of imaging, biomarkers, ICH prevention and treatment trials in CAA, focusing on its current diagnosis and management and opportunities for future therapeutic approaches. Expert commentary: There is likely a significant unrecognized burden of CAA in the elderly population. Continued research efforts to discover biomarkers that allow the early diagnosis of CAA will enhance the opportunity to develop treatment interventions.

AB - Introduction: Cerebral amyloid angiopathy (CAA) is characterized by the pathologic deposition of amyloid-beta within cortical and leptomeningeal arteries, arterioles, capillaries and, in rare cases, the venules of the brain. It is often associated with the development of lobar intracerebral hemorrhages (ICHs) but may cause other neurologic symptoms or be asymptomatic. Magnetic resonance imaging characteristics, such as lobar microbleeds, support a diagnosis of CAA and assist with hemorrhage risk assessments. Immunosuppressants are used to treat rarer inflammatory forms of CAA. For the more common forms of CAA, the use of antihypertensive medications can prevent ICH recurrence while the use of antithrombotics may increase hemorrhage risk. Anti-amyloid approaches to treatment have not yet been investigated in phase 3 trials. Areas covered: A literature search was conducted using MEDLINE on the topics of imaging, biomarkers, ICH prevention and treatment trials in CAA, focusing on its current diagnosis and management and opportunities for future therapeutic approaches. Expert commentary: There is likely a significant unrecognized burden of CAA in the elderly population. Continued research efforts to discover biomarkers that allow the early diagnosis of CAA will enhance the opportunity to develop treatment interventions.

KW - CAA-related inflammation

KW - Cerebral amyloid angiopathy

KW - lobar hemorrhage

KW - microbleed

KW - β-amyloid-related angiitis

UR - http://www.scopus.com/inward/record.url?scp=85048355924&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85048355924&partnerID=8YFLogxK

U2 - 10.1080/14737175.2018.1480938

DO - 10.1080/14737175.2018.1480938

M3 - Review article

C2 - 29792540

AN - SCOPUS:85048355924

VL - 18

SP - 503

EP - 513

JO - Expert Review of Neurotherapeutics

JF - Expert Review of Neurotherapeutics

SN - 1473-7175

IS - 6

ER -