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Lansdell TA, Dorrance AM. Chronic cerebral hypoperfusion in male rats results in sustained HPA activation and hyperinsulinemia. Am J Physiol Endocrinol Metab 2022; 322:E24-E33. [PMID: 34747203 PMCID: PMC8721904 DOI: 10.1152/ajpendo.00233.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Vascular contributions to cognitive impairment and dementia (VCID) is a spectrum of cognitive deficits caused by cerebrovascular disease, for which insulin resistance is a major risk factor. A major cause of VCID is chronic cerebral hypoperfusion (CCH). Under stress, sustained hypothalamic-pituitary-adrenal axis (HPA) activation can result in insulin resistance. Little is known about the effects of CCH on the HPA axis. We hypothesized that CCH causes sustained HPA activation and insulin resistance. Male rats were subjected to bilateral carotid artery stenosis (BCAS) for 12 wk to induce CCH and VCID. BCAS reduced cerebral blood flow and caused memory impairment. Plasma adrenocorticotropic hormone was increased in the BCAS rats (117.2 ± 9.6 vs. 88.29 ± 9.1 pg/mL, BCAS vs. sham, P = 0.0236), as was corticosterone (220 ± 21 vs. 146 ± 18 ng/g feces, BCAS vs. sham, P = 0.0083). BCAS rats were hypoglycemic (68.1 ± 6.1 vs. 76.5 ± 5.9 mg/dL, BCAS vs. sham, P = 0.0072), with increased fasting insulin (481.6 ± 242.6 vs. 97.94 ± 40.02 pmol/L, BCAS vs. sham, P = 0.0003) indicating that BCAS rats were insulin resistant [homeostasis model assessment of β-cell function-insulin resistance (HOMA-IR): 11.71 ± 6.47 vs. 2.62 ± 0.93; BCAS vs. control, P = 0.0008]. Glucose tolerance tests revealed that BCAS rats had lower blood glucose areas under the curve (AUCs) than controls (250 ± 12 vs. 326 ± 20 mg/dL/h, BCAS vs. sham, P = 0.0075). These studies indicate that CCH causes sustained activation of the HPA and results in insulin resistance, a condition that is expected to worsen VCID.NEW & NOTEWORTHY Cerebrovascular disease and insulin resistance are two major risk factors for the development of dementia. Here, we demonstrate that chronic cerebral hypoperfusion results in glucocorticoid excess and hyperinsulinemia. This study indicates that chronic cerebral hypoperfusion, glucocorticoid excess, and insulin resistance participate in a detrimental cycle that could exacerbate cerebral vascular disease and dementia.
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Affiliation(s)
- Theresa A Lansdell
- Department of Pharmacology and Toxicology, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan
| | - Anne M Dorrance
- Department of Pharmacology and Toxicology, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan
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2
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Nadebaum DP, Krishnadas N, Poon AMT, Kalff V, Lichtenstein M, Villemagne VL, Jones G, Rowe CC. Head-to-head comparison of cerebral blood flow single-photon emission computed tomography and 18 F-fluoro-2-deoxyglucose positron emission tomography in the diagnosis of Alzheimer disease. Intern Med J 2021; 51:1243-1250. [PMID: 32388925 PMCID: PMC8457212 DOI: 10.1111/imj.14890] [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] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/05/2020] [Accepted: 05/07/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Clinical diagnosis of Alzheimer disease (AD) is only 70% accurate. Reduced cerebral blood flow (CBF) and metabolism in parieto-temporal and posterior cingulate cortex may assist diagnosis. While widely accepted that 18 F-fluoro-2-deoxyglucose positron emission tomography (18 F-FDG PET) has superior accuracy to CBF-SPECT for AD, there are very limited head-to-head data from clinically relevant populations and these studies relied on clinical diagnosis as the reference standard. AIMS To compare directly the accuracy of CBF-SPECT and 18 F-FDG PET in patients referred for diagnostic studies in detecting β-amyloid PET confirmed AD. METHODS A total of 126 patients, 56% with mild cognitive impairment and 44% with dementia, completed both CBF-SPECT and 18 F-FDG PET as part of their diagnostic assessment, and subsequently underwent β-amyloid PET for research purposes. Transaxial slices and Neurostat 3D-SSP analyses of 18 F-FDG PET and CBF-SPECT scans were independently reviewed by five nuclear medicine clinicians blinded to all other data. Operators selected the most likely diagnosis and their diagnostic confidence. Accuracy analysis used final diagnosis incorporating β-amyloid PET as the reference standard. RESULTS Clinicians reported high diagnostic confidence in 83% of 18 F-FDG PET compared to 67% for CBF-SPECT (P = 0.001). All reviewers showed individually higher accuracy using 18 F-FDG PET. Based on majority read, the combined area under the receiver operating characteristic curve in diagnosing AD was 0.71 for 18 F-FDG PET and 0.61 for CBF-SPECT (P = 0.02). The sensitivity of 18 F-FDG PET and CBF-SPECT was 76% versus 43% (P < 0.001), while specificity was 74% versus 83% (P = 0.45). CONCLUSIONS 18 F-FDG PET is superior to CBF-SPECT in detecting AD among patients referred for the assessment of cognitive impairment.
