1
|
Zhang M, Meng H, Zhou Q, Chunyu H, He L, Meng H, Wang H, Wang Y, Sun C, Xi Y, Hai W, Huang Q, Li B, Chen S. Microglial Activation Imaging Using 18F-DPA-714 PET/MRI for Detecting Autoimmune Encephalitis. Radiology 2024; 310:e230397. [PMID: 38441089 DOI: 10.1148/radiol.230397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
Background Translocator protein (TSPO) PET has been used to visualize microglial activation in neuroinflammation and is a potential imaging tool for detecting autoimmune encephalitis (AIE). Purpose To compare the detection rate between TSPO radioligand fluorine 18 (18F) DPA-714 PET and conventional MRI and assess the relationship between 18F-DPA-714 uptake and clinical features in participants with AIE. Materials and Methods Healthy volunteers and patients with AIE were enrolled in this prospective study between December 2021 and April 2023. All participants underwent hybrid brain 18F-DPA-714 PET/MRI and antibody testing. Modified Rankin scale scoring and AIE-related symptoms were assessed in participants with AIE. Positive findings were defined as intensity of 18F-DPA-714 uptake above a threshold of the mean standardized uptake value ratio (SUVR) plus 2 SD inside the corresponding brain regions of healthy controls. The McNemar test was used to compare the positive detection rate between the two imaging modalities; the independent samples t test was used to compare continuous variables; and correlation with Bonferroni correction was used to assess the relationship between 18F-DPA-714 uptake and clinical features. Results A total of 25 participants with AIE (mean age, 39.24 years ± 19.03 [SD]) and 10 healthy controls (mean age, 28.70 years ± 5.14) were included. The positive detection rate of AIE was 72% (18 of 25) using 18F-DPA-714 PET compared to 44% (11 of 25) using conventional MRI, but the difference was not statistically significant (P = .065). Participants experiencing seizures exhibited significantly higher mean SUVR in the entire cortical region than those without seizures (1.23 ± 0.21 vs 1.15 ± 0.18; P = .003). Of the 13 participants with AIE who underwent follow-up PET/MRI, 11 (85%) demonstrated reduced uptake of 18F-DPA-714 accompanied by relief of symptoms after immunosuppressive treatment. Conclusion 18F-DPA-714 PET has potential value in supplementing MRI for AIE detection. Clinical trial registration no. NCT05293405 © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Zaharchuk in this issue.
Collapse
Affiliation(s)
- Min Zhang
- From the Departments of Nuclear Medicine (M.Z., H.C., Hongping Meng, Y.W., C.S., Y.X., W.H., B.L.) and Neurology (Huanyu Meng, Q.Z., L.H., S.C.), Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Rd, Shanghai, China; Shanxi Medical University-Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Taiyuan, China (M.Z., B.L.); School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China (H.W., Q.H.); and Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, China (S.C.)
| | - Huanyu Meng
- From the Departments of Nuclear Medicine (M.Z., H.C., Hongping Meng, Y.W., C.S., Y.X., W.H., B.L.) and Neurology (Huanyu Meng, Q.Z., L.H., S.C.), Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Rd, Shanghai, China; Shanxi Medical University-Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Taiyuan, China (M.Z., B.L.); School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China (H.W., Q.H.); and Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, China (S.C.)
| | - Qinming Zhou
- From the Departments of Nuclear Medicine (M.Z., H.C., Hongping Meng, Y.W., C.S., Y.X., W.H., B.L.) and Neurology (Huanyu Meng, Q.Z., L.H., S.C.), Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Rd, Shanghai, China; Shanxi Medical University-Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Taiyuan, China (M.Z., B.L.); School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China (H.W., Q.H.); and Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, China (S.C.)
| | - Hangxing Chunyu
- From the Departments of Nuclear Medicine (M.Z., H.C., Hongping Meng, Y.W., C.S., Y.X., W.H., B.L.) and Neurology (Huanyu Meng, Q.Z., L.H., S.C.), Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Rd, Shanghai, China; Shanxi Medical University-Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Taiyuan, China (M.Z., B.L.); School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China (H.W., Q.H.); and Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, China (S.C.)
| | - Lu He
- From the Departments of Nuclear Medicine (M.Z., H.C., Hongping Meng, Y.W., C.S., Y.X., W.H., B.L.) and Neurology (Huanyu Meng, Q.Z., L.H., S.C.), Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Rd, Shanghai, China; Shanxi Medical University-Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Taiyuan, China (M.Z., B.L.); School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China (H.W., Q.H.); and Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, China (S.C.)
