The Associations between Intracranial Stenosis, Brain Amyloid-beta, and Cognition in a Memory Clinic Sample

Background: Intracranial stenosis (ICS) and brain amyloid-beta (Aβ) have been associated with cognition and dementia. We aimed to investigate the association between ICS and brain Aβ and their independent and joint associations with cognition. Methods: We conducted a cross-sectional study of 185 patients recruited from a memory clinic. ICS was measured on 3-dimensional time-of-flight magnetic resonance angiography and defined as stenosis ≥50%. Brain Aβ was measured with [¹¹C] Pittsburgh compound B-positron emission tomography imaging. Cognition was assessed with a locally validated neuropsychological battery. Results: A total of 17 (9.2%) patients had ICS, and the mean standardized uptake value ratio was 1.4 (±0.4 SD). ICS was not significantly associated with brain Aβ deposition. ICS was significantly associated with worse global cognition (β: -1.26, 95% CI: -2.25; -0.28, P=0.013), executive function (β: -1.04, 95% CI: -1.86; -0.22, P=0.015) and visuospatial function (β: -1.29, 95% CI: -2.30; -0.27, P=0.015). Moreover, in ICS patients without dementia (n=8), the presence of Aβ was associated with worse performance on visuomotor speed. Conclusions: ICS was significantly associated with worse cognition and showed interaction with brain Aβ such that patients with both pathologies performed worse on visuomotor speed specifically in those without dementia. Further studies may clarify if ICS and brain Aβ deposition indeed have a synergistic association with cognition.