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Affiliation(s)
- David P Nadebaum
- Department of Molecular Imaging and Therapy, Austin Hospital, Melbourne, Victoria, Australia.,Department of Nuclear Medicine, Austin Hospital, Melbourne, Victoria, Australia
| | - Natasha Krishnadas
- Department of Molecular Imaging and Therapy, Austin Hospital, Melbourne, Victoria, Australia
| | - Aurora M T Poon
- Department of Molecular Imaging and Therapy, Austin Hospital, Melbourne, Victoria, Australia
| | - Victor Kalff
- Department of Nuclear Medicine, Austin Hospital, Melbourne, Victoria, Australia
| | - Meir Lichtenstein
- Department of Nuclear Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Victor L Villemagne
- Department of Molecular Imaging and Therapy, Austin Hospital, Melbourne, Victoria, Australia.,Florey Department of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Gareth Jones
- Department of Molecular Imaging and Therapy, Austin Hospital, Melbourne, Victoria, Australia
| | - Christopher C Rowe
- Department of Molecular Imaging and Therapy, Austin Hospital, Melbourne, Victoria, Australia.,Florey Department of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
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Ferrando R, Damian A. Brain SPECT as a Biomarker of Neurodegeneration in Dementia in the Era of Molecular Imaging: Still a Valid Option? Front Neurol 2021; 12:629442. [PMID: 34040574 PMCID: PMC8141564 DOI: 10.3389/fneur.2021.629442] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 04/06/2021] [Indexed: 12/21/2022] Open
Abstract
Biomarkers are playing a progressively leading role in both clinical practice and scientific research in dementia. Although amyloid and tau biomarkers have gained ground in the clinical community in recent years, neurodegeneration biomarkers continue to play a key role due to their ability to identify different patterns of brain involvement that sign the transition between asymptomatic and symptomatic stages of the disease with high sensitivity and specificity. Both 18F-FDG positron emission tomography (PET) and perfusion single photon emission computed tomography (SPECT) have proved useful to reveal the functional alterations underlying various neurodegenerative diseases. Although the focus of nuclear neuroimaging has shifted to PET, the lower cost and wider availability of SPECT make it a still valid alternative for the study of patients with dementia. This review discusses the principles of both techniques, compares their diagnostic performance for the diagnosis of neurodegenerative diseases and highlights the role of SPECT to characterize patients from low- and middle-income countries, where special care of additional costs is particularly needed to meet the new recommendations for the diagnosis and characterization of patients with dementia.
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Affiliation(s)
- Rodolfo Ferrando
- Centro de Medicina Nuclear e Imagenología Molecular, Hospital de Clínicas, Universidad de la República (UdelaR), Montevideo, Uruguay.,Centro Uruguayo de Imagenología Molecular (CUDIM), Montevideo, Uruguay
| | - Andres Damian
- Centro de Medicina Nuclear e Imagenología Molecular, Hospital de Clínicas, Universidad de la República (UdelaR), Montevideo, Uruguay.,Centro Uruguayo de Imagenología Molecular (CUDIM), Montevideo, Uruguay
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4
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Ducharme S, Dols A, Laforce R, Devenney E, Kumfor F, van den Stock J, Dallaire-Théroux C, Seelaar H, Gossink F, Vijverberg E, Huey E, Vandenbulcke M, Masellis M, Trieu C, Onyike C, Caramelli P, de Souza LC, Santillo A, Waldö ML, Landin-Romero R, Piguet O, Kelso W, Eratne D, Velakoulis D, Ikeda M, Perry D, Pressman P, Boeve B, Vandenberghe R, Mendez M, Azuar C, Levy R, Le Ber I, Baez S, Lerner A, Ellajosyula R, Pasquier F, Galimberti D, Scarpini E, van Swieten J, Hornberger M, Rosen H, Hodges J, Diehl-Schmid J, Pijnenburg Y. Recommendations to distinguish behavioural variant frontotemporal dementia from psychiatric disorders. Brain 2020; 143:1632-1650. [PMID: 32129844 PMCID: PMC7849953 DOI: 10.1093/brain/awaa018] [Citation(s) in RCA: 145] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 11/27/2019] [Accepted: 12/08/2019] [Indexed: 12/12/2022] Open
Abstract
The behavioural variant of frontotemporal dementia (bvFTD) is a frequent cause of early-onset dementia. The diagnosis of bvFTD remains challenging because of the limited accuracy of neuroimaging in the early disease stages and the absence of molecular biomarkers, and therefore relies predominantly on clinical assessment. BvFTD shows significant symptomatic overlap with non-degenerative primary psychiatric disorders including major depressive disorder, bipolar disorder, schizophrenia, obsessive-compulsive disorder, autism spectrum disorders and even personality disorders. To date, ∼50% of patients with bvFTD receive a prior psychiatric diagnosis, and average diagnostic delay is up to 5-6 years from symptom onset. It is also not uncommon for patients with primary psychiatric disorders to be wrongly diagnosed with bvFTD. The Neuropsychiatric International Consortium for Frontotemporal Dementia was recently established to determine the current best clinical practice and set up an international collaboration to share a common dataset for future research. The goal of the present paper was to review the existing literature on the diagnosis of bvFTD and its differential diagnosis with primary psychiatric disorders to provide consensus recommendations on the clinical assessment. A systematic literature search with a narrative review was performed to determine all bvFTD-related diagnostic evidence for the following topics: bvFTD history taking, psychiatric assessment, clinical scales, physical and neurological examination, bedside cognitive tests, neuropsychological assessment, social cognition, structural neuroimaging, functional neuroimaging, CSF and genetic testing. For each topic, responsible team members proposed a set of minimal requirements, optimal clinical recommendations, and tools requiring further research or those that should be developed. Recommendations were listed if they reached a ≥ 85% expert consensus based on an online survey among all consortium participants. New recommendations include performing at least one formal social cognition test in the standard neuropsychological battery for bvFTD. We emphasize the importance of 3D-T1 brain MRI with a standardized review protocol including validated visual atrophy rating scales, and to consider volumetric analyses if available. We clarify the role of 18F-fluorodeoxyglucose PET for the exclusion of bvFTD when normal, whereas non-specific regional metabolism abnormalities should not be over-interpreted in the case of a psychiatric differential diagnosis. We highlight the potential role of serum or CSF neurofilament light chain to differentiate bvFTD from primary psychiatric disorders. Finally, based on the increasing literature and clinical experience, the consortium determined that screening for C9orf72 mutation should be performed in all possible/probable bvFTD cases or suspected cases with strong psychiatric features.