| | - Hongping Meng
- From the Departments of Nuclear Medicine (M.Z., H.C., Hongping Meng, Y.W., C.S., Y.X., W.H., B.L.) and Neurology (Huanyu Meng, Q.Z., L.H., S.C.), Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Rd, Shanghai, China; Shanxi Medical University-Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Taiyuan, China (M.Z., B.L.); School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China (H.W., Q.H.); and Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, China (S.C.)
| | - Hanzhong Wang
- From the Departments of Nuclear Medicine (M.Z., H.C., Hongping Meng, Y.W., C.S., Y.X., W.H., B.L.) and Neurology (Huanyu Meng, Q.Z., L.H., S.C.), Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Rd, Shanghai, China; Shanxi Medical University-Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Taiyuan, China (M.Z., B.L.); School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China (H.W., Q.H.); and Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, China (S.C.)
| | - Yue Wang
- From the Departments of Nuclear Medicine (M.Z., H.C., Hongping Meng, Y.W., C.S., Y.X., W.H., B.L.) and Neurology (Huanyu Meng, Q.Z., L.H., S.C.), Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Rd, Shanghai, China; Shanxi Medical University-Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Taiyuan, China (M.Z., B.L.); School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China (H.W., Q.H.); and Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, China (S.C.)
| | - Chenwei Sun
- From the Departments of Nuclear Medicine (M.Z., H.C., Hongping Meng, Y.W., C.S., Y.X., W.H., B.L.) and Neurology (Huanyu Meng, Q.Z., L.H., S.C.), Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Rd, Shanghai, China; Shanxi Medical University-Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Taiyuan, China (M.Z., B.L.); School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China (H.W., Q.H.); and Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, China (S.C.)
| | - Yun Xi
- From the Departments of Nuclear Medicine (M.Z., H.C., Hongping Meng, Y.W., C.S., Y.X., W.H., B.L.) and Neurology (Huanyu Meng, Q.Z., L.H., S.C.), Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Rd, Shanghai, China; Shanxi Medical University-Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Taiyuan, China (M.Z., B.L.); School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China (H.W., Q.H.); and Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, China (S.C.)
| | - Wangxi Hai
- From the Departments of Nuclear Medicine (M.Z., H.C., Hongping Meng, Y.W., C.S., Y.X., W.H., B.L.) and Neurology (Huanyu Meng, Q.Z., L.H., S.C.), Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Rd, Shanghai, China; Shanxi Medical University-Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Taiyuan, China (M.Z., B.L.); School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China (H.W., Q.H.); and Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, China (S.C.)
| | - Qiu Huang
- From the Departments of Nuclear Medicine (M.Z., H.C., Hongping Meng, Y.W., C.S., Y.X., W.H., B.L.) and Neurology (Huanyu Meng, Q.Z., L.H., S.C.), Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Rd, Shanghai, China; Shanxi Medical University-Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Taiyuan, China (M.Z., B.L.); School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China (H.W., Q.H.); and Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, China (S.C.)
| | - Biao Li
- From the Departments of Nuclear Medicine (M.Z., H.C., Hongping Meng, Y.W., C.S., Y.X., W.H., B.L.) and Neurology (Huanyu Meng, Q.Z., L.H., S.C.), Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Rd, Shanghai, China; Shanxi Medical University-Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Taiyuan, China (M.Z., B.L.); School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China (H.W., Q.H.); and Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, China (S.C.)
| | - Sheng Chen
- From the Departments of Nuclear Medicine (M.Z., H.C., Hongping Meng, Y.W., C.S., Y.X., W.H., B.L.) and Neurology (Huanyu Meng, Q.Z., L.H., S.C.), Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Rd, Shanghai, China; Shanxi Medical University-Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Taiyuan, China (M.Z., B.L.); School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China (H.W., Q.H.); and Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, China (S.C.)
