Corticosteroids lead to short-term improvement in cerebral amyloid angiopathy-related inflammation

Torge Rempe; Carlos Eduardo Vervloet Sollero; Elsa Rodriguez; Vyas Tenkasi Viswanathan; Aaron Carlson; John Rees; Ibrahim Sacit Tuna; Jesse Kresak; Tirisham Victoria Gyang

doi:10.1016/j.jneuroim.2020.577377

Corticosteroids lead to short-term improvement in cerebral amyloid angiopathy-related inflammation

J Neuroimmunol. 2020 Nov 15:348:577377. doi: 10.1016/j.jneuroim.2020.577377. Epub 2020 Aug 29.

Authors

Torge Rempe¹, Carlos Eduardo Vervloet Sollero², Elsa Rodriguez³, Vyas Tenkasi Viswanathan⁴, Aaron Carlson⁵, John Rees⁶, Ibrahim Sacit Tuna⁶, Jesse Kresak⁷, Tirisham Victoria Gyang³

Affiliations

¹ Dept. of Neurology, University of Florida, College of Medicine, 1600 SW Archer Rd, Gainesville, FL, 32608, US; Dept. of Neurosciences, University of California San Diego, School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093, USA. Electronic address: trempe@health.ucsd.edu.
² Dept. of Neurology, University of Florida, College of Medicine, 1600 SW Archer Rd, Gainesville, FL, 32608, US; Dept of Neurology, University of Rochester, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USA.
³ Dept. of Neurology, University of Florida, College of Medicine, 1600 SW Archer Rd, Gainesville, FL, 32608, US.
⁴ Dept. of Neurology, University of Florida, College of Medicine, 1600 SW Archer Rd, Gainesville, FL, 32608, US; Duke University, Dept. of Neurology, Joseph and Kathleen Bryan Research Building, 311 Research Drive, Durham, NC 27710, USA.
⁵ Dept. of Neurology, University of Florida, College of Medicine, 1600 SW Archer Rd, Gainesville, FL, 32608, US; University of Colorado, School of Medicine, 13001 E 17th Pl, Aurora, CO 80045, USA.
⁶ Dept. of Radiology, University of Florida, College of Medicine, 1600 SW Archer Rd, Gainesville, FL, 32608, US.
⁷ Dept of Pathology, University of Florida, College of Medicine, 1600 SW Archer Rd, Gainesville, FL, 32608, US.

PMID: 32919147
DOI: 10.1016/j.jneuroim.2020.577377

Abstract

Background: Cerebral amyloid angiopathy - related inflammation (CAA-ri) is an uncommon manifestation of CAA.

Methods: Single-center, retrospective review of all charts with ICD-code I68.0 (CAA) from 2/2/2016-1/1/2020.

Results: Of 152 CAA cases, 13 (8.6%) were consistent with CAA-ri. Corticosteroid-treatment led to short-term reduction in modified Rankin Scale scores (2.6 ± 1.4 vs. 1.6 ± 1.5; p = 0.01) and T2/FLAIR lesion volume (78.1 ± 52.2 cm³ vs. 30 ± 30.9 cm³, p < 0.01) as well as short-term improvement in post-treatment Clinical Global Impression - Global Change scores compared to pre-treatment scores (clinical: 6 ± 1 vs. 2.6 ± 1.3, p = 0.03; radiological: 4.6 ± 1.9 vs. 1.2 ± 0.4, p = 0.03).

Interpretation: Corticosteroid-treatment leads to clinical and radiological short-term improvement (class IV evidence).

Keywords: ABRA; CAA; CAA-related inflammation; CAA-ri; CAARI.

MeSH terms

Adrenal Cortex Hormones / therapeutic use*
Aged
Brain / drug effects
Brain / pathology
Cerebral Amyloid Angiopathy / complications*
Female
Humans
Inflammation / drug therapy*
Inflammation / etiology
Inflammation / pathology
Magnetic Resonance Imaging
Male
Methylprednisolone / therapeutic use*
Middle Aged
Prednisolone / therapeutic use*
Retrospective Studies

Substances

Adrenal Cortex Hormones
Prednisolone
Methylprednisolone