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@ARTICLE{Hoenig:140809,
      author       = {Hoenig, Merle C and Bischof, Gérard N and Onur, Özgür A
                      and Kukolja, Juraj and Jessen, Frank and Fliessbach, Klaus
                      and Neumaier, Bernd and Fink, Gereon R and Kalbe, Elke and
                      Drzezga, Alexander and Eimeren, Thilo and Initiative,
                      Alzheimer’s Disease Neuroimaging},
      title        = {{L}evel of education mitigates the impact of tau pathology
                      on neuronal function.},
      journal      = {European journal of nuclear medicine and molecular imaging},
      volume       = {46},
      number       = {9},
      issn         = {1619-7070},
      address      = {Heidelberg [u.a.]},
      publisher    = {Springer-Verl.},
      reportid     = {DZNE-2020-07131},
      pages        = {1787-1795},
      year         = {2019},
      abstract     = {Using PET imaging in a group of patients with Alzheimer's
                      disease (AD), we investigated whether level of education, a
                      proxy for resilience, mitigates the harmful impact of tau
                      pathology on neuronal function.We included 38 patients with
                      mild-to-moderate AD (mean age 67 ± 7 years, mean MMSE
                      score 24 ± 4, mean years of education 14 ± 4; 20
                      men, 18 women) in whom a [18F]AV-1451 scan (a measure of tau
                      pathology) and an [18F]FDG scan (a measure of neuronal
                      function) were available. The preprocessed PET scans were
                      z-transformed using templates for [18F]AV-1451 and [18F]FDG
                      from healthy controls, and subsequently thresholded at a
                      z-score of ≥3.0, representing an one-tailed p value of
                      0.001. Next, three volumes were computed in each patient:
                      the tau-specific volume (tau pathology without neuronal
                      dysfunction), the FDG-specific volume (neuronal dysfunction
                      without tau pathology), and the overlap volume (tau
                      pathology and neuronal dysfunction). Mean z-scores and
                      volumes were extracted and used as dependent variables in
                      regression analysis with years of education as predictor,
                      and age and MMSE score as covariates.Years of education were
                      positively associated with tau-specific volume
                      (β = 0.362, p = 0.022), suggesting a lower impact
                      of tau pathology on neuronal function in patients with
                      higher levels of education. Concomitantly, level of
                      education was positively related to tau burden in the
                      overlap volume (β = 0.303, p = 0.036) implying that
                      with higher levels of education more tau pathology is
                      necessary to induce neuronal dysfunction.In patients with
                      higher levels of education, tau pathology is less paralleled
                      by regional and remote neuronal dysfunction. The data
                      suggest that early life-time factors such as level of
                      education support resilience mechanisms, which ameliorate
                      AD-related effects later in life.},
      keywords     = {Aged / Alzheimer Disease: diagnostic imaging / Alzheimer
                      Disease: metabolism / Alzheimer Disease: pathology /
                      Alzheimer Disease: physiopathology / Educational Status /
                      Female / Humans / Male / Neurons: pathology /
                      Positron-Emission Tomography / tau Proteins: metabolism},
      cin          = {AG Jessen / Patient Studies (Bonn) / AG Boecker},
      ddc          = {610},
      cid          = {I:(DE-2719)1011102 / I:(DE-2719)1011101 /
                      I:(DE-2719)1011202},
      pnm          = {344 - Clinical and Health Care Research (POF3-344)},
      pid          = {G:(DE-HGF)POF3-344},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:31183635},
      doi          = {10.1007/s00259-019-04342-3},
      url          = {https://pub.dzne.de/record/140809},
}