Nailfold capillary morphology in Alzheimer's disease dementia

Clara C. Cousins, Michael L. Alosco, Henry C. Cousins, Alicia Chua, Eric G. Steinberg, Kimberly R. Chapman, Hanaan Bing-Canar, Yorghos Tripodis, Paul A. Knepper, Robert A. Stern*, Louis R. Pasquale

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: Cerebrovascular disease (CVD) is highly comorbid with Alzheimer's disease (AD), yet its role is not entirely understood. Nailfold video capillaroscopy (NVC) is a noninvasive method of live imaging the capillaries near the fingernail's cuticle and may help to describe further vascular contributions to AD. Objective: To examine finger nailfold capillary morphology using NVC in subjects with AD dementia, mild cognitive impairment (MCI), and normal cognition (NC). Methods: We evaluated nailfold capillary hemorrhages, avascular zones ≥100 microns, and degree of tortuosity in 28 NC, 15 MCI, and 18 AD dementia subjects using NVC. Tortuosity was measured with a semi-quantitative rating scale. To assess the relation between nailfold capillary morphological features and diagnostic grouping, univariate and multivariable logistic regression models were fit to the data. Results: 56% of subjects with AD dementia compared to 14% with NC and 13% with MCI displayed moderate to severe tortuosity. Greater severity of tortuosity was associated with 10.6-fold (95% confidence interval [CI]: 2.4, 46.2; p = 0.0018) and 7.4-fold (95% CI: 1.3, 41.3; p = 0.023) increased odds of AD dementia relative to NC and MCI, respectively, after adjusting for multiple covariates. Conclusion: Greater nailfold capillary tortuosity was found in participants with AD dementia compared to those with MCI or NC. These data provide preliminary evidence of a systemic microvasculopathy in AD that may be noninvasively and inexpensively evaluated through NVC.

Original languageEnglish (US)
Pages (from-to)601-611
Number of pages11
JournalJournal of Alzheimer's Disease
Volume66
Issue number2
DOIs
StatePublished - Jan 1 2018

Keywords

  • Alzheimer's disease
  • biomarkers
  • cerebral blood flow
  • cerebrovascular disease
  • dementia
  • mild cognitive impairment
  • nailfold capillaroscopy
  • tortuosity

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

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