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Kim GH, Kim BR, Yoon HJ, Jeong JH. Elevated cerebral blood flow proxy with increased beta-amyloid burden in Alzheimer's disease preclinical phase evaluated by dual-phase 18F-florbetaben positron emission tomography. Sci Rep 2024; 14:18480. [PMID: 39122860 PMCID: PMC11315901 DOI: 10.1038/s41598-024-68916-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 07/30/2024] [Indexed: 08/12/2024] Open
Abstract
This study investigated the earliest change of cerebral blood flow (CBF) and its relationship with β-amyloid (Aβ) burden in preclinical Alzheimer's disease (AD) employing dual-phase 18F-florbetaben (FBB) PET. Seventy-one cognitively normal (NC) individuals were classified as Aβ negative (Aβ-NC) or positive (Aβ+NC) based on two different cutoff values: an SUVR of > 1.08 and a Centiloid scale of > 20. The PET scans were acquired in two phases: an early phase (0-10 min, eFBB) and a delayed phase (90-110 min, dFBB), which were averaged to generate single-frame images for each phase. Furthermore, an R1 parametric map was generated from the early phase data using a simplified reference tissue model. We conducted regional and voxel-based analyses to compare the eFBB, dFBB, and R1 images between the Aβ positive and negative groups. In addition, the correlations between the CBF proxy R1 and the dFBB SUVR were analyzed. The Aβ+NC group showed significantly higher dFBB SUVR in both the global cerebral cortex and target regions compared to the Aβ-NC group, while no significant differences were observed in eFBB SUVR between the two groups. Furthermore, the Aβ+NC group exhibited significantly higher R1 values, a proxy for cerebral perfusion, in both the global cerebral cortex and target regions compared to the Aβ-NC group. Significant positive correlations were observed between R1 and dFBB SUVR in both the global cerebral cortex and target regions, which remained significant after controlling for demographics and cognitive profiles, except for the medial temporal and occipital cortices. The findings reveal increased CBF in preclinical AD and a positive correlation between CBF and amyloid pathology. The positive correlation between R1 and amyloid burden may indicate a compensatory mechanism in the preclinical stage of Alzheimer's disease, but to elucidate this hypothesis, further longitudinal observational studies are necessary.
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Affiliation(s)
- Geon Ha Kim
- Department of Neurology, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Bori R Kim
- Department of Neurology, Ewha Womans University College of Medicine, Seoul, Republic of Korea
- Ewha Medical Research Institute, Ewha Womans University, Seoul, Republic of Korea
| | - Hai-Jeon Yoon
- Department of Nuclear Medicine, Ewha Womans University, College of Medicine, Seoul, Republic of Korea.
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University College of Medicine, Seoul, Republic of Korea.
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2
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Wu KY, Lin KJ, Chen CH, Liu CY, Wu YM, Yen TC, Hsiao IT. Atrophy, hypometabolism and implication regarding pathology in late-life major depression with suspected non-alzheimer pathophysiology (SNAP). Biomed J 2023; 46:100589. [PMID: 36914051 PMCID: PMC10749882 DOI: 10.1016/j.bj.2023.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 07/16/2022] [Accepted: 03/08/2023] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND A substantial proportion of individuals with late-life major depression could be classified as having a suspected non-Alzheimer disease pathophysiology (SNAP), as indicated by a negative test for the biomarker β-amyloid (Aβ-) but a positive test for neurodegeneration (ND+). This study investigated the clinical features, characteristic patterns of brain atrophy and hypometabolism, and implications regarding pathology in this population. METHODS Forty-six amyloid-negative patients with late-life major depressive disorder (MDD) patients, including 23 SNAP (Aβ-/ND+) and 23 Aβ-/ND- MDD subjects, and 22 Aβ-/ND-healthy control subjects were included in this study. Voxel-wise group comparisons between the SNAP MDD, Aβ-/ND- MDD and control subjects were performed, adjusting for age, gender and level of education. For exploratory comparisons, 8 Aβ+/ND- and 4 Aβ+/ND + MDD patients were included in the Supplementary Material. RESULTS The SNAP MDD patients had atrophy extending to regions outside the hippocampus, predominately in the medial temporal, dorsomedial and ventromedial prefrontal cortex; hypometabolism involving a large portion of the lateral and medial prefrontal cortex in addition to the bilateral temporal, parietal and precuneus cortex within typical Alzheimer disease regions were observed. Metabolism ratios of the inferior to the medial temporal lobe were significantly elevated in the SNAP MDD patients. We further discussed the implications with regards to underlying pathologies. CONCLUSION The present study demonstrated characteristic patterns of atrophy and hypometabolism in patients with late-life major depression with SNAP. Identifying individuals with SNAP MDD may provide insights into currently unspecified neurodegenerative processes. Future refinement of neurodegeneration biomarkers is essential in order to identify potential pathological correlates while in vivo reliable pathological biomarkers are not forthcoming.
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Affiliation(s)
- Kuan-Yi Wu
- Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Kun-Ju Lin
- Department of Nuclear Medicine and Center for Advanced Molecular Imaging and Translation, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Medical Imaging and Radiological Sciences and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Neuroscience Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Chia-Hsiang Chen
- Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Yih Liu
- Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Ming Wu
- Department of Radiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Tzu-Chen Yen
- Department of Nuclear Medicine and Center for Advanced Molecular Imaging and Translation, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Medical Imaging and Radiological Sciences and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; APRINOIA Therapeutics Inc., Taipei, Taiwan
| | - Ing-Tsung Hsiao
- Department of Nuclear Medicine and Center for Advanced Molecular Imaging and Translation, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Medical Imaging and Radiological Sciences and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.
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Matthews DC, Lukic AS, Andrews RD, Wernick MN, Strother SC, Schmidt ME. Measurement of neurodegeneration using a multivariate early frame amyloid PET classifier. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12325. [PMID: 35846158 PMCID: PMC9270637 DOI: 10.1002/trc2.12325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 03/28/2022] [Accepted: 06/01/2022] [Indexed: 11/18/2022]
Abstract
Introduction Amyloid measurement provides important confirmation of pathology for Alzheimer's disease (AD) clinical trials. However, many amyloid positive (Am+) early-stage subjects do not worsen clinically during a clinical trial, and a neurodegenerative measure predictive of decline could provide critical information. Studies have shown correspondence between perfusion measured by early amyloid frames post-tracer injection and fluorodeoxyglucose (FDG) positron emission tomography (PET), but with limitations in sensitivity. Multivariate machine learning approaches may offer a more sensitive means for detection of disease related changes as we have demonstrated with FDG. Methods Using summed dynamic florbetapir image frames acquired during the first 6 minutes post-injection for 107 Alzheimer's Disease Neuroimaging Initiative subjects, we applied optimized machine learning to develop and test image classifiers aimed at measuring AD progression. Early frame amyloid (EFA) classification was compared to that of an independently developed FDG PET AD progression classifier by scoring the FDG scans of the same subjects at the same time point. Score distributions and correlation with clinical endpoints were compared to those obtained from FDG. Region of interest measures were compared between EFA and FDG to further understand discrimination performance. Results The EFA classifier produced a primary pattern similar to that of the FDG classifier whose expression correlated highly with the FDG pattern (R-squared 0.71), discriminated cognitively normal (NL) amyloid negative (Am-) subjects from all Am+ groups, and that correlated in Am+ subjects with Mini-Mental State Examination, Clinical Dementia Rating Sum of Boxes, and Alzheimer's Disease Assessment Scale-13-item Cognitive subscale (R = 0.59, 0.63, 0.73) and with subsequent 24-month changes in these measures (R = 0.67, 0.73, 0.50). Discussion Our results support the ability to use EFA with a multivariate machine learning-derived classifier to obtain a sensitive measure of AD-related loss in neuronal function that correlates with FDG PET in preclinical and early prodromal stages as well as in late mild cognitive impairment and dementia. Highlights The summed initial post-injection minutes of florbetapir positron emission tomography correlate with fluorodeoxyglucose.A machine learning classifier enabled sensitive detection of early prodromal Alzheimer's disease.Early frame amyloid (EFA) classifier scores correlate with subsequent change in Mini-Mental State Examination, Clinical Dementia Rating Sum of Boxes, and Alzheimer's Disease Assessment Scale-13-item Cognitive subscale.EFA classifier effect sizes and clinical prediction outperformed region of interest standardized uptake value ratio.EFA classification may aid in stratifying patients to assess treatment effect.
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Affiliation(s)
| | | | | | | | - Stephen C. Strother
- Baycrest Hospitaland Department of Medical BiophysicsUniversity of TorontoNorth YorkOntarioCanada
| | - Mark E. Schmidt
- Janssen Research and DevelopmentDivision of Janssen PharmaceuticaBeerseBelgium
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Early phase amyloid PET or “two birds with one Stone”. Rev Esp Med Nucl Imagen Mol 2022; 41:213-214. [DOI: 10.1016/j.remnie.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 06/07/2022] [Indexed: 11/23/2022]
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Estudios PET Amiloide precoz o “dos pájaros de un tiro”. Rev Esp Med Nucl Imagen Mol 2022. [DOI: 10.1016/j.remn.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Wu KY, Lin KJ, Chen CH, Liu CY, Wu YM, Chen CS, Yen TC, Hsiao IT. Decreased Cerebral Amyloid-β Depositions in Patients With a Lifetime History of Major Depression With Suspected Non-Alzheimer Pathophysiology. Front Aging Neurosci 2022; 14:857940. [PMID: 35721010 PMCID: PMC9204309 DOI: 10.3389/fnagi.2022.857940] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/11/2022] [Indexed: 11/19/2022] Open
Abstract
Cerebral amyloid-β (Aβ) depositions in depression in old age are controversial. A substantial proportion of individuals with late-life major depressive disorder (MDD) could be classified as having suspected non-Alzheimer’s disease pathophysiology (SNAP) by a negative test for the biomarker amyloid-β (Aβ−) but positive neurodegeneration (ND+). This study aimed to evaluate subthreshold Aβ loads in amyloid-negative MDD, particularly in SNAP MDD patients. This study included 46 amyloid-negative MDD patients: 23 SNAP (Aβ−/ND+) MDD and 23 Aβ−/ND− MDD, and 22 Aβ−/ND− control subjects. All subjects underwent 18F-florbetapir PET, FDG-PET, and MRI. Regions of interest (ROIs) and voxel-wise group comparisons were performed with adjustment for age, gender, and level of education. The SNAP MDD patients exhibited significantly deceased 18F-florbetapir uptakes in most cortical regions but not the parietal and precuneus cortex, as compared with the Aβ−/ND− MDD and control subjects (FDR correction, p < 0.05). No correlations of neuropsychological tests or depression characteristics with global cortical uptakes, but significant positive correlations between cognitive functions and adjusted hippocampal volumes among different groups were observed. The reduced Aβ depositions in the amyloid-negative MDD patients might be attributed mainly to the SNAP MDD patients. Our results indicated that meaningfully low amounts of subclinical Aβ might contain critical information on the non-amyloid-mediated pathogenesis.