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Affiliation(s)
- Simon Ducharme
- Department of Psychiatry, McGill University Health Centre, McGill University, Montreal, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, 3801 University Str., Montreal, Quebec, H3A 2B4, Canada
| | - Annemiek Dols
- Department of Old Age Psychiatry, GGZ InGeest, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Robert Laforce
- Clinique Interdisciplinaire de Mémoire (CIME), Laval University, Quebec, Canada
| | - Emma Devenney
- Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Fiona Kumfor
- Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Jan van den Stock
- Laboratory for Translational Neuropsychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | | | - Harro Seelaar
- Department of Neurology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Flora Gossink
- Department of Old Age Psychiatry, GGZ InGeest, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Everard Vijverberg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Edward Huey
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Department of Psychiatry, Colombia University, New York, USA
| | - Mathieu Vandenbulcke
- Department of Geriatric Psychiatry, University Hospitals Leuven, Leuven, Belgium
| | - Mario Masellis
- Department of Neurology, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Calvin Trieu
- Department of Old Age Psychiatry, GGZ InGeest, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Chiadi Onyike
- Division of Geriatric Psychiatry and Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Research Group, Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Leonardo Cruz de Souza
- Behavioral and Cognitive Neurology Research Group, Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Maria Landqvist Waldö
- Division of Clinical Sciences Helsingborg, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | | | - Olivier Piguet
- Division of Clinical Sciences Helsingborg, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Wendy Kelso
- Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne, Australia
| | - Dhamidhu Eratne
- Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne, Australia
| | - Dennis Velakoulis
- Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne, Australia
| | - Manabu Ikeda
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - David Perry
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, USA
| | - Peter Pressman
- Department of Neurology, University of Colorado Denver, Aurora, USA
| | - Bradley Boeve
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Rik Vandenberghe
- Department of Neurology, University Hospital Leuven, Leuven, Belgium
| | - Mario Mendez
- Department of Neurology, UCLA Medical Centre, University of California Los Angeles, Los Angeles, USA
| | - Carole Azuar
- Department of Neurology, Hôpital La Pitié Salpêtrière, Paris, France
| | - Richard Levy
- Department of Neurology, Hôpital La Pitié Salpêtrière, Paris, France
| | - Isabelle Le Ber
- Department of Neurology, Hôpital La Pitié Salpêtrière, Paris, France
| | - Sandra Baez
- Department of Psychology, Andes University, Bogota, Colombia
| | - Alan Lerner
- Department of Neurology, University Hospital Cleveland Medical Center, Cleveland, USA
| | - Ratnavalli Ellajosyula
- Department of Neurology, Manipal Hospital and Annasawmy Mudaliar Hospital, Bangalore, India
| | - Florence Pasquier
- Univ Lille, Inserm U1171, Memory Center, CHU Lille, DISTAlz, Lille, France
| | - Daniela Galimberti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Centro Dino Ferrari, Milan, Italy
- Fondazione IRCCS Ca’ Granda, Ospedale Policlinico, Neurodegenerative Diseases Unit Milan, Italy
| | - Elio Scarpini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Centro Dino Ferrari, Milan, Italy
- Fondazione IRCCS Ca’ Granda, Ospedale Policlinico, Neurodegenerative Diseases Unit Milan, Italy
| | - John van Swieten
- Department of Neurology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | | | - Howard Rosen
- Memory and Aging Center, University of California San Francisco, San Francisco, USA
| | - John Hodges
- Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Janine Diehl-Schmid
- Department of Psychiatry and Psychotherapy, Technical University of Munich, School of Medicine, Munich, Germany
| | - Yolande Pijnenburg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
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5
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Kalligerou F, Ntanasi E, Voskou P, Velonakis G, Karavasilis E, Mamalaki E, Kyrozis A, Sigala E, Economou NT, Patas K, Yannakoulia M, Scarmeas N. Aiginition Longitudinal Biomarker Investigation Of Neurodegeneration (ALBION): study design, cohort description, and preliminary data. Postgrad Med 2019; 131:501-508. [PMID: 31483196 DOI: 10.1080/00325481.2019.1663708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Objectives: Aiginition Longitudinal Biomarker Investigation Of Neurodegeneration (ALBION) is a longitudinal ongoing study initiated in 2018 that takes place in the Cognitive Disorders Clinic of Aiginition Hospital of the National and Kapodistrian University of Athens. Its aim is to address several research questions concerning the preclinical and prodromal stage of Alzheimer's disease and explore potential markers for early detection, prediction, and primary prevention of dementia. Methods: We here present the design and the preliminary baseline characteristics of ALBION. The sample of our study consists of people aged over 50 who are concerned about their memory but are cognitively normal (CN) or have mild cognitive deficits. Each participant undergoes an extensive assessment including several demographic, medical, social, environmental, clinical, nutritional, neuropsychological determinants and lifestyle activities. Furthermore, we are collecting data from portable devices, neuroimaging techniques and biological samples (blood, stools, CSF). All participants are assessed annually for a period of 10 years. Results: In total, 47 participants have completed the initial evaluation up to date and are divided in two groups, CN individuals (N = 26) and MCI patients (N = 21), based on their cognitive status. The participants are, on average, 64 years old, 46.3% of the sample is male with an average of 12.73 years of education. MCI patients report more comorbidities and have a lower score in the MMSE test. Regarding APOE status, 2 participants are ε4 homozygotes and 10 ε4 heterozygotes. CSF analyses (Aβ42, Τ-tau, P-tau) revealed no differences between the two groups. Conclusion: The ALBION study offers an opportunity to explore preclinical dementia and identify new and tailored markers, particularly relating to lifestyle. Further investigation of these populations may provide a wider profile of the changes taking place in the preclinical phase of dementia, leading to potentially effective therapeutic and preventive strategies.
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Affiliation(s)
- F Kalligerou
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School , Athens , Greece
| | - E Ntanasi
- Department of Nutrition and Diatetics, Harokopio University , Athens , Greece
| | - P Voskou
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School , Athens , Greece
| | - G Velonakis
- 2nd department of Radliology, University General Hospital "Attikon", National and Kapodistrian University of Athens, Medical School , Athens , Greece
| | - E Karavasilis
- 2nd department of Radliology, University General Hospital "Attikon", National and Kapodistrian University of Athens, Medical School , Athens , Greece
| | - E Mamalaki
- Department of Nutrition and Diatetics, Harokopio University , Athens , Greece
| | - A Kyrozis
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School , Athens , Greece
| | - E Sigala
- Department of Nutrition and Diatetics, Harokopio University , Athens , Greece
| | - N T Economou
- Sleep Study Unit, Department of Psychiatry, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School , Athens , Greece
| | - K Patas
- Laboratory of Biopathology, Aiginition Hospital , Athens , Greece
| | - M Yannakoulia
- Department of Nutrition and Diatetics, Harokopio University , Athens , Greece
| | - N Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School , Athens , Greece
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6
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Bunai T, Kakimoto A, Yoshikawa E, Terada T, Ouchi Y. Biopathological Significance of Early-Phase Amyloid Imaging in the Spectrum of Alzheimer’s Disease. J Alzheimers Dis 2019; 69:529-538. [DOI: 10.3233/jad-181188] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Tomoyasu Bunai
- Department of Biofunctional Imaging, Preeminent Medical Photonics Education & Research Center, Hamamatsu University School of Medicine, Higashi-ku, Hamamatsu, Japan
| | - Akihiro Kakimoto
- PET Medical Application Group, Central Research Laboratory, Hamamatsu Photonics K.K., Hamakita-ku, Hamamatsu, Japan
| | - Etsuji Yoshikawa
- PET Medical Application Group, Central Research Laboratory, Hamamatsu Photonics K.K., Hamakita-ku, Hamamatsu, Japan
| | - Tatsuhiro Terada
- Department of Biofunctional Imaging, Preeminent Medical Photonics Education & Research Center, Hamamatsu University School of Medicine, Higashi-ku, Hamamatsu, Japan
- Department of Neurology, Shizuoka Institute of Epilepsy and Neurological Disorders, Aoi-ku, Shizuoka, Japan
| | - Yasuomi Ouchi
- Department of Biofunctional Imaging, Preeminent Medical Photonics Education & Research Center, Hamamatsu University School of Medicine, Higashi-ku, Hamamatsu, Japan
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7
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Clinical utility of FDG-PET for the clinical diagnosis in MCI. Eur J Nucl Med Mol Imaging 2018; 45:1497-1508. [DOI: 10.1007/s00259-018-4039-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Accepted: 04/19/2018] [Indexed: 10/17/2022]
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8
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Laver K, Cumming RG, Dyer SM, Agar MR, Anstey KJ, Beattie E, Brodaty H, Broe T, Clemson L, Crotty M, Dietz M, Draper BM, Flicker L, Friel M, Heuzenroeder LM, Koch S, Kurrle S, Nay R, Pond CD, Thompson J, Santalucia Y, Whitehead C, Yates MW. Clinical practice guidelines for dementia in Australia. Med J Aust 2016; 204:191-3. [DOI: 10.5694/mja15.01339] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 01/28/2016] [Indexed: 11/17/2022]
Affiliation(s)
| | | | | | - Meera R Agar
- Braeside Hospital, Sydney, NSW
- UNSW Australia, Sydney, NSW
| | | | | | | | - Tony Broe
- Neuroscience Research Australia, Sydney, NSW
| | | | | | | | | | | | | | | | - Susan Koch
- Royal District Nursing Service, Melbourne, VIC
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9
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Eisenmenger LB, Huo EJ, Hoffman JM, Minoshima S, Matesan MC, Lewis DH, Lopresti BJ, Mathis CA, Okonkwo DO, Mountz JM. Advances in PET Imaging of Degenerative, Cerebrovascular, and Traumatic Causes of Dementia. Semin Nucl Med 2016; 46:57-87. [DOI: 10.1053/j.semnuclmed.2015.09.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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10
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Bergeron D, Beauregard JM, Guimond J, Fortin MP, Houde M, Poulin S, Verret L, Bouchard RW, Laforce R. Clinical Impact of a Second FDG-PET in Atypical/Unclear Dementia Syndromes. J Alzheimers Dis 2015; 49:695-705. [DOI: 10.3233/jad-150302] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- David Bergeron
- Clinique Interdisciplinaire de Mémoire (CIME), CHU de Québec, PQ, Canada
| | | | - Jean Guimond
- Service de médecine nucléaire, Institut de Cardiologie et de Pneumologie de Québec (IUCPQ), PQ, Canada
| | | | - Michèle Houde
- Clinique Interdisciplinaire de Mémoire (CIME), CHU de Québec, PQ, Canada
| | - Stéphane Poulin
- Clinique Interdisciplinaire de Mémoire (CIME), CHU de Québec, PQ, Canada
| | - Louis Verret
- Clinique Interdisciplinaire de Mémoire (CIME), CHU de Québec, PQ, Canada
- Département des Sciences Neurologiques, Université Laval, PQ, Canada
| | - Rémi W. Bouchard
- Clinique Interdisciplinaire de Mémoire (CIME), CHU de Québec, PQ, Canada
- Département des Sciences Neurologiques, Université Laval, PQ, Canada
| | - Robert Laforce
- Clinique Interdisciplinaire de Mémoire (CIME), CHU de Québec, PQ, Canada
- Département des Sciences Neurologiques, Université Laval, PQ, Canada
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11
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Arbizu J, García-Ribas G, Carrió I, Garrastachu P, Martínez-Lage P, Molinuevo JL. Recommendations for the use of PET imaging biomarkers in the diagnosis of neurodegenerative conditions associated with dementia: consensus proposal from the SEMNIM and SEN. Rev Esp Med Nucl Imagen Mol 2015. [DOI: 10.1016/j.remnie.2015.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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12
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Arbizu J, García-Ribas G, Carrió I, Garrastachu P, Martínez-Lage P, Molinuevo JL. Recommendations for the use of PET imaging biomarkers in the diagnosis of neurodegenerative conditions associated with dementia: SEMNIM and SEN consensus. Rev Esp Med Nucl Imagen Mol 2015; 34:303-13. [PMID: 26099942 DOI: 10.1016/j.remn.2015.03.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 03/10/2015] [Indexed: 10/23/2022]
Abstract
The new diagnostic criteria for Alzheimer's disease (AD) acknowledges the interest given to biomarkers to improve the specificity in subjects with dementia and to facilitate an early diagnosis of the pathophysiological process of AD in the prodromal or pre-dementia stage. The current availability of PET imaging biomarkers of synaptic dysfunction (PET-FDG) and beta amyloid deposition using amyloid-PET provides clinicians with the opportunity to apply the new criteria and improve diagnostic accuracy in their clinical practice. Therefore, it seems essential for the scientific societies involved to use the new clinical diagnostic support tools to establish clear, evidence-based and agreed set of recommendations for their appropriate use. The present work includes a systematic review of the literature on the utility of FDG-PET and amyloid-PET for the diagnosis of AD and related neurodegenerative diseases that occur with dementia. Thus, we propose a series of recommendations agreed on by the Spanish Society of Nuclear Medicine and Spanish Society of Neurology as a consensus statement on the appropriate use of PET imaging biomarkers.
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Affiliation(s)
- Javier Arbizu
- Servicio de Medicina Nuclear, Clínica Universidad de Navarra, Pamplona, España.
| | | | - Ignasi Carrió
- Servicio de Medicina Nuclear, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - Puy Garrastachu
- Servicio de Medicina Nuclear, Hospital San Pedro y Centro de Investigación Biomédica de La Rioja (CIBIR), Logroño, España
| | - Pablo Martínez-Lage
- Neurología Fundación CITA-Alzhéimer Fundazioa, Centro de Investigación y Terapias Avanzadas, San Sebastián, España
| | - José Luis Molinuevo
- Unidad de Enfermedad de Alzheimer y Otros Trastornos Cognitivos, Servicio de Neurología, Hospital Clinic i Universitari ICN y Fundación Pasqual Maragall, Barcelona, España
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Brucher N, Mandegaran R, Filleron T, Wagner T. Measurement of inter- and intra-observer variability in the routine clinical interpretation of brain 18-FDG PET-CT. Ann Nucl Med 2014; 29:233-9. [DOI: 10.1007/s12149-014-0932-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 11/16/2014] [Indexed: 01/06/2023]
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Ito K, Shimano Y, Imabayashi E, Nakata Y, Omachi Y, Sato N, Arima K, Matsuda H. Concordance between (99m)Tc-ECD SPECT and 18F-FDG PET interpretations in patients with cognitive disorders diagnosed according to NIA-AA criteria. Int J Geriatr Psychiatry 2014; 29:1079-86. [PMID: 24687634 DOI: 10.1002/gps.4102] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 02/16/2014] [Accepted: 02/20/2014] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The purpose of this study was to clarify the concordance of diagnostic abilities and interobserver agreement between 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) and brain perfusion single photon-emission computed tomography (SPECT) in patients with Alzheimer's disease (AD) who were diagnosed according to the research criteria of the National Institute of Aging-Alzheimer's Association Workshop. METHODS Fifty-five patients with "AD and mild cognitive impairment (MCI)" (n = 40) and "non-AD" (n = 15) were evaluated with 18F-FDG PET and (99m)Tc-ethyl cysteinate dimer (ECD) SPECT during an 8-week period. Three radiologists independently graded the regional uptake in the frontal, temporal, parietal, and occipital lobes as well as the precuneus/posterior cingulate cortex in both images. Kappa values were used to determine the interobserver reliability regarding regional uptake. RESULTS The regions with better interobserver reliability between 18F-FDG PET and (99m)Tc-ECD SPECT were the frontal, parietal, and temporal lobes. The (99m)Tc-ECD SPECT agreement in the occipital lobes was not significant. The frontal, temporal, and parietal lobes showed good correlations between 18F-FDG PET and (99m)Tc-ECD SPECT in the degree of uptake, but the occipital lobe and precuneus/posterior cingulate cortex did not show good correlations. The diagnostic accuracy rates of "AD and MCI" ranged from 60% to 70% in both of the techniques. CONCLUSIONS The degree of uptake on 18F-FDG PET and (99m)Tc-ECD SPECT showed significant correlations in the frontal, temporal, and parietal lobes. The diagnostic abilities of 18F-FDG PET and (99m)Tc-ECD SPECT for "AD and MCI," when diagnosed according to the National Institute of Aging-Alzheimer's Association Workshop criteria, were nearly identical.
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Affiliation(s)
- Kimiteru Ito
- Department of Diagnostic Radiology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
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Davison CM, O'Brien JT. A comparison of FDG-PET and blood flow SPECT in the diagnosis of neurodegenerative dementias: a systematic review. Int J Geriatr Psychiatry 2014; 29:551-61. [PMID: 24123413 DOI: 10.1002/gps.4036] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 09/16/2013] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Perfusion single photon emission computed tomography (SPECT) and 18F fluorodeoxyglucose positron emission tomography (FDG-PET) both have clinical utility for the differential diagnosis of dementia. Although PET is often viewed by some as more accurate and therefore preferential, the extent to which published evidence supports this is not clear. The aim of this review was to address the question by reviewing studies of SPECT and PET imaging in dementia diagnosis, with a particular focus on all published head-to-head studies. DESIGN A MEDLINE search was carried out using the following keywords: "PET" and "SPECT" and "dementia" or "Mild Cognitive Impairment," together with "alzheimers" or "DLB" or "lewy body" or "frontotemporal" or "FTD" or "Picks." Articles were included up to February 2013, limited to human studies and in English language. RESULTS Published studies of SPECT accuracy show that it is a useful tool for differential diagnosis, with sensitivities of 65-85% for diagnosing Alzheimer's disease (AD) and specificities (for other neurodegenerative dementias) of 72-87%. PET studies generally report higher accuracy, with sensitivities of 75-99% for AD and specificities of 71-93%. However, there have been few direct head-to-head comparisons, with some indicating SPECT and PET to be equally useful in dementia diagnosis and others favouring PET. Many of these studies are limited with respect to numbers and methodically with poorly matched control groups. CONCLUSIONS Overall, although studies suggest superiority of PET over SPECT, the evidence base for this is actually quite limited. We suggest that further direct comparative studies, including health economic and patient preference evaluations, are needed to help direct future service provision.
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Fiandaca MS, Mapstone ME, Cheema AK, Federoff HJ. The critical need for defining preclinical biomarkers in Alzheimer's disease. Alzheimers Dement 2014; 10:S196-212. [DOI: 10.1016/j.jalz.2014.04.015] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Massimo S. Fiandaca
- Department of NeurologyGeorgetown University Medical CenterWashingtonDCUSA
- Department of NeuroscienceGeorgetown University Medical CenterWashingtonDCUSA
| | - Mark E. Mapstone
- Department of NeurologyUniversity of Rochester School of MedicineRochesterNYUSA
| | - Amrita K. Cheema
- Department of OncologyGeorgetown University Medical CenterWashingtonDCUSA
- Department of BiochemistryGeorgetown University Medical CenterWashingtonDCUSA
| | - Howard J. Federoff
- Department of NeurologyGeorgetown University Medical CenterWashingtonDCUSA
- Department of NeuroscienceGeorgetown University Medical CenterWashingtonDCUSA
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The diagnosis and evaluation of dementia and mild cognitive impairment with emphasis on SPECT perfusion neuroimaging. CNS Spectr 2012; 17:176-206. [PMID: 22929226 DOI: 10.1017/s1092852912000636] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
As the world population ages, the incidence of dementing illnesses will dramatically increase. The number of people afflicted with dementia is expected to quadruple in the next 50 years. Since the neuropathology of the dementias precedes clinical symptoms often by several years, earlier detection and intervention could be key steps to mitigating the progression and burden of these diseases. This review will explore methods of evaluating, differentiating, and diagnosing the multiple forms of dementia. Particular emphasis will be placed on the diagnosis of mild cognitive impairment-the precursor to dementia. Anatomical imaging; cerebrospinal fluid markers; functional neuroimaging, such as positron emission tomography and single photon emission tomography; and molecular imaging, such as amyloid marker imaging, will be assessed in terms of sensitivity and specificity. Cost will also be a consideration, as the growing population afflicted with dementia represents an increasingly large financial encumbrance to the healthcare systems of every nation. In the face of expensive new markers and limited availability of cyclotrons, single photon emission computer tomography (SPECT) provides relatively high sensitivity and specificity at a comparatively low overall cost.
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Forsberg A, Engler H, Blomquist G, Långström B, Nordberg A. The use of PIB-PET as a dual pathological and functional biomarker in AD. Biochim Biophys Acta Mol Basis Dis 2012; 1822:380-5. [PMID: 22115832 DOI: 10.1016/j.bbadis.2011.11.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Revised: 11/05/2011] [Accepted: 11/07/2011] [Indexed: 10/15/2022]
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Bohnen NI, Djang DSW, Herholz K, Anzai Y, Minoshima S. Effectiveness and safety of 18F-FDG PET in the evaluation of dementia: a review of the recent literature. J Nucl Med 2011; 53:59-71. [PMID: 22173840 DOI: 10.2967/jnumed.111.096578] [Citation(s) in RCA: 189] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Imaging that can detect pathophysiologic change in the brain holds great promise for diagnostic assessment of patients with Alzheimer disease (AD) and dementia. Although a previous metaanalysis centering on literature from 1990 to 2000 showed a summary accuracy of 86% for (18)F-FDG PET for AD diagnosis, the clinical value was considered uncertain because of methodologic shortcomings. Review of the recent literature since 2000 demonstrates that the evidence for (18)F-FDG PET in assessment of dementia has increased with new studies that include autopsy confirmation, wide-diagnostic-spectrum recruitment in primary care settings, historical and prospective cohort studies, and multicenter data analyses. These data support the role of (18)F-FDG PET as an effective and useful adjunct to other diagnostic information in the assessment of patients with symptoms of dementia. Findings are in line with recently revised diagnostic criteria of AD that for the first time recognize the unique role of biomarker evidence in disease definition.
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Affiliation(s)
- Nicolaas I Bohnen
- Department of Radiology, University of Michigan, Ann Arbor, Michigan 48109-0028, USA.
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Pascual B, Prieto E, Arbizu J, Marti-Climent J, Olier J, Masdeu JC. Brain Glucose Metabolism in Vascular White Matter Disease With Dementia. Stroke 2010; 41:2889-93. [DOI: 10.1161/strokeaha.110.591552] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
The boundary between vascular dementia and Alzheimer disease (AD) continues to be unclear. Some posit that gradually progressive vascular dementia, as with small vessel disease, is simply vascular disease plus AD. Because AD presents a characteristic pattern on fluorodeoxyglucose positron emission tomography, we sought to determine whether the fluorodeoxyglucose pattern of vascular dementia resembled more AD or the pattern in nondemented patients with severe microvascular brain disease.
Methods—
Vascular disease patients were selected on the basis of confluent white matter lesions on both hemispheres. Among them, with a similar degree of vascular disease on MRI, neuropsychological testing separated groups with dementia and without dementia. Patients with AD and healthy controls were also studied. The 4 groups, with 12 subjects each, were matched by age, gender, and educational level. Fluorodeoxyglucose distribution was analyzed using both voxel-based and volume of interest methods.
Results—
The AD group had the characteristic pattern of bilaterally decreased metabolism in parieto-temporal association cortex and precuneus. By contrast, patients with vascular disease and dementia had a similar anatomic pattern to that of the vascular patients without dementia, but with greater metabolic abnormalities, particularly in the frontal lobes and deep nuclei.
Conclusions—
The anatomy of metabolic abnormalities in vascular disease with dementia suggests that, at least in some cases, dementia with vascular disease may be independent of AD. The metabolic abnormality involves the thalamus, caudate, and frontal lobe, a pattern concordant with the neuropsychological findings of impaired executive function characteristic of vascular dementia.
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Affiliation(s)
- Belen Pascual
- From the Neuroscience Division (B.P., J.C.M.), Center for Applied Medical Research, University of Navarra, Pamplona, Spain; CIBERNED (B.P., E.P., J.A., J.M.-C., J.C.M.), Pamplona, Spain; Department of Nuclear Medicine (E.P., J.A., J.O.), University of Navarra, Pamplona, Spain and Department of Radiology (J.O.), Hospital de Navarra, Pamplona, Spain
| | - Elena Prieto
- From the Neuroscience Division (B.P., J.C.M.), Center for Applied Medical Research, University of Navarra, Pamplona, Spain; CIBERNED (B.P., E.P., J.A., J.M.-C., J.C.M.), Pamplona, Spain; Department of Nuclear Medicine (E.P., J.A., J.O.), University of Navarra, Pamplona, Spain and Department of Radiology (J.O.), Hospital de Navarra, Pamplona, Spain
| | - Javier Arbizu
- From the Neuroscience Division (B.P., J.C.M.), Center for Applied Medical Research, University of Navarra, Pamplona, Spain; CIBERNED (B.P., E.P., J.A., J.M.-C., J.C.M.), Pamplona, Spain; Department of Nuclear Medicine (E.P., J.A., J.O.), University of Navarra, Pamplona, Spain and Department of Radiology (J.O.), Hospital de Navarra, Pamplona, Spain
| | - Josep Marti-Climent
- From the Neuroscience Division (B.P., J.C.M.), Center for Applied Medical Research, University of Navarra, Pamplona, Spain; CIBERNED (B.P., E.P., J.A., J.M.-C., J.C.M.), Pamplona, Spain; Department of Nuclear Medicine (E.P., J.A., J.O.), University of Navarra, Pamplona, Spain and Department of Radiology (J.O.), Hospital de Navarra, Pamplona, Spain
| | - Jorge Olier
- From the Neuroscience Division (B.P., J.C.M.), Center for Applied Medical Research, University of Navarra, Pamplona, Spain; CIBERNED (B.P., E.P., J.A., J.M.-C., J.C.M.), Pamplona, Spain; Department of Nuclear Medicine (E.P., J.A., J.O.), University of Navarra, Pamplona, Spain and Department of Radiology (J.O.), Hospital de Navarra, Pamplona, Spain
| | - Joseph C. Masdeu
- From the Neuroscience Division (B.P., J.C.M.), Center for Applied Medical Research, University of Navarra, Pamplona, Spain; CIBERNED (B.P., E.P., J.A., J.M.-C., J.C.M.), Pamplona, Spain; Department of Nuclear Medicine (E.P., J.A., J.O.), University of Navarra, Pamplona, Spain and Department of Radiology (J.O.), Hospital de Navarra, Pamplona, Spain
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Hampel H, Broich K, Hoessler Y, Pantel J. Biological markers for early detection and pharmacological treatment of Alzheimer's disease. DIALOGUES IN CLINICAL NEUROSCIENCE 2009. [PMID: 19585950 PMCID: PMC3181918 DOI: 10.31887/dcns.2009.11.2/hhampel] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The introduction of biological markers in the clinical management of Alzheimer's disease (AD) will not only improve diagnosis relating to early detection of neuropathology with underlying molecular mechanisms, but also provides tools for the assessment of objective treatment benefits. In this review, we identify a number of in vivo neurochemistry and neuroimaging techniques, which can reliably assess aspects of physiology, pathology, chemistry, and neuroanatomy of AD, and hold promise as meaningful biomarkers in the early diagnostic process, as well as for the tracking of disease-modifying pharmacological effects. These neurobiological measures appear to relate closely to pathophysiological, neuropathological, and clinical data, such as hyperphosphorylation of tau, abeta metabolism, lipid peroxidation, pattern and rate of atrophy, loss of neuronal integrity, and functional and cognitive decline, as well as risk of future decline. As a perspective, the important role of biomarkers in the development of innovative drug treatments for AD and the related regulatory process is discussed.
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Affiliation(s)
- Harald Hampel
- Department of Psychiatry, Ludwig-Maximilian University Munich, Alzheimer Memorial Center, Munich, Germany.
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22
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Panegyres PK, Rogers JM, McCarthy M, Campbell A, Wu JS. Fluorodeoxyglucose-positron emission tomography in the differential diagnosis of early-onset dementia: a prospective, community-based study. BMC Neurol 2009; 9:41. [PMID: 19674446 PMCID: PMC2736156 DOI: 10.1186/1471-2377-9-41] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2008] [Accepted: 08/12/2009] [Indexed: 11/25/2022] Open
Abstract
Background The aim of this study was to evaluate the diagnostic accuracy of positron emission tomography (PET) using F18 fluorodeoxyglucose (FDG) in the differential diagnosis of early-onset Alzheimer's disease (AD) and other dementias in a community-dwelling population. Methods A prospective sample of 102 individuals presenting consecutively to a primary care centre for examination of suspected early-onset dementing diseases. The mean age of symptom onset of dementia in our patients was 60.06 ± 4.28 years (mean ± 1SD, 95% lower confidence intervals (CI) 54.75, upper 63.37). Patients were evaluated using standard clinical criteria for the diagnosis of dementia. Functional neuroimaging data was obtained and nuclear medicine physicians blind to the clinical diagnosis generated FDG-PET diagnoses. Final clinical diagnoses based on all available data were then established and compared against PET diagnoses. Results Forty-nine patients received a final clinical diagnosis of early-stage AD (MMSE score 20.97 ± 5.10). There were 29 non-AD demented patients, 11 depressed patients and a miscellaneous group of 13 patients. Among patients with AD, the sensitivity and specificity of FDG-PET was 78% (95% CI: 66–90%) and 81% (95% CI: 68–86%), respectively. The positive likelihood ratio (PLR) for a FDG-PET scan positive for the diagnosis of AD was 4.11 (95% CI: 2.29–7.32) and negative likelihood ratio (NLR) for a negative FDG-PET scan in the absence of AD was 0.27 (95% CI: 0.16–0.46). The pre-test probability was 48% and post-test probability was 79.02%. The specificity of FDG-PET in the differential diagnosis of other dementias, including frontotemporal dementia, was greater than 95%. Recruitment methods in this study provide a sample that may be more representative of patients in the general population and indicate that FDG-PET imaging can contribute to the diagnosis of AD in younger adults with major increases in the positive likelihood rates and post-test probability. Conclusion The high specificity of FDG-PET suggests this technique might help in the diagnosis of frontotemporal dementia and other forms of early-onset dementia.
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Affiliation(s)
- Peter K Panegyres
- Neurodegenerative Disorders Research, 185 York St, Subiaco WA, Australia.
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23
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Ceravolo R, Borghetti D, Kiferle L, Tognoni G, Giorgetti A, Neglia D, Sassi N, Frosini D, Rossi C, Petrozzi L, Siciliano G, Murri L. CSF phosporylated TAU protein levels correlate with cerebral glucose metabolism assessed with PET in Alzheimer's disease. Brain Res Bull 2008; 76:80-4. [PMID: 18395614 DOI: 10.1016/j.brainresbull.2008.01.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2007] [Revised: 11/20/2007] [Accepted: 01/15/2008] [Indexed: 11/19/2022]
Abstract
One major goal of drug development would be the establishment of biomarkers as objective indicators of normal biological and pathogenetic processes, or pharmacological response to a therapeutic intervention. A potential approach is to investigate proteins in CSF linked to key neuropathological features of Alzheimer's disease (AD). Recently CSF phosphorylated-Tau (p-Tau) levels have been reported to reflect neurofibrillary changes within the brain of patients with AD, however the use of serial CSF investigations in order to monitor the disease progression is not applicable. PET with FDG reveals characteristic patterns in AD patients, however so far no correlation between in vivo metabolic information and pathological features has been reported. In the present study, we tested whether CSF Tau levels correlate with metabolic rate for glucose consumption in a cohort of 28 AD patients. We found a statistically significative correlation between both CSF total and p-TAU protein and relative metabolic indexes obtained from 18FDG-PET scans in parietal, temporal and occipital lobes bilaterally. These results indicate the existence of a correlation between impairment of cerebral metabolism, estimated throughout FDG-PET, and CSF Tau protein levels.
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Affiliation(s)
- R Ceravolo
- Department of Neuroscience, University of Pisa, Via Roma 67, 56126 Pisa, Italy
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Nihashi T, Yatsuya H, Hayasaka K, Kato R, Kawatsu S, Arahata Y, Iwai K, Takeda A, Washimi Y, Yoshimura K, Mizuno K, Kato T, Naganawa S, Ito K. Direct comparison study between FDG-PET and IMP-SPECT for diagnosing Alzheimer's disease using 3D-SSP analysis in the same patients. ACTA ACUST UNITED AC 2007; 25:255-62. [PMID: 17634878 DOI: 10.1007/s11604-007-0132-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2006] [Accepted: 02/23/2007] [Indexed: 11/24/2022]
Abstract
PURPOSE The purpose of this study was to evaluate and compare the diagnostic ability of 2-[(18)F]-fluoro-2-deoxy-D: -glucose (FDG) positron emission tomography (PET) and N-isopropyl-p-(123)I iodoamphetamine single photon emission computed tomography (IMP-SPECT) using three-dimensional stereotactic surface projections (3D-SSP) in patients with moderate Alzheimer's disease (AD). MATERIALS AND METHODS FDG-PET and IMP-SPECT were performed within 3 months in 14 patients with probable moderate AD. Z-score maps of FDG-PET and IMP-SPECT images of a patient were obtained by comparison with data obtained from control subjects. Four expert physicians evaluated and graded the glucose hypometabolism and regional cerebral blood flow (rCBF), focusing in particular on the posterior cingulate gyri/precunei and parietotemporal regions, and determined the reliability for AD. Receiver operating characteristic (ROC) curves were applied to the results for clarification. To evaluate the correlation between two modalities, the regions of interest (ROIs) were set in the posterior cingulate gyri/precunei and parietotemporal region on 3D-SSP images, and mean Z-values were calculated. CONCLUSION No significant difference was observed in the area under the ROC curve (AUC) between FDG-PET and IMP-SPECT images (FDG-PET 0.95, IMP-SPECT 0.94). However, a significant difference (P < 0.05) was observed in the AUC for the posterior cingulate gyri/precuneus (FDG-PET 0.94, IMP-SPECT 0.81). The sensitivity and specificity of each modality were 86%, and 97% for FDG-PET and 70% and 100% for IMP-SPECT. We could find no significant difference between FDG-PET and IMP-SPECT in terms of diagnosing moderate AD using 3D-SSP. There was a high correlation between the two modalities in the parietotemporal region (Spearman's r = 0.82, P < 0.001). The correlation in the posterior cingulate gyri/precunei region was lower than that in the parietotemporal region (Spearman's r = 0.63, P < 0.016).
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Affiliation(s)
- Takashi Nihashi
- Department of Radiology, National Center for Geriatrics and Gerontology, 36-3 Gengo, Morioka-Cho, Ohbu, 474-8522, Japan.
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Rentz DM, Sardinha LM, Huh TJ, Searl MM, Daffner KR, Sperling RA. IQ-based norms for highly intelligent adults. Clin Neuropsychol 2006; 20:637-48. [PMID: 16980251 DOI: 10.1080/13854040500477498] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study presents normative data of commonly used neuropsychological tests administered to 75 individuals with high levels of intelligence (estimated IQ > or = 120). Participants were living independently in the community with ages ranging from 44 to 86. To avoid including individuals with an incipient dementia, we selected subjects who scored within the normal range on all cognitive tests for at least a two-year period. The norms are presented in table format to help clinicians easily identify a typical cognitive performance in highly intelligent individuals and to provide a useful guide for detecting abnormal cognitive decline in individuals at risk for progressive dementia.
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Affiliation(s)
- Dorene M Rentz
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
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Pupi A, Nobili FM. PET is better than perfusion SPECT for early diagnosis of Alzheimer's disease -- against. Eur J Nucl Med Mol Imaging 2006; 32:1466-72. [PMID: 16283180 DOI: 10.1007/s00259-005-1937-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Alberto Pupi
- Clinical Pathophysiology Department, University of Florence, Italy.
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Ishii K, Minoshima S. PET is better than perfusion SPECT for early diagnosis of Alzheimer’s disease. Eur J Nucl Med Mol Imaging 2005; 32:1463-5. [PMID: 16283181 DOI: 10.1007/s00259-005-1936-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Kazunari Ishii
- Department of Radiology and Nuclear Medicine, Hyogo Brain and Heart Center, 520 Saisho-Ko, Himeji, Hyogo 670-0981, Japan.
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