| |
Collapse
|
2
|
Cousins O, Schubert JJ, Chandra A, Veronese M, Valkimadi P, Creese B, Khan Z, Arathimos R, Hampshire A, Rosenzweig I, Ballard C, Corbett A, Aasland D, Velayudhan L, O'Neill M, Collier D, Awais R, Sander K, Årstad E, Howes O, Turkheimer F, Hodges A. Microglial activation, tau and amyloid deposition in TREM2 p.R47H carriers and mild cognitive impairment patients: a multi-modal/multi-tracer PET/MRI imaging study with influenza vaccine immune challenge. J Neuroinflammation 2023; 20:272. [PMID: 37990275 PMCID: PMC10664604 DOI: 10.1186/s12974-023-02945-0] [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: 03/21/2023] [Accepted: 10/31/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Microglia are increasingly understood to play an important role in the pathogenesis of Alzheimer's disease. The rs75932628 (p.R47H) TREM2 variant is a well-established risk factor for Alzheimer's disease. TREM2 is a microglial cell surface receptor. In this multi-modal/multi-tracer PET/MRI study we investigated the effect of TREM2 p.R47H carrier status on microglial activation, tau and amyloid deposition, brain structure and cognitive profile. METHODS We compared TREM2 p.R47H carriers (n = 8; median age = 62.3) and participants with mild cognitive impairment (n = 8; median age = 70.7). Participants underwent two [18F]DPA-714 PET/MRI scans to assess TSPO signal, indicative of microglial activation, before and after receiving the seasonal influenza vaccination, which was used as an immune stimulant. Participants also underwent [18F]florbetapir and [18F]AV1451 PET scans to assess amyloid and tau burden, respectively. Regional tau and TSPO signal were calculated for regions of interest linked to Braak stage. An additional comparison imaging healthy control group (n = 8; median age = 45.5) had a single [18F]DPA-714 PET/MRI. An expanded group of participants underwent neuropsychological testing, to determine if TREM2 status influenced clinical phenotype. RESULTS Compared to participants with mild cognitive impairment, TREM2 carriers had lower TSPO signal in Braak II (P = 0.04) and Braak III (P = 0.046) regions, despite having a similar burden of tau and amyloid. There were trends to suggest reduced microglial activation following influenza vaccine in TREM2 carriers. Tau deposition in the Braak VI region was higher in TREM2 carriers (P = 0.04). Furthermore, compared to healthy controls TREM2 carriers had smaller caudate (P = 0.02), total brain (P = 0.049) and white matter volumes (P = 0.02); and neuropsychological assessment revealed worse ADAS-Cog13 (P = 0.03) and Delayed Matching to Sample (P = 0.007) scores. CONCLUSIONS TREM2 p.R47H carriers had reduced levels of microglial activation in brain regions affected early in the Alzheimer's disease course and differences in brain structure and cognition. Changes in microglial response may underlie the increased Alzheimer's disease risk in TREM2 p.R47H carriers. Future therapeutic agents in Alzheimer's disease should aim to enhance protective microglial actions.
Collapse
Affiliation(s)
- Oliver Cousins
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RT, UK
| | - Julia J Schubert
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RT, UK
| | - Avinash Chandra
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RT, UK
| | - Mattia Veronese
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RT, UK
- Department of Information Engineering, University of Padua, 35131, Padua, Italy
| | - Polena Valkimadi
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RT, UK
| | - Byron Creese
- College of Medicine and Health, University of Exeter, Exeter, EX1 2HZ, UK
- Division of Psychology, Department of Life Sciences, Brunel University London, London, UB8 3PH, UK
| | - Zunera Khan
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RT, UK
| | - Ryan Arathimos
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RT, UK
| | - Adam Hampshire
- Faculty of Medicine, Imperial College London, London, SW7 2AZ, UK
| | - Ivana Rosenzweig
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RT, UK
| | - Clive Ballard
- College of Medicine and Health, University of Exeter, Exeter, EX1 2HZ, UK
| | - Anne Corbett
- College of Medicine and Health, University of Exeter, Exeter, EX1 2HZ, UK
| | - Dag Aasland
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RT, UK
| | - Latha Velayudhan
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RT, UK
| | | | | | - Ramla Awais
- Centre for Radiopharmaceutical Chemistry, University College London, London, WC1E 6BS, UK
| | - Kerstin Sander
- Centre for Radiopharmaceutical Chemistry, University College London, London, WC1E 6BS, UK
| | - Erik Årstad
- Centre for Radiopharmaceutical Chemistry, University College London, London, WC1E 6BS, UK
| | - Oliver Howes
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RT, UK
| | - Federico Turkheimer
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RT, UK
| | - Angela Hodges
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RT, UK.