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Affiliation(s)
- Kuan-Yi Wu
- Department of Psychiatry, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Kun-Ju Lin
- Department of Nuclear Medicine, Center for Advanced Molecular Imaging and Translation, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
- Department of Medical Imaging and Radiological Sciences, College of Medicine and Healthy Aging Research Center, Chang Gung University, Taoyuan City, Taiwan
- Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan
| | - Chia-Hsiang Chen
- Department of Psychiatry, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Chia-Yih Liu
- Department of Psychiatry, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Yi-Ming Wu
- Department of Radiology, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
| | - Cheng-Sheng Chen
- Department of Psychiatry, Kaohsiung Medical University Hospital, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Tzu-Chen Yen
- Department of Nuclear Medicine, Center for Advanced Molecular Imaging and Translation, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
- Department of Medical Imaging and Radiological Sciences, College of Medicine and Healthy Aging Research Center, Chang Gung University, Taoyuan City, Taiwan
| | - Ing-Tsung Hsiao
- Department of Nuclear Medicine, Center for Advanced Molecular Imaging and Translation, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
- Department of Medical Imaging and Radiological Sciences, College of Medicine and Healthy Aging Research Center, Chang Gung University, Taoyuan City, Taiwan
- Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan
- *Correspondence: Ing-Tsung Hsiao,
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Zhang H, Wang Y, Lyu D, Li Y, Li W, Wang Q, Li Y, Qin Q, Wang X, Gong M, Jiao H, Liu W, Jia J. Cerebral blood flow in mild cognitive impairment and Alzheimer's disease: A systematic review and meta-analysis. Ageing Res Rev 2021; 71:101450. [PMID: 34419673 DOI: 10.1016/j.arr.2021.101450] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/05/2021] [Accepted: 08/17/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Reduced cerebral blood flow (CBF) contributes to the pathophysiology of Alzheimer's disease (AD). However, it is unclear whether there is a spatial-temporal-specific pattern of changed CBF in AD progression. METHODS We systematically screened literature databases for cross-sectional and longitudinal studies reporting resting CBF or CBF velocity (CBFv) among patients with AD, mild cognitive impairment (MCI), and healthy controls (HCs). Standardised mean differences (SMDs) for CBF and mean differences (MDs) for CBFv were calculated. Quality assessments, meta-analysis, subgroup analysis, and meta-regression were subsequently performed (PROSPERO: CRD42020207548). RESULTS Overall, 244 studies comprising 13,644 participants and 60 regions were included. Compared with HCs, AD subjects had decreased resting CBF throughout the brain (SMD range: -1.87 to -0.32), especially within the posterior cingulate and temporal-parietal regions. However, MCI subjects presented decreased CBF in ten regions with modest effects (SMD range: -0.86 to -0.25), especially in the precuneus. We identified the decreased CBF in the temporal, parietal, and hippocampal regions was associated with the lower AD Mini-Mental State Examination scores. CONCLUSIONS Our findings suggest that the spatial-temporal pattern of CBF decreased from the precuneus, posterior cingulate and temporal-parietal regions to broader areas with progression from HC to MCI to AD, supporting the incorporation of CBF into the AD research framework.
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Pfeil J, Hoenig MC, Doering E, van Eimeren T, Drzezga A, Bischof GN. Unique regional patterns of amyloid burden predict progression to prodromal and clinical stages of Alzheimer's disease. Neurobiol Aging 2021; 106:119-129. [PMID: 34284259 PMCID: PMC8461082 DOI: 10.1016/j.neurobiolaging.2021.06.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/22/2021] [Accepted: 06/15/2021] [Indexed: 01/21/2023]
Abstract
Although beta-amyloid (Aβ) positivity has shown to be associated with higher risk of progression to Alzheimer's disease (AD) in mild cognitive impairment (MCI), information on the time to conversion to manifest dementia cannot be readily deduced from this binary classification. Here, we assessed if regional patterns of Aβ deposition measured with 18F-florbetapir may serve as biomarker for progression risk in Aβ-positive cognitively normal (CN) and MCI patients, including clinical follow-up data and cerebrospinal fluid (CSF) biomarkers. Voxel-wise group comparisons between age and sex-matched Aβ-positive groups (i.e., CN-stables [n = 38] vs. CN-to-MCI/AD progressors [n = 38], MCI-stables [n = 104] versus MCI-to-AD progressors [n = 104]) revealed higher Aβ burden in precuneus, subcortical, and parietal regions in CN-to-MCI/AD progressors and cingulate, temporal, and frontal regions in MCI-to-AD progressors. Importantly, these regional patterns predicted progression to advanced stages on the AD spectrum in the short and the long-term beyond global Aβ burden and CSF biomarkers. These results suggest that distinct regional patterns of Aβ burden are a valuable biomarker for risk of disease progression in CN and MCI.
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Affiliation(s)
- Julia Pfeil
- Department of Nuclear Medicine, Multimodal Neuroimaging Group, University of Cologne, University Hospital of Cologne, Cologne, Germany.
| | - Merle C Hoenig
- Department of Nuclear Medicine, Multimodal Neuroimaging Group, University of Cologne, University Hospital of Cologne, Cologne, Germany; Research Center Juelich, Institute for Neuroscience and Medicine II, Molecular Organization of the Brain, Juelich, Germany
| | - Elena Doering
- Department of Nuclear Medicine, Multimodal Neuroimaging Group, University of Cologne, University Hospital of Cologne, Cologne, Germany; German Center for Neurodegenerative Diseases, Bonn/Cologne, Germany
| | - Thilo van Eimeren
- Department of Nuclear Medicine, Multimodal Neuroimaging Group, University of Cologne, University Hospital of Cologne, Cologne, Germany; German Center for Neurodegenerative Diseases, Bonn/Cologne, Germany; University of Cologne, University Hospital of Cologne, Department of Neurology, Cologne, Germany
| | - Alexander Drzezga
- Department of Nuclear Medicine, Multimodal Neuroimaging Group, University of Cologne, University Hospital of Cologne, Cologne, Germany; Research Center Juelich, Institute for Neuroscience and Medicine II, Molecular Organization of the Brain, Juelich, Germany; German Center for Neurodegenerative Diseases, Bonn/Cologne, Germany
| | - Gérard N Bischof
- Department of Nuclear Medicine, Multimodal Neuroimaging Group, University of Cologne, University Hospital of Cologne, Cologne, Germany
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Seiffert AP, Gómez-Grande A, Villarejo-Galende A, González-Sánchez M, Bueno H, Gómez EJ, Sánchez-González P. High Correlation of Static First-Minute-Frame (FMF) PET Imaging after 18F-Labeled Amyloid Tracer Injection with [ 18F]FDG PET Imaging. SENSORS (BASEL, SWITZERLAND) 2021; 21:5182. [PMID: 34372416 PMCID: PMC8348394 DOI: 10.3390/s21155182] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/26/2021] [Accepted: 07/28/2021] [Indexed: 01/17/2023]
Abstract
Dynamic early-phase PET images acquired with radiotracers binding to fibrillar amyloid-beta (Aβ) have shown to correlate with [18F]fluorodeoxyglucose (FDG) PET images and provide perfusion-like information. Perfusion information of static PET scans acquired during the first minute after radiotracer injection (FMF, first-minute-frame) is compared to [18F]FDG PET images. FMFs of 60 patients acquired with [18F]florbetapir (FBP), [18F]flutemetamol (FMM), and [18F]florbetaben (FBB) are compared to [18F]FDG PET images. Regional standardized uptake value ratios (SUVR) are directly compared and intrapatient Pearson's correlation coefficients are calculated to evaluate the correlation of FMFs to their corresponding [18F]FDG PET images. Additionally, regional interpatient correlations are calculated. The intensity profiles of mean SUVRs among the study cohort (r = 0.98, p < 0.001) and intrapatient analyses show strong correlations between FMFs and [18F]FDG PET images (r = 0.93 ± 0.05). Regional VOI-based analyses also result in high correlation coefficients. The FMF shows similar information to the cerebral metabolic patterns obtained by [18F]FDG PET imaging. Therefore, it could be an alternative to the dynamic imaging of early phase amyloid PET and be used as an additional neurodegeneration biomarker in amyloid PET studies in routine clinical practice while being acquired at the same time as amyloid PET images.
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Affiliation(s)
- Alexander P. Seiffert
- Biomedical Engineering and Telemedicine Centre, ETSI Telecomunicación, Center for Biomedical Technology, Universidad Politécnica de Madrid, 28040 Madrid, Spain;
| | - Adolfo Gómez-Grande
- Department of Nuclear Medicine, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain;
- Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain; (A.V.-G.); (H.B.)
| | - Alberto Villarejo-Galende
- Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain; (A.V.-G.); (H.B.)
- Department of Neurology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain;
- Group of Neurodegenerative Diseases, Hospital 12 de Octubre Research Institute (imas12), 28041 Madrid, Spain
- Biomedical Research Networking Center in Neurodegenerative Diseases (CIBERNED), 28029 Madrid, Spain
| | - Marta González-Sánchez
- Department of Neurology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain;
- Group of Neurodegenerative Diseases, Hospital 12 de Octubre Research Institute (imas12), 28041 Madrid, Spain
- Biomedical Research Networking Center in Neurodegenerative Diseases (CIBERNED), 28029 Madrid, Spain
| | - Héctor Bueno
- Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain; (A.V.-G.); (H.B.)
- Department of Cardiology and Instituto de Investigación Sanitaria (imas12), Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), 28029 Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain
| | - Enrique J. Gómez
- Biomedical Engineering and Telemedicine Centre, ETSI Telecomunicación, Center for Biomedical Technology, Universidad Politécnica de Madrid, 28040 Madrid, Spain;
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 28029 Madrid, Spain
| | - Patricia Sánchez-González
- Biomedical Engineering and Telemedicine Centre, ETSI Telecomunicación, Center for Biomedical Technology, Universidad Politécnica de Madrid, 28040 Madrid, Spain;
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 28029 Madrid, Spain
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Yoon HJ, Kim BS, Jeong JH, Kim GH, Park HK, Chun MY, Ha S. Dual-phase 18F-florbetaben PET provides cerebral perfusion proxy along with beta-amyloid burden in Alzheimer's disease. NEUROIMAGE-CLINICAL 2021; 31:102773. [PMID: 34339946 PMCID: PMC8346681 DOI: 10.1016/j.nicl.2021.102773] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 07/13/2021] [Accepted: 07/20/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND This study investigated changes in brain perfusion and Aβ burden according to the progression of Alzheimer's disease (AD) by using a dual-phase 18F-florbetaben (FBB) PET protocol. METHODS Sixty subjects, including 12 with Aβ-negative normal cognition (Aβ-NC), 32 with Aβ-positive mild cognitive impairment (Aβ+MCI), and 16 with Aβ-positive AD (Aβ+AD), were enrolled. A dynamic PET scan was obtained in the early phase (0-10 min, eFBB) and delayed phase (90-110 min, dFBB), which were then averaged into a single frame, respectively. In addition to the averaged eFBB, an R1 parametric map was calculated from the eFBB scan based on a simplified reference tissue model (SRTM). Between-group regional and voxel-wise analyses of the images were performed. The associations between cognitive profiles and PET-derived parameters were investigated. RESULTS Both the R1 and eFBB perfusion reductions in the cortical regions were not significantly different between the Aβ-NC and Aβ+MCI groups, while they were significantly reduced from the Aβ+MCI to Aβ+AD groups in regional and voxel-wise analyses. However, cortical Aβ depositions on dFBB were not significantly different between the Aβ+MCI and Aβ+AD groups. There were strong positive correlations between the R1 and eFBB images in regional and voxel-wise analyses. Both perfusion components showed significant correlations with general and specific cognitive profiles. CONCLUSION The results of this study demonstrated the feasibility of dual-phase 18F-FBB PET to evaluate different trajectories of dual biomarkers for neurodegeneration and Aβ burden over the course of AD. In addition, both eFBB and SRTM-based R1 can provide robust indices of brain perfusion.
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Affiliation(s)
- Hai-Jeon Yoon
- Department of Nuclear Medicine, Ewha Womans University, School of Medicine, Seoul, Republic of Korea
| | - Bom Sahn Kim
- Department of Nuclear Medicine, Ewha Womans University, School of Medicine, Seoul, Republic of Korea.
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University School of Medicine, Republic of Korea.
| | - Geon Ha Kim
- Department of Neurology, Ewha Womans University School of Medicine, Republic of Korea
| | - Hee Kyung Park
- Department of Neurology, Ewha Womans University School of Medicine, Republic of Korea; Division of Psychiatry, Department of mental health care of older people, University College London, London, UK
| | - Min Young Chun
- Department of Neurology, Ewha Womans University School of Medicine, Republic of Korea
| | - Seunggyun Ha
- Division of Nuclear Medicine, Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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11
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Vanhoutte M, Landeau B, Sherif S, de la Sayette V, Dautricourt S, Abbas A, Manrique A, Chocat A, Chételat G. Evaluation of the early-phase [ 18F]AV45 PET as an optimal surrogate of [ 18F]FDG PET in ageing and Alzheimer's clinical syndrome. Neuroimage Clin 2021; 31:102750. [PMID: 34247116 PMCID: PMC8274342 DOI: 10.1016/j.nicl.2021.102750] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/27/2021] [Accepted: 06/28/2021] [Indexed: 12/05/2022]
Abstract
Dual-phase [18F]AV45 positron emission tomography (PET) is highly promising in the assessment of neurodegenerative diseases, allowing to obtain information on both neurodegeneration (early-phase; eAV45) and amyloid deposition (late-phase; lAV45) which are highly complementary; yet eAV45 needs further evaluation. This study aims at validating eAV45 as an optimal proxy of [18F]FDG PET in a large mixed-population of healthy ageing and Alzheimer's clinical syndrome participants (n = 191) who had [18F]FDG PET, eAV45 and lAV45 scans. We found early time frame 0-4 min to give maximal correlation with [18F]FDG PET and minimal correlation with lAV45. Moreover, maximal overlap of [18F]FDG PET versus eAV45 associations with clinical diagnosis and cognition was obtained with pons scaling. Across reference regions, classification performance between clinical subgroups was similar for both eAV45 and [18F]FDG PET. These findings highlight the optimal use of eAV45 to assess neurodegeneration as a validated proxy of [18F]FDG PET. On top of this purpose, this study showed that combined [18F]AV45 PET dual-biomarker even outperformed [18F]FDG PET or lAV45 alone.
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Affiliation(s)
- Matthieu Vanhoutte
- Inserm UMR-S U1237, Caen-Normandie University, GIP Cyceron, Caen, France.
| | - Brigitte Landeau
- Inserm UMR-S U1237, Caen-Normandie University, GIP Cyceron, Caen, France
| | - Siya Sherif
- Inserm UMR-S U1237, Caen-Normandie University, GIP Cyceron, Caen, France
| | - Vincent de la Sayette
- Inserm U1077, Caen-Normandie University, École Pratique des Hautes Études, Caen, France; University Hospital, Neurology Department, Caen, France
| | - Sophie Dautricourt
- Inserm UMR-S U1237, Caen-Normandie University, GIP Cyceron, Caen, France; University Hospital, Neurology Department, Caen, France
| | - Ahmed Abbas
- Inserm U1077, Caen-Normandie University, École Pratique des Hautes Études, Caen, France
| | - Alain Manrique
- University Hospital, Nuclear Medicine Department, Caen, France
| | - Anne Chocat
- Inserm UMR-S U1237, Caen-Normandie University, GIP Cyceron, Caen, France
| | - Gaël Chételat
- Inserm UMR-S U1237, Caen-Normandie University, GIP Cyceron, Caen, France; Inserm U1077, Caen-Normandie University, École Pratique des Hautes Études, Caen, France.
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12
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Association of quality of life with structural, functional and molecular brain imaging in community-dwelling older adults. Neuroimage 2021; 231:117819. [PMID: 33549750 DOI: 10.1016/j.neuroimage.2021.117819] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/18/2021] [Accepted: 01/24/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND As the population ages, maintaining mental health and well-being of older adults is a public health priority. Beyond objective measures of health, self-perceived quality of life (QoL) is a good indicator of successful aging. In older adults, it has been shown that QoL is related to structural brain changes. However, QoL is a multi-faceted concept and little is known about the specific relationship of each QoL domain to brain structure, nor about the links with other aspects of brain integrity, including white matter microstructure, brain perfusion and amyloid deposition, which are particularly relevant in aging. Therefore, we aimed to better characterize the brain biomarkers associated with each QoL domain using a comprehensive multimodal neuroimaging approach in older adults. METHODS One hundred and thirty-five cognitively unimpaired older adults (mean age ± SD: 69.4 ± 3.8 y) underwent structural and diffusion magnetic resonance imaging, together with early and late florbetapir positron emission tomography scans. QoL was assessed using the brief version of the World Health Organization's QoL instrument, which allows measuring four distinct domains of QoL: self-perceived physical health, psychological health, social relationships and environment. Multiple regression analyses were carried out to identify the independent global neuroimaging predictor(s) of each QoL domain, and voxel-wise analyses were then conducted with the significant predictor(s) to highlight the brain regions involved. Age, sex, education and the other QoL domains were entered as covariates in these analyses. Finally, forward stepwise multiple regressions were conducted to determine the specific items of the relevant QoL domain(s) that contributed the most to these brain associations. RESULTS Only physical health QoL was associated with global neuroimaging values, specifically gray matter volume and white matter mean kurtosis, with higher physical health QoL being associated with greater brain integrity. These relationships were still significant after correction for objective physical health and physical activity measures. No association was found with global brain perfusion or global amyloid deposition. Voxel-wise analyses revealed that the relationships with physical health QoL concerned the anterior insula and ventrolateral prefrontal cortex, and the corpus callosum, corona radiata, inferior frontal white matter and cingulum. Self-perceived daily living activities and self-perceived pain and discomfort were the items that contributed the most to these associations with gray matter volume and white matter mean kurtosis, respectively. CONCLUSIONS Better self-perceived physical health, encompassing daily living activities and pain and discomfort, was the only QoL domain related to brain structural integrity including higher global gray matter volume and global white matter microstructural integrity in cognitively unimpaired older adults. The relationships involved brain structures belonging to the salience network, the pain pathway and the empathy network. While previous studies showed a link between objective measures of physical health, our findings specifically highlight the relevance of monitoring and promoting self-perceived physical health in the older population. Longitudinal studies are needed to assess the direction and causality of the relationships between QoL and brain integrity.
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Wang M, Yan Z, Zhang H, Lu J, Li L, Yu J, Wang J, Matsuda H, Zuo C, Jiang J. Parametric estimation of reference signal intensity in the quantification of amyloid-beta deposition: an 18F-AV-45 study. Quant Imaging Med Surg 2021; 11:249-263. [PMID: 33392026 PMCID: PMC7719939 DOI: 10.21037/qims-20-110] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 09/07/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Positron emission tomography (PET) with the radiotracer florbetapir (18F-AV-45) allows the pathophysiology of Alzheimer's disease (AD) to be tracked in vivo. The semi-quantification of amyloid-beta (Aβ) has been extensively evaluated with the standardized uptake value ratio (SUVR) but is susceptible to disturbance from the candidate reference region and the partial volume effect (PVE). In the present study, we applied the parametric estimation of reference signal intensity (PERSI) method to 18F-AV-45 PET images for intensity normalization. METHODS We enrolled 479 people with 18F-AV-45 images from the Alzheimer's Disease Neuroimaging Initiative database: 261 healthy controls (HCs), 102 patients with mild cognitive impairment (MCI), and 116 AD patients. We used white matter post-processed by PERSI (PERSI-WM) as the reference region and compared our proposed method with the traditional method for semi-quantification. SUVRs were calculated for eight regions of interest: the frontal lobe, the parietal lobe, the temporal lobe, the occipital lobe, the anterior cingulate cortex, the posterior cingulate cortex, the precuneus, and the global cortex. The SUVRs derived from PERSI-WM and other reference regions were evaluated by effect size and receiver-operator characteristic curve analyses. RESULTS The SUVRs derived from PERSI-WM showed significantly higher trace retention in the frontal, parietal, temporal, and occipital lobes, as well as in the anterior cingulate, posterior cingulate, precuneus, and global cortex in the AD Aβ-positive (+) group (mean: +43.3%±5.4%, P<0.01) and MCI Aβ+ group (mean: +29.6%±5.3%, P<0.01). For the global cortex, PERSI-WM had the greatest Cohen's d effect size compared with the HC Aβ-negative (-) group (AD Aβ+ and MCI Aβ+: 3.02, AD Aβ+: 3.56, MCI Aβ+: 2.34), and the highest area under the curve (AUC) between the HC Aβ- and AD Aβ+ groups (AUC: 0.983, 95% confidence interval: 0.978-0.998). CONCLUSIONS PERSI-WM could mitigate the influence of PVE and improve the semi-quantification of 18F-AV-45 images; therefore, it could be used for large-scale clinical application in the nuclear medicine domain.
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Affiliation(s)
- Min Wang
- Shanghai Institute for Advanced Communication and Data Science, School of Communication and Information Engineering, Shanghai University, Shanghai, China
- Institute of Biomedical Engineering, School of Communication and Information Engineering, Shanghai University, Shanghai, China
| | - Zhuangzhi Yan
- Institute of Biomedical Engineering, School of Communication and Information Engineering, Shanghai University, Shanghai, China
| | - Huiwei Zhang
- PET Center, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jiaying Lu
- PET Center, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ling Li
- PET Center, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jintai Yu
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jian Wang
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Hiroshi Matsuda
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Chuantao Zuo
- PET Center, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jiehui Jiang
- Shanghai Institute for Advanced Communication and Data Science, School of Communication and Information Engineering, Shanghai University, Shanghai, China
- Institute of Biomedical Engineering, School of Communication and Information Engineering, Shanghai University, Shanghai, China
| | - the Alzheimer’s Disease Neuroimaging Initiative
- Shanghai Institute for Advanced Communication and Data Science, School of Communication and Information Engineering, Shanghai University, Shanghai, China
- Institute of Biomedical Engineering, School of Communication and Information Engineering, Shanghai University, Shanghai, China
- PET Center, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
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Kim JH, Son YD, Kim HK, Kim JH. Association Between Lack of Insight and Prefrontal Serotonin Transporter Availability in Antipsychotic-Free Patients with Schizophrenia: A High-Resolution PET Study with [ 11C]DASB. Neuropsychiatr Dis Treat 2021; 17:3195-3203. [PMID: 34707358 PMCID: PMC8544267 DOI: 10.2147/ndt.s336126] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/08/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Previous studies suggested a link between serotonergic neurotransmission and impaired insight in schizophrenia. In this study, we examined the relationship between serotonin transporter (SERT) availability in regions of the prefrontal cortex (dorsolateral, ventrolateral, ventromedial, and orbitofrontal cortices) and insight deficits in antipsychotic-free patients with schizophrenia using high-resolution positron emission tomography (PET) with [11C]DASB. METHODS Nineteen patients underwent [11C]DASB PET and 7-Tesla magnetic resonance imaging scans. To assess SERT availability, the binding potential with respect to non-displaceable compartment (BPND) was derived using the simplified reference tissue model. Patients' level of insight was assessed using the Insight and Treatment Attitude Questionnaire (ITAQ). The relationship between ITAQ scores and [11C]DASB BPND values was examined using the region-of-interest (ROI)- and voxel-based analyses with relevant variables as covariates. The prefrontal cortex and its four subregions were selected as a priori ROIs since the prefrontal cortex has been implicated as the critical neuroanatomical substrate of impaired insight in schizophrenia. RESULTS The ROI-based analysis revealed that the ITAQ illness insight dimension had significant negative correlations with the [11C]DASB BPND in the left dorsolateral, left orbitofrontal, and bilateral ventrolateral prefrontal cortices. The ITAQ treatment insight dimension had significant negative correlations with the [11C]DASB BPND in the bilateral dorsolateral, left orbitofrontal, and bilateral ventrolateral prefrontal cortices. The ITAQ total score showed significant negative correlations with the [11C]DASB BPND in the bilateral prefrontal cortex and three subregions (dorsolateral, ventrolateral, and orbitofrontal cortices). A supplementary voxel-based analysis corroborated a significant negative association between the ITAQ score and the [11C]DASB BPND in the prefrontal cortices. CONCLUSION Our study provides in vivo evidence of significant negative correlations between insight deficits and prefrontal SERT availability in patients with schizophrenia, suggesting significant involvement of prefrontal serotonergic signaling in impaired insight, one of the core symptoms of schizophrenia.
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Affiliation(s)
- Jeong-Hee Kim
- Neuroscience Research Institute, Gachon University, Incheon, Republic of Korea.,Department of Biomedical Engineering, College of Health Science, Gachon University, Incheon, Republic of Korea
| | - Young-Don Son
- Neuroscience Research Institute, Gachon University, Incheon, Republic of Korea.,Department of Biomedical Engineering, College of Health Science, Gachon University, Incheon, Republic of Korea.,Gachon Advanced Institute for Health Sciences & Technology, Gachon University, Incheon, Republic of Korea
| | - Hang-Keun Kim
- Neuroscience Research Institute, Gachon University, Incheon, Republic of Korea.,Department of Biomedical Engineering, College of Health Science, Gachon University, Incheon, Republic of Korea.,Gachon Advanced Institute for Health Sciences & Technology, Gachon University, Incheon, Republic of Korea
| | - Jong-Hoon Kim
- Neuroscience Research Institute, Gachon University, Incheon, Republic of Korea.,Gachon Advanced Institute for Health Sciences & Technology, Gachon University, Incheon, Republic of Korea.,Department of Psychiatry, Gachon University College of Medicine, Gil Medical Center, Incheon, Republic of Korea
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15
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Papanastasiou G, Rodrigues MA, Wang C, Heurling K, Lucatelli C, Salman RAS, Wardlaw JM, van Beek EJR, Thompson G. Pharmacokinetic modelling for the simultaneous assessment of perfusion and 18F-flutemetamol uptake in cerebral amyloid angiopathy using a reduced PET-MR acquisition time: Proof of concept. Neuroimage 2020; 225:117482. [PMID: 33157265 DOI: 10.1016/j.neuroimage.2020.117482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 09/24/2020] [Accepted: 10/19/2020] [Indexed: 01/05/2023] Open
Abstract
PURPOSE Cerebral amyloid angiopathy (CAA) is a cerebral small vessel disease associated with perivascular β-amyloid deposition. CAA is also associated with strokes due to lobar intracerebral haemorrhage (ICH). 18F-flutemetamol amyloid ligand PET may improve the early detection of CAA. We performed pharmacokinetic modelling using both full (0-30, 90-120 min) and reduced (30 min) 18F-flutemetamol PET-MR acquisitions, to investigate regional cerebral perfusion and amyloid deposition in ICH patients. METHODS Dynamic18F-flutemetamol PET-MR was performed in a pilot cohort of sixteen ICH participants; eight lobar ICH cases with probable CAA and eight deep ICH patients. A model-based input function (mIF) method was developed for compartmental modelling. mIF 1-tissue (1-TC) and 2-tissue (2-TC) compartmental modelling, reference tissue models and standardized uptake value ratios were assessed in the setting of probable CAA detection. RESULTS The mIF 1-TC model detected perfusion deficits and 18F-flutemetamol uptake in cases with probable CAA versus deep ICH patients, in both full and reduced PET acquisition time (all P < 0.05). In the reduced PET acquisition, mIF 1-TC modelling reached the highest sensitivity and specificity in detecting perfusion deficits (0.87, 0.77) and 18F-flutemetamol uptake (0.83, 0.71) in cases with probable CAA. Overall, 52 and 48 out of the 64 brain areas with 18F-flutemetamol-determined amyloid deposition showed reduced perfusion for 1-TC and 2-TC models, respectively. CONCLUSION Pharmacokinetic (1-TC) modelling using a 30 min PET-MR time frame detected impaired haemodynamics and increased amyloid load in probable CAA. Perfusion deficits and amyloid burden co-existed within cases with CAA, demonstrating a distinct imaging pattern which may have merit in elucidating the pathophysiological process of CAA.