| |
Collapse
|
3
|
Cheval M, Rodrigo S, Taussig D, Caillé F, Petrescu AM, Bottlaender M, Tournier N, Besson FL, Leroy C, Bouilleret V. [ 18F]DPA-714 PET Imaging in the Presurgical Evaluation of Patients With Drug-Resistant Focal Epilepsy. Neurology 2023; 101:e1893-e1904. [PMID: 37748889 PMCID: PMC10663012 DOI: 10.1212/wnl.0000000000207811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 07/17/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Translocator protein 18 kDa (TSPO) PET imaging is used to monitor glial activation. Recent studies have proposed TSPO PET as a marker of the epileptogenic zone (EZ) in drug-resistant focal epilepsy (DRFE). This study aims to assess the contributions of TSPO imaging using [18F]DPA-714 PET and [18F]FDG PET for localizing the EZ during presurgical assessment of DRFE, when phase 1 presurgical assessment does not provide enough information. METHODS We compared [18F]FDG and [18F]DPA-714 PET images of 23 patients who had undergone a phase 1 presurgical assessment, using qualitative visual analysis and quantitative analysis, at both the voxel and the regional levels. PET abnormalities (increase in binding for [18F]DPA-714 vs decrease in binding for [18F]FDG) were compared with clinical hypotheses concerning the localization of the EZ based on phase 1 presurgical assessment. The additional value of [18F]DPA-714 PET imaging to [18F]FDG for refining the localization of the EZ was assessed. To strengthen the visual analysis, [18F]DPA-714 PET imaging was also reviewed by 2 experienced clinicians blind to the EZ location. RESULTS The study included 23 patients. Visual analysis of [18F]DPA-714 PET was significantly more accurate than [18F]FDG PET to both, show anomalies (95.7% vs 56.5%, p = 0.022), and provide additional information to refine the EZ localization (65.2% vs 17.4%, p = 0.019). All 10 patients with normal [18F]FDG PET had anomalies when using [18F]DPA-714 PET. The additional value of [18F]DPA-714 PET seemed to be greater in patients with normal brain MRI or with neocortical EZ (especially if insula is involved). Regional analysis of [18F]DPA-714 and [18F]FDG PET provided similar results. However, using voxel-wise analysis, [18F]DPA-714 was more effective than [18F]FDG for unveiling clusters whose localization was more often consistent with the EZ hypothesis (87.0% vs 39.1%, p = 0.019). Nonrelevant bindings were seen in 14 of 23 patients in visual analysis and 9 patients of 23 patients in voxel-wise analysis. DISCUSSION [18F]DPA-714 PET imaging provides valuable information for presurgical assessments of patients with DRFE. TSPO PET could become an additional tool to help to the localization of the EZ, especially in patients with negative [18F]FDG PET. TRIAL REGISTRATION INFORMATION Eudract 2017-003381-27. Inclusion of the first patient: September 24, 2018. CLASSIFICATION OF EVIDENCE This study provides Class IV evidence on the utility of [18F]DPA-714 PET compared with [18F]FDG PET in identifying the epileptic zone in patients undergoing phase 1 presurgical evaluation for intractable epilepsy.
Collapse
Affiliation(s)
- Margaux Cheval
- From the Université Paris-Saclay (M.C., C.L., M.B., N.T.); BioMAPS (S.R., F.C., F.L.B.); Bicetre University Hospital (D.T., A.M.P.), Paris; and Imagerie Moléculaire In Vivo (V.B.), SHFJ, CEA, Orsay, France.
| | - Sebastian Rodrigo
- From the Université Paris-Saclay (M.C., C.L., M.B., N.T.); BioMAPS (S.R., F.C., F.L.B.); Bicetre University Hospital (D.T., A.M.P.), Paris; and Imagerie Moléculaire In Vivo (V.B.), SHFJ, CEA, Orsay, France
| | - Delphine Taussig
- From the Université Paris-Saclay (M.C., C.L., M.B., N.T.); BioMAPS (S.R., F.C., F.L.B.); Bicetre University Hospital (D.T., A.M.P.), Paris; and Imagerie Moléculaire In Vivo (V.B.), SHFJ, CEA, Orsay, France
| | - Fabien Caillé
- From the Université Paris-Saclay (M.C., C.L., M.B., N.T.); BioMAPS (S.R., F.C., F.L.B.); Bicetre University Hospital (D.T., A.M.P.), Paris; and Imagerie Moléculaire In Vivo (V.B.), SHFJ, CEA, Orsay, France
| | - Ana Maria Petrescu
- From the Université Paris-Saclay (M.C., C.L., M.B., N.T.); BioMAPS (S.R., F.C., F.L.B.); Bicetre University Hospital (D.T., A.M.P.), Paris; and Imagerie Moléculaire In Vivo (V.B.), SHFJ, CEA, Orsay, France
| | - Michel Bottlaender
- From the Université Paris-Saclay (M.C., C.L., M.B., N.T.); BioMAPS (S.R., F.C., F.L.B.); Bicetre University Hospital (D.T., A.M.P.), Paris; and Imagerie Moléculaire In Vivo (V.B.), SHFJ, CEA, Orsay, France