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Affiliation(s)
- Giorgos Papanastasiou
- Edinburgh Imaging Facility, Queen's Medical Research Institute, The University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK.
| | - Mark A Rodrigues
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | - Chengjia Wang
- Edinburgh Imaging Facility, Queen's Medical Research Institute, The University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | | | - Christophe Lucatelli
- Edinburgh Imaging Facility, Queen's Medical Research Institute, The University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | | | - Joanna M Wardlaw
- Edinburgh Imaging Facility, Queen's Medical Research Institute, The University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK; Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | - Edwin J R van Beek
- Edinburgh Imaging Facility, Queen's Medical Research Institute, The University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Gerard Thompson
- Edinburgh Imaging Facility, Queen's Medical Research Institute, The University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK; Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
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16
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Yang BH, Chen JC, Chou WH, Huang WS, Fuh JL, Liu R, Wu CH. Classification of Alzheimer’s Disease from 18F-FDG and 11C-PiB PET Imaging Biomarkers Using Support Vector Machine. J Med Biol Eng 2020. [DOI: 10.1007/s40846-020-00548-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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17
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Lu J, Bao W, Li M, Li L, Zhang Z, Alberts I, Brendel M, Cumming P, Lu H, Xiao Z, Zuo C, Guan Y, Zhao Q, Rominger A. Associations of [ 18F]-APN-1607 Tau PET Binding in the Brain of Alzheimer's Disease Patients With Cognition and Glucose Metabolism. Front Neurosci 2020; 14:604. [PMID: 32694971 PMCID: PMC7338611 DOI: 10.3389/fnins.2020.00604] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 05/18/2020] [Indexed: 11/16/2022] Open
Abstract
Molecular imaging of tauopathies is complicated by the differing specificities and off-target binding properties of available radioligands for positron emission tomography (PET). [18F]-APN-1607 ([18F]-PM-PBB3) is a newly developed PET tracer with promising properties for tau imaging. We aimed to characterize the cerebral binding of [18F]-APN-1607 in Alzheimer's disease (AD) patients compared to normal control (NC) subjects. Therefore, we obtained static late frame PET recordings with [18F]-APN-1607 and [18F]-FDG in patients with a clinical diagnosis of AD group, along with an age-matched NC group ([18F]-APN-1607 only). Using statistical parametric mapping (SPM) and volume of interest (VOI) analyses of the reference region normalized standardized uptake value ratio maps, we then tested for group differences and relationships between both PET biomarkers, as well as their associations with clinical general cognition. In the AD group, [18F]-APN-1607 binding was elevated in widespread cortical regions (P < 0.001 for VOI analysis, familywise error-corrected P < 0.01 for SPM analysis). The regional uptake in AD patients correlated negatively with Mini-Mental State Examination score (frontal lobe: R = -0.632, P = 0.004; temporal lobe: R = -0.593, P = 0.008; parietal lobe: R = -0.552, P = 0.014; insula: R = -0.650, P = 0.003; cingulum: R = -0.665, P = 0.002) except occipital lobe (R = -0.417, P = 0.076). The hypometabolism to [18F]-FDG PET in AD patients also showed negative correlations with regional [18F]-APN-1607 binding in some signature areas of AD (temporal lobe: R = -0.530, P = 0.020; parietal lobe: R = -0.637, P = 0.003; occipital lobe: R = -0.567, P = 0.011). In conclusion, our results suggested that [18F]-APN-1607 PET sensitively detected tau deposition in AD and that individual tauopathy correlated with impaired cerebral glucose metabolism and cognitive function.
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Affiliation(s)
- Jiaying Lu
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Weiqi Bao
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Ming Li
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Ling Li
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhengwei Zhang
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Ian Alberts
- Department of Nuclear Medicine, University Hospital Bern, Bern, Switzerland
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital of Munich, Ludwig Maximilian University of Munich, Munich, Germany
| | - Paul Cumming
- Department of Nuclear Medicine, University Hospital Bern, Bern, Switzerland
- Faculty of Health, School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia
| | - Huimeng Lu
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhenxu Xiao
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Chuantao Zuo
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Yihui Guan
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Qianhua Zhao
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Axel Rominger
- Department of Nuclear Medicine, University Hospital Bern, Bern, Switzerland
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Segovia F, Gómez-Río M, Sánchez-Vañó R, Górriz JM, Ramírez J, Triviño-Ibáñez E, Carnero-Pardo C, Martínez-Lozano MD, Sopena-Novales P. Usefulness of Dual-Point Amyloid PET Scans in Appropriate Use Criteria: A Multicenter Study. J Alzheimers Dis 2019; 65:765-779. [PMID: 30103321 DOI: 10.3233/jad-180232] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Biomarkers of neurodegeneration play a major role in the diagnosis of Alzheimer's disease (AD). Information on both amyloid-β accumulation, e.g., from amyloid positron emission tomography (PET), and downstream neuronal injury, e.g., from 18F-fluorodeoxyglucose (FDG) PET, would ideally be obtained in a single procedure. OBJECTIVE On the basis that the parallelism between brain perfusion and glucose metabolism is well documented, the objective of this work is to evaluate whether brain perfusion estimated in a dual-point protocol of 18F-florbetaben (FBB) PET can be a surrogate of FDG PET in appropriate use criteria (AUC) for amyloid PET. METHODS This study included 47 patients fulfilling international AUC for amyloid PET. FDG PET, early FBB (pFBB) PET (0-10 min post injection), and standard FBB (sFBB) PET (90-110 min post injection) scans were acquired. Results of clinical subjective reports and of quantitative region of interest (ROI)-based analyses were compared between procedures using statistical techniques such as Pearson's correlation coefficients and t-tests. RESULTS pFBB and FDG visual reports on the 47 patients showed good agreement (k > 0.74); ROI quantitative analysis indicated that both data modalities are highly correlated; and the t-test analysis does not reject the null hypothesis that data from pFBB and FDG examinations comes from independent random samples from normal distributions with equal means and variances. CONCLUSIONS A good agreement was found between pFBB and FDG data as obtained by subjective visual and quantitative analyses. Dual-point FBB PET scans could offer complementary information (similar to that from FDG PET and FBB PET) in a single procedure, considering pFBB as a surrogate of FDG.
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Affiliation(s)
- Fermín Segovia
- Department of Signal Theory, Networking and Communications, University of Granada, Granada, Spain.,DASCI Institute, University of Granada, Granada, Spain
| | - Manuel Gómez-Río
- Department of Nuclear Medicine, "Virgen de las Nieves" University Hospital, Granada, Spain.,Biosanitary Investigation Institute of Granada, Granada, Spain
| | - Raquel Sánchez-Vañó
- Department of Nuclear Medicine, "9 de Octubre" Hospital, Valencia, Spain.,Clinical Medicine and Public Health Doctoral Program of the University of Granada, Granada, Spain
| | - Juan Manuel Górriz
- Department of Signal Theory, Networking and Communications, University of Granada, Granada, Spain.,DASCI Institute, University of Granada, Granada, Spain.,Biosanitary Investigation Institute of Granada, Granada, Spain
| | - Javier Ramírez
- Department of Signal Theory, Networking and Communications, University of Granada, Granada, Spain.,DASCI Institute, University of Granada, Granada, Spain.,Biosanitary Investigation Institute of Granada, Granada, Spain
| | - Eva Triviño-Ibáñez
- Department of Nuclear Medicine, "Virgen de las Nieves" University Hospital, Granada, Spain.,Biosanitary Investigation Institute of Granada, Granada, Spain
| | - Cristóbal Carnero-Pardo
- Biosanitary Investigation Institute of Granada, Granada, Spain.,Department of Neurology, "Virgen de las Nieves" University Hospital, Granada, Spain
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18F-FDG PET, the early phases and the delivery rate of 18F-AV45 PET as proxies of cerebral blood flow in Alzheimer's disease: Validation against 15O-H 2O PET. Alzheimers Dement 2019; 15:1172-1182. [PMID: 31405824 DOI: 10.1016/j.jalz.2019.05.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 04/27/2019] [Accepted: 05/21/2019] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Dual-biomarker positron emission tomography (PET), providing complementary information on cerebral blood flow and amyloid-β deposition, is of clinical interest for Alzheimer's disease (AD). The purpose of this study was to validate the perfusion components of early-phase 18F-florbetapir (eAV45), the 18F-AV45 delivery rate (R1), and 18F-FDG against 15O-H2O PET and assess how they change with disease severity. METHODS This study included ten controls, 19 amnestic mild cognitive impairment, and 10 AD dementia subjects. Within-subject regional correlations between modalities, between-group regional and voxel-wise analyses of covariance per modality, and receiver operating characteristic analyses for discrimination between groups were performed. RESULTS FDG standardized uptake value ratio, eAV45 (0-2 min) standardized uptake value ratio, and AV45-R1 were significantly associated with H2O PET (regional Pearson r = 0.54-0.82, 0.70-0.94, and 0.65-0.92, respectively; P < .001). All modalities confirmed reduced cerebral blood flow in the posterior cingulate of patients with amnestic mild cognitive impairment and AD dementia, which was associated with lower cognition (r = 0.36-0.65, P < .025) and could discriminate between patient and control groups (area under the curve > 0.80). However, eAV45 was less sensitive to reflect the disease severity than AV45-R1 or FDG. DISCUSSION R1 is preferable over eAV45 for accurate representation of brain perfusion in dual-biomarker PET for AD.
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20
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Belohlavek O, Jaruskova M, Skopalova M, Szarazova G, Simonova K. Improved beta-amyloid PET reproducibility using two-phase acquisition and grey matter delineation. Eur J Nucl Med Mol Imaging 2019; 46:297-303. [PMID: 30159586 PMCID: PMC6333723 DOI: 10.1007/s00259-018-4140-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 08/17/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE We investigated whether the reproducibility of standard visual reporting (STD method) in flutemetamol (FMM) PET can be improved using a newly introduced method that uses grey matter edges derived from the perfusion phase (GM-EDGE method). METHODS Two-phase FMM PET was performed in 121 patients with mild cognitive impairment. Five nuclear medicine physicians blindly and independently evaluated all late-phase scans, initially employing the STD method and later the GM-EDGE method. A five-point scale was used to express the degree of amyloid positivity, and a binary classification (positive/negative) was used in combination with subjective confidence (five-point scale). Multirater Fleiss' kappa, intraclass correlation coefficient (ICC) and inter-rater reliability (Cohen's kappa) were determined for the STD and GM-EDGE methods. RESULTS The weighted Cohen's kappa values for the five-point measure of amyloid positivity ranged from 0.63 to 0.73 (median 0.70) for the STD method and from 0.76 to 0.89 (median 0.80) for the GM-EDGE method (ICC 0.84, 95% CI 0.79-0.88, for the STD method; 0.91, 95% CI 0.89-0.94, for the GM-EDGE method). The nonweighted Cohen's kappa value for the binary classification ranged from 0.73 to 0.93 (median 0.82) for the STD method and 0.90 to 0.97 (median 0.93) for the GM-EDGE method (Fleiss' kappa 0.82, 95% CI 0.77-0.88, for the STD method; 0.93, 95% CI 0.87-0.99, for the GM-EDGE method). The GM-EDGE method resulted in significantly greater subjective confidence in the readings of four physicians (p < 0.010). The binary classification was concordant among all five physicians in 80.8% of the scans using the STD method and in 91.6% of the scans using the GM-EDGE method (p = 0.016). CONCLUSION The newly introduced GM-EDGE method was associated with significantly higher inter-rater agreement among physicians and higher subjective confidence in the reading. The method is easy to implement in clinical practice, especially when the perfusion phase is utilized clinically.
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Affiliation(s)
- Otakar Belohlavek
- Department of Nuclear Medicine - PET Centre, Na Homolce Hospital, Roentgenova 37/2, 150 30, Prague 5, Czech Republic.
| | - Monika Jaruskova
- Department of Nuclear Medicine - PET Centre, Na Homolce Hospital, Roentgenova 37/2, 150 30, Prague 5, Czech Republic
| | - Magdalena Skopalova
- Department of Nuclear Medicine - PET Centre, Na Homolce Hospital, Roentgenova 37/2, 150 30, Prague 5, Czech Republic
| | - Gabriela Szarazova
- Department of Nuclear Medicine - PET Centre, Na Homolce Hospital, Roentgenova 37/2, 150 30, Prague 5, Czech Republic
| | - Katerina Simonova
- Department of Nuclear Medicine - PET Centre, Na Homolce Hospital, Roentgenova 37/2, 150 30, Prague 5, Czech Republic
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21
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Florek L, Tiepolt S, Schroeter ML, Berrouschot J, Saur D, Hesse S, Jochimsen T, Luthardt J, Sattler B, Patt M, Hoffmann KT, Villringer A, Classen J, Gertz HJ, Sabri O, Barthel H. Dual Time-Point [18F]Florbetaben PET Delivers Dual Biomarker Information in Mild Cognitive Impairment and Alzheimer’s Disease. J Alzheimers Dis 2018; 66:1105-1116. [DOI: 10.3233/jad-180522] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Lisa Florek
- Department of Nuclear Medicine, Leipzig University Hospital, Leipzig, Germany
| | - Solveig Tiepolt
- Department of Nuclear Medicine, Leipzig University Hospital, Leipzig, Germany
| | - Matthias L. Schroeter
- Day Clinic for Cognitive Neurology, Leipzig University Hospital & Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | | | - Dorothee Saur
- Department of Neurology, Leipzig University Hospital, Leipzig, Germany
| | - Swen Hesse
- Department of Nuclear Medicine, Leipzig University Hospital, Leipzig, Germany
- IFB Adiposity Diseases, Leipzig University Hospital, Leipzig, Germany
| | - Thies Jochimsen
- Department of Nuclear Medicine, Leipzig University Hospital, Leipzig, Germany
| | - Julia Luthardt
- Department of Nuclear Medicine, Leipzig University Hospital, Leipzig, Germany
| | - Bernhard Sattler
- Department of Nuclear Medicine, Leipzig University Hospital, Leipzig, Germany
| | - Marianne Patt
- Department of Nuclear Medicine, Leipzig University Hospital, Leipzig, Germany
| | | | - Arno Villringer
- IFB Adiposity Diseases, Leipzig University Hospital, Leipzig, Germany
- Day Clinic for Cognitive Neurology, Leipzig University Hospital & Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Joseph Classen
- Department of Neurology, Leipzig University Hospital, Leipzig, Germany
| | | | - Osama Sabri
- Department of Nuclear Medicine, Leipzig University Hospital, Leipzig, Germany
| | - Henryk Barthel
- Department of Nuclear Medicine, Leipzig University Hospital, Leipzig, Germany
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22
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Abstract
Corticobasal syndrome is the most common phenotype of corticobasal degeneration (CBD). F-FP-CIT PET and MRI are not helpful in distinguishing CBD from idiopathic Parkinson disease. Dual-phase F-FP-CIT PET is a recently developed imaging that shows regional cerebral perfusion in the early phase and dopamine transporter density in the late phase. We investigated the usefulness of dual-phase F-FP-CIT PET imaging in 3 patients with corticobasal syndrome. This image highlights that the early phases of F-FP-CIT PET may reflect regional cerebral perfusion with a pattern very similar to that of regional glucose metabolism in CBD.
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23
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Joseph-Mathurin N, Su Y, Blazey TM, Jasielec M, Vlassenko A, Friedrichsen K, Gordon BA, Hornbeck RC, Cash L, Ances BM, Veale T, Cash DM, Brickman AM, Buckles V, Cairns NJ, Cruchaga C, Goate A, Jack CR, Karch C, Klunk W, Koeppe RA, Marcus DS, Mayeux R, McDade E, Noble JM, Ringman J, Saykin AJ, Thompson PM, Xiong C, Morris JC, Bateman RJ, Benzinger TL. Utility of perfusion PET measures to assess neuronal injury in Alzheimer's disease. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2018; 10:669-677. [PMID: 30417072 PMCID: PMC6215983 DOI: 10.1016/j.dadm.2018.08.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) is commonly used to estimate neuronal injury in Alzheimer's disease (AD). Here, we evaluate the utility of dynamic PET measures of perfusion using 11C-Pittsburgh compound B (PiB) to estimate neuronal injury in comparison to FDG PET. METHODS FDG, early frames of PiB images, and relative PiB delivery rate constants (PiB-R1) were obtained from 110 participants from the Dominantly Inherited Alzheimer Network. Voxelwise, regional cross-sectional, and longitudinal analyses were done to evaluate the correlation between images and estimate the relationship of the imaging biomarkers with estimated time to disease progression based on family history. RESULTS Metabolism and perfusion images were spatially correlated. Regional PiB-R1 values and FDG, but not early frames of PiB images, significantly decreased in the mutation carriers with estimated year to onset and with increasing dementia severity. DISCUSSION Hypometabolism estimated by PiB-R1 may provide a measure of brain perfusion without increasing radiation exposure.
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Affiliation(s)
- Nelly Joseph-Mathurin
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Yi Su
- Banner Alzheimer's Institute, Phoenix, AZ, USA
| | - Tyler M. Blazey
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Mateusz Jasielec
- Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA
| | - Andrei Vlassenko
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Karl Friedrichsen
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Brian A. Gordon
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Russ C. Hornbeck
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Lisa Cash
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Beau M. Ances
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Thomas Veale
- Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - David M. Cash
- Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Adam M. Brickman
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Virginia Buckles
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Nigel J. Cairns
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, USA
| | - Alison Goate
- Neuroscience Department Laboratories, Mount Sinai School of Medicine, New York, NY, USA
| | | | - Celeste Karch
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - William Klunk
- Departments of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Robert A. Koeppe
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Daniel S. Marcus
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Richard Mayeux
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Eric McDade
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - James M. Noble
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - John Ringman
- Memory and Aging Center, Department of Neurology, Keck School of Medicine at the University of Southern California, Los Angeles, CA, USA
| | - Andrew J. Saykin
- Center for Neuroimaging, Department of Radiology and Imaging Science, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Paul M. Thompson
- Laboratory of Neuroimaging, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Chengjie Xiong
- Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA
| | - John C. Morris
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Randall J. Bateman
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Tammie L.S. Benzinger
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
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24
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Hsu PH, Lin YT, Chung YH, Lin KJ, Yang LY, Yen TC, Liu HL. Focused Ultrasound-Induced Blood-Brain Barrier Opening Enhances GSK-3 Inhibitor Delivery for Amyloid-Beta Plaque Reduction. Sci Rep 2018; 8:12882. [PMID: 30150769 PMCID: PMC6110796 DOI: 10.1038/s41598-018-31071-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 07/31/2018] [Indexed: 12/25/2022] Open
Abstract
Alzheimer's disease (AD) is a neurodegenerative disease that is the leading cause of age-related dementia. Currently, therapeutic agent delivery to the CNS is a valued approach for AD therapy. Unfortunately, the CNS penetration is greatly hampered by the blood-brain barrier (BBB). Focused-ultrasound (FUS) has been demonstrated to temporally open the BBB, thus promoting therapeutic agent delivery to the CNS. Recently, the BBB opening procedure was further reported to clear the deposited Aβ plaque due to microglia activation. In this study, we aimed to evaluate whether the use of FUS-induced BBB opening to enhance GSK-3 inhibitor delivery, which would bring additive effect of Aβ plaque clearance by FUS with the reduction of Aβ plaque synthesis by GSK-3 inhibitor in an AD mice model. FUS-induced BBB opening on APPswe/PSEN1-dE9 transgenic mice was performed unilaterally, with the contralateral hemisphere serving as a reference. GSK-3 level was confirmed by immunohistochemistry (IHC) and autoradiography (ARG) was also conducted to quantitatively confirm the Aβ plaque reduction. Results from IHC showed GSK-3 inhibitor effectively reduced GSK-3 activity up to 61.3% with the addition of FUS-BBB opening and confirming the proposed therapeutic route. ARG also showed significant Aβ-plaque reduction up to 31.5%. This study reveals the therapeutic potentials of ultrasound to AD treatment, and may provide a useful strategy for neurodegenerative disease treatment.
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Affiliation(s)
- Po-Hung Hsu
- Center for Advanced Molecular Imaging and Translation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Electrical Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Ya-Tin Lin
- Graduate Institute of Biomedical Sciences, Department of Physiology and Pharmacology, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Hsiu Chung
- Center for Advanced Molecular Imaging and Translation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Kun-Ju Lin
- Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Liang-Yo Yang
- Department of Physiology, School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Biotechnology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Tzu-Chen Yen
- Center for Advanced Molecular Imaging and Translation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Hao-Li Liu
- Department of Electrical Engineering, Chang Gung University, Taoyuan, Taiwan.
- Department of Neurosurgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
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25
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Visualization of ischemic stroke-related changes on 18F-THK-5351 positron emission tomography. EJNMMI Res 2018; 8:62. [PMID: 30014313 PMCID: PMC6047954 DOI: 10.1186/s13550-018-0417-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 06/27/2018] [Indexed: 12/11/2022] Open
Abstract
Background The 18F-THK-5351 radiotracer has been used to detect the in vivo tau protein distribution in patients with tauopathy, such as Alzheimer’s disease and corticobasal syndrome. In addition, 18F-THK-5351 can also monitor neuroinflammatory process due to high affinity to astrogliosis. We aimed to explore 18F-THK-5351 distribution patterns and characteristics in patients with recent ischemic stroke. Results Fifteen patients received 18F-THK-5351 positron emission tomography (PET) and diffusion tensor imaging (DTI) approximately 3 months after ischemic stroke. A region of interest (ROI) was placed in the peri-ischemic area and was mirrored on the contralateral side as the control, and a proportional value was derived from the ratio of the peri-ischemic ROI value over the mirrored ROI value. Increased 18F-THK-5351 retention was observed in the areas around and remote from the stroke location. The proportional 18F-THK-5351 values were negatively correlated with the proportional fractional anisotropy values (r = − 0.39, P = 0.04). Conclusion 18F-THK-5351 PET imaging provides a potential tool for in vivo visualization of the widespread ischemia-related changes associated with a microstructural disruption in recent ischemic stroke patients. Electronic supplementary material The online version of this article (10.1186/s13550-018-0417-1) contains supplementary material, which is available to authorized users.
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26
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The Added Value of Dynamic 18F-Florbetapir PET in the Assessment of Dementia With Lewy Bodies. Clin Nucl Med 2018; 43:e85-e86. [PMID: 29261640 DOI: 10.1097/rlu.0000000000001952] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Dementia with Lewy bodies (DLB) is the most common cause of dementia after Alzheimer disease. It is often underdiagnosed because of the overlapping with Alzheimer disease symptoms. We report the F-FDG and F-florbetapir dynamic PET images (early and delay phases) of an 83-year-old woman with cognitive impairment associated with visual hallucinations and parkinsonism due to probable DLB. This image highlights that the early phases of F-florbetapir may reflect regional cerebral perfusion with a pattern very similar to that of regional glucose metabolism in DLB.
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27
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Nobili F, Cagnin A, Calcagni ML, Chincarini A, Guerra UP, Morbelli S, Padovani A, Paghera B, Pappatà S, Parnetti L, Sestini S, Schillaci O. Emerging topics and practical aspects for an appropriate use of amyloid PET in the current Italian context. THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING : OFFICIAL PUBLICATION OF THE ITALIAN ASSOCIATION OF NUCLEAR MEDICINE (AIMN) [AND] THE INTERNATIONAL ASSOCIATION OF RADIOPHARMACOLOGY (IAR), [AND] SECTION OF THE SOCIETY OF RADIOPHARMACEUTICAL CHEMISTRY AND BIOLOGY 2018; 63:83-92. [PMID: 29697220 DOI: 10.23736/s1824-4785.18.03069-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In May 2017 some representatives of the Italian nuclear medicine and neurological communities spontaneously met to discuss the issues emerged during the first two years of routine application of amyloid PET with fluorinated radiopharmaceuticals in the real world. The limitations of a binary classification of scans, the possibility to obtain early images as a surrogate marker of regional cerebral bloos flow, the need for (semi-)quantification and, thus, the opportunity of ranking brain amyloidosis, the correlation with Aβ42 levels in the cerebrospinal fluid, the occurrence and biological meaning of uncertain/boderline scans, the issue of incidental amyloidosis, the technical pittfalls leading to false negative/positive results, the position of the tool in the diagnostic flow-chart in the national reality, are the main topics that have been discussed. Also, a card to justify the examination to be filled by the dementia specialist and a card for the nuclear medicine physician to report the exam in detail have been approved and are available in the web, which should facilitate the creation of a national register, as previewed by the 2015 intersocietal recommendation on the use of amyloid PET in Italy. The content of this discussion could stimulate both public institutions and companies to support further research on these topics.
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Affiliation(s)
- Flavio Nobili
- Department of Neuroscience (DINOGMI), University of Genoa and Neurology Clinic, San Martino Polyclinic Hospital, Genoa, Italy -
| | - Annachiara Cagnin
- Department of Neurosciences (DNS), University of Padua, Padua, Italy.,San Camillo IRCCS Hospital, Venice, Italy
| | - Maria L Calcagni
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea Chincarini
- National Institute for Nuclear Physics (INFN), Genoa Section, Genoa, Italy
| | - Ugo P Guerra
- Unit of Nuclear Medicine, Poliambulanza Fundation, Brescia, Italy
| | - Silvia Morbelli
- Unit of Nuclear Medicine, Department of Health Sciences (DISSAL), Polyclinic San Martino Hospital, University of Genoa, Genoa, Italy
| | - Alessandro Padovani
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Neurology Clinic, Spedali Civili, Brescia, Italy
| | - Barbara Paghera
- Unit of Nuclear Medicine, ASST-Spedali Civili, University of Brescia, Brescia, Italy
| | - Sabina Pappatà
- Institute of Biostructure and Bioimaging, National Research Council, Naples, Italy
| | - Lucilla Parnetti
- Center for Memory Disorders, Laboratory of Clinical Neurochemistry, Neurology Clinic, University of Perugia, Perugia, Italy
| | - Stelvio Sestini
- Unit of Nuclear Medicine, Department of Diagnostic Imaging, N.O.P. - S. Stefano, U.S.L. Toscana Centro, Prato, Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,IRCCS Neuromed, Rome, Italy
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Donaghy PC, Firbank MJ, Thomas AJ, Lloyd J, Petrides G, Barnett N, Olsen K, O'Brien JT. Clinical and imaging correlates of amyloid deposition in dementia with Lewy bodies. Mov Disord 2018; 33:1130-1138. [PMID: 29672930 PMCID: PMC6175485 DOI: 10.1002/mds.27403] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 03/13/2018] [Accepted: 03/19/2018] [Indexed: 01/06/2023] Open
Abstract
Background: Amyloid deposition is common in dementia with Lewy bodies, but its pathophysiological significance is unclear. Objective: The objective of this study was to investigate the relationship between amyloid deposition and clinical profile, gray matter volume, and brain perfusion in dementia with Lewy bodies. Methods: Dementia with Lewy bodies (n = 37), Alzheimer's disease (n = 20), and controls (n = 20) underwent a thorough clinical assessment, 3T MRI, and early‐ and late‐phase 18F‐Florbetapir PET‐CT to assess cortical perfusion and amyloid deposition, respectively. Amyloid scans were visually categorized as positive or negative. Image analysis was carried out using statistical parametric mapping (SPM) 8. Results: There were no significant differences between amyloid‐positive and amyloid‐negative dementia with Lewy bodies cases in age (P = .78), overall cognitive impairment (P = .83), level of functional impairment (P = .80), or any other clinical or cognitive scale. There were also no significant differences in hippocampal or gray matter volumes. However, amyloid‐positive dementia with Lewy bodies cases had lower medial temporal lobe perfusion (P = .03) than amyloid‐negative cases, although a combination of medial temporal lobe perfusion, hippocampal volume, and cognitive measures was unable to accurately predict amyloid status in dementia with Lewy bodies. Conclusions: Amyloid deposition was not associated with differences in clinical or neuropsychological profiles in dementia with Lewy bodies, but was associated with imaging evidence of medial temporal lobe dysfunction. The presence of amyloid in dementia with Lewy bodies cannot be identified on the basis of clinical and other imaging features and will require direct assessment via PET imaging or CSF. © 2018 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Paul C Donaghy
- Institute for Ageing and Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Michael J Firbank
- Institute for Ageing and Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Alan J Thomas
- Institute for Ageing and Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Jim Lloyd
- Nuclear Medicine Department, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, Newcastle upon Tyne, UK
| | - George Petrides
- Nuclear Medicine Department, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, Newcastle upon Tyne, UK
| | - Nicola Barnett
- Institute for Ageing and Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Kirsty Olsen
- Institute for Ageing and Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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29
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Wu KY, Hsiao IT, Chen CH, Liu CY, Hsu JL, Huang SY, Yen TC, Lin KJ. Plasma Aβ analysis using magnetically-labeled immunoassays and PET 18F-florbetapir binding in non-demented patients with major depressive disorder. Sci Rep 2018; 8:2739. [PMID: 29426824 PMCID: PMC5807319 DOI: 10.1038/s41598-018-21140-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 01/30/2018] [Indexed: 01/25/2023] Open
Abstract
An increased level of brain amyloid deposition and a decreased level of cerebral spinal fluid (CSF) Aβ42 are currently considered reliable biomarkers of Alzheimer’s disease (AD); however, the usefulness of plasma Aβ levels are not well-established. This study investigated the relationships between plasma Aβ levels and cerebral amyloidosis in 36 non-demented patients with major depressive disorder (MDD). All participants underwent 18F-florbetapir PET imaging and provided a blood sample at the same time for immunomagnetic reduction assay to measure the plasma levels of Aβ40 and Aβ42. We found inverse associations of the plasma Aβ42 level and the Aβ42/Aβ40 ratio, and a positive association of the plasma Aβ40 level, with cerebral amyloid deposition in the precuneus, parietal and posterior cingulate cortex. Subgroup analyses in subjects with higher 18F-florbetapir uptake values or MDD with amnestic mild cognitive impairment revealed more pervasive relationships of plasma Aβ measures with 18F-florbetapir binding across the brain regions examined. The study suggested that regional brain amyloid deposition in terms of 18F-florbetapir PET uptake had weak-to-moderate associations with plasma Aβ42 and Aβ40 levels, and the Aβ42/Aβ40 ratio. Validation in a larger population of subjects of known cerebral amyloidosis status is needed. Careful interpretation of plasma data is warranted.
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Affiliation(s)
- Kuan-Yi Wu
- Department of Psychiatry, Chang Gung Memorial Hospital and Chang Gung University, Tao-Yuan, Taiwan
| | - Ing-Tsung Hsiao
- Department of Nuclear Medicine and Center for Advanced Molecular Imaging and Translation, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan.,Department of Medical Imaging and Radiological Sciences and Healthy Aging Research Center, Chang Gung University, Tao-Yuan, Taiwan
| | - Chia-Hsiang Chen
- Department of Psychiatry, Chang Gung Memorial Hospital and Chang Gung University, Tao-Yuan, Taiwan
| | - Chia-Yih Liu
- Department of Psychiatry, Chang Gung Memorial Hospital and Chang Gung University, Tao-Yuan, Taiwan
| | - Jung-Lung Hsu
- Department of Neurology and Dementia Center, Chang Gung Memorial Hospital and Chang Gung University, Tao-Yuan, Taiwan.,Graduate Institute of Humanities in Medicine and Brain and Consciousness Research Center, Taipei Medical University, Taipei, Taiwan
| | - Sheng-Yao Huang
- Department of Nuclear Medicine and Center for Advanced Molecular Imaging and Translation, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan.,Department of Medical Imaging and Radiological Sciences and Healthy Aging Research Center, Chang Gung University, Tao-Yuan, Taiwan
| | - Tzu-Chen Yen
- Department of Nuclear Medicine and Center for Advanced Molecular Imaging and Translation, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan.,Department of Medical Imaging and Radiological Sciences and Healthy Aging Research Center, Chang Gung University, Tao-Yuan, Taiwan
| | - Kun-Ju Lin
- Department of Nuclear Medicine and Center for Advanced Molecular Imaging and Translation, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan. .,Department of Medical Imaging and Radiological Sciences and Healthy Aging Research Center, Chang Gung University, Tao-Yuan, Taiwan.
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30
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Oliveira FP, Moreira AP, de Mendonça A, Verdelho A, Xavier C, Barroca D, Rio J, Cardoso E, Cruz Â, Abrunhosa A, Castelo-Branco M. Can 11C-PiB-PET Relative Delivery R1 or 11C-PiB-PET Perfusion Replace 18F-FDG-PET in the Assessment of Brain Neurodegeneration? J Alzheimers Dis 2018; 65:89-97. [PMID: 30056421 PMCID: PMC6087437 DOI: 10.3233/jad-180274] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND Pittsburgh Compound B (PiB) positron emission tomography (PET) is used to visualize in vivo amyloid plaques in the brain. Frequently the PiB examinations are complemented with a fluorodeoxyglucose (FDG) PET scan to further assess neurodegeneration. OBJECTIVE Our goal is to identify alternative correlates of FDG images by assessing which kinetic methods originate PiB derived relative delivery ratio (R1) images that can be correlated with the FDG images, and to compare them with PiB perfusion (pPiB) images obtained from the early-phase of PiB acquisition. METHODS We selected 52 patients with cognitive impairment who underwent a dynamic PiB and FDG acquisitions. To compute the R1 images, two simplified reference tissue models (SRTM and SRTM2) and two multi-linear reference tissue models (MRTM and MRTM2) were used. The pPiB images were obtained in two different time intervals. RESULTS All six types of images were of good quality and highly correlated with the FDG images (mean voxelwise within-subjects r > 0.92). The higher correlation was found for FDG-R1(MRTM). Regarding the voxelwise regional correlation, the higher mean all brain correlations was r = 0.825 for FDG-R1(MRTM) and statistically significant in the whole brain analysis. CONCLUSION All R1 and pPiB images here tested have potential to assess the metabolic impact of neurodegeneration almost as reliably as the FDG images. However, this is not enough to validate these images for a single-subject analysis compared with the FDG image, and thus they cannot yet be used clinically to replace the FDG image before such evaluation.
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Affiliation(s)
- Francisco P.M. Oliveira
- CIBIT, Institute for Nuclear Sciences Applied to Health (ICNAS - P), University of Coimbra, Coimbra, Portugal
- Institute for Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Ana Paula Moreira
- Nuclear Medicine Department, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Alexandre de Mendonça
- Department of Neurology and Laboratory of Neurosciences, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Ana Verdelho
- Department of Neurosciences and Mental Health, Santa Maria Hospital – CHLN, ISAMB, University of Lisbon, Lisbon, Portugal
| | - Carolina Xavier
- CIBIT, Institute for Nuclear Sciences Applied to Health (ICNAS - P), University of Coimbra, Coimbra, Portugal
| | - Dalila Barroca
- CIBIT, Institute for Nuclear Sciences Applied to Health (ICNAS - P), University of Coimbra, Coimbra, Portugal
| | - Joana Rio
- CIBIT, Institute for Nuclear Sciences Applied to Health (ICNAS - P), University of Coimbra, Coimbra, Portugal
| | - Eva Cardoso
- CIBIT, Institute for Nuclear Sciences Applied to Health (ICNAS - P), University of Coimbra, Coimbra, Portugal
| | - Ângela Cruz
- CIBIT, Institute for Nuclear Sciences Applied to Health (ICNAS - P), University of Coimbra, Coimbra, Portugal
| | - Antero Abrunhosa
- CIBIT, Institute for Nuclear Sciences Applied to Health (ICNAS - P), University of Coimbra, Coimbra, Portugal
| | - Miguel Castelo-Branco
- CIBIT, Institute for Nuclear Sciences Applied to Health (ICNAS - P), University of Coimbra, Coimbra, Portugal
- Institute for Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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31
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Chen YJ, Nasrallah IM. Brain amyloid PET interpretation approaches: from visual assessment in the clinic to quantitative pharmacokinetic modeling. Clin Transl Imaging 2017. [DOI: 10.1007/s40336-017-0257-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Multimodal correlation of dynamic [ 18F]-AV-1451 perfusion PET and neuronal hypometabolism in [ 18F]-FDG PET. Eur J Nucl Med Mol Imaging 2017; 44:2249-2256. [PMID: 29026951 DOI: 10.1007/s00259-017-3840-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 09/22/2017] [Indexed: 01/30/2023]
Abstract
PURPOSE Cerebral glucose metabolism measured with [18F]-FDG PET is a well established marker of neuronal dysfunction in neurodegeneration. The tau-protein tracer [18F]-AV-1451 PET is currently under evaluation and shows promising results. Here, we assess the feasibility of early perfusion imaging with AV-1451 as a substite for FDG PET in assessing neuronal injury. METHODS Twenty patients with suspected neurodegeneration underwent FDG and early phase AV-1451 PET imaging. Ten one-minute timeframes were acquired after application of 200 MBq AV-1451. FDG images were acquired on a different date according to clinical protocol. Early AV-1451 timeframes were coregistered to individual FDG-scans and spatially normalized. Voxel-wise intermodal correlations were calculated on within-subject level for every possible time window. The window with highest pooled correlation was considered optimal. Z-transformed deviation maps (ZMs) were created from both FDG and early AV-1451 images, comparing against FDG images of healthy controls. RESULTS Regional patterns and extent of perfusion deficits were highly comparable to metabolic deficits. Best results were observed in a time window from 60 to 360 s (r = 0.86). Correlation strength ranged from r = 0.96 (subcortical gray matter) to 0.83 (frontal lobe) in regional analysis. ZMs of early AV-1451 and FDG images were highly similar. CONCLUSION Perfusion imaging with AV-1451 is a valid biomarker for assessment of neuronal dysfunction in neurodegenerative diseases. Radiation exposure and complexity of the diagnostic workup could be reduced significantly by routine acquisition of early AV-1451 images, sparing additional FDG PET.
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Hsiao IT, Lin KJ, Huang KL, Huang CC, Chen HS, Wey SP, Yen TC, Okamura N, Hsu JL. Biodistribution and Radiation Dosimetry for the Tau Tracer 18F-THK-5351 in Healthy Human Subjects. J Nucl Med 2017; 58:1498-1503. [DOI: 10.2967/jnumed.116.189126] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 03/13/2017] [Indexed: 12/30/2022] Open
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Del Sole A, Malaspina S, Magenta Biasina A. Magnetic resonance imaging and positron emission tomography in the diagnosis of neurodegenerative dementias. FUNCTIONAL NEUROLOGY 2017; 31:205-215. [PMID: 28072381 DOI: 10.11138/fneur/2016.31.4.205] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Neuroimaging, both with magnetic resonance imaging (MRI) and positron emission tomography (PET), has gained a pivotal role in the diagnosis of primary neurodegenerative diseases. These two techniques are used as biomarkers of both pathology and progression of Alzheimer's disease (AD) and to differentiate AD from other neurodegenerative diseases. MRI is able to identify structural changes including patterns of atrophy characterizing neurodegenerative diseases, and to distinguish these from other causes of cognitive impairment, e.g. infarcts, space-occupying lesions and hydrocephalus. PET is widely used to identify regional patterns of glucose utilization, since distinct patterns of distribution of cerebral glucose metabolism are related to different subtypes of neurodegenerative dementia. The use of PET in mild cognitive impairment, though controversial, is deemed helpful for predicting conversion to dementia and the dementia clinical subtype. Recently, new radiopharmaceuticals for the in vivo imaging of amyloid burden have been licensed and more tracers are being developed for the assessment of tauopathies and inflammatory processes, which may underlie the onset of the amyloid cascade. At present, the cerebral amyloid burden, imaged with PET, may help to exclude the presence of AD as well as forecast its possible onset. Finally PET imaging may be particularly useful in ongoing clinical trials for the development of dementia treatments. In the near future, the use of the above methods, in accordance with specific guidelines, along with the use of effective treatments will likely lead to more timely and successful treatment of neurodegenerative dementias.
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Giacomelli C, Daniele S, Martini C. Potential biomarkers and novel pharmacological targets in protein aggregation-related neurodegenerative diseases. Biochem Pharmacol 2017; 131:1-15. [PMID: 28159621 DOI: 10.1016/j.bcp.2017.01.017] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 01/26/2017] [Indexed: 10/20/2022]
Abstract
The aggregation of specific proteins plays a pivotal role in the etiopathogenesis of several neurodegenerative diseases (NDs). β-Amyloid (Aβ) peptide-containing plaques and intraneuronal neurofibrillary tangles composed of hyperphosphorylated protein tau are the two main neuropathological lesions in Alzheimer's disease. Meanwhile, Parkinson's disease is defined by the presence of intraneuronal inclusions (Lewy bodies), in which α-synuclein (α-syn) has been identified as a major protein component. The current literature provides considerable insights into the mechanisms underlying oligomeric-related neurodegeneration, as well as the relationship between protein aggregation and ND, thus facilitating the development of novel putative biomarkers and/or pharmacological targets. Recently, α-syn, tau and Aβ have been shown to interact each other or with other "pathological proteins" to form toxic heteroaggregates. These latest findings are overcoming the concept that each neurodegenerative disease is related to the misfolding of a single specific protein. In this review, potential opportunities and pharmacological approaches targeting α-syn, tau and Aβ and their oligomeric forms are highlighted with examples from recent studies. Protein aggregation as a biomarker of NDs, in both the brain and peripheral fluids, is deeply explored. Finally, the relationship between biomarker establishment and assessment and their use as diagnostics or therapeutic targets are discussed.
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Affiliation(s)
- Chiara Giacomelli
- Department of Pharmacy, University of Pisa, Via Bonanno 6, 56126 Pisa, Italy
| | - Simona Daniele
- Department of Pharmacy, University of Pisa, Via Bonanno 6, 56126 Pisa, Italy
| | - Claudia Martini
- Department of Pharmacy, University of Pisa, Via Bonanno 6, 56126 Pisa, Italy.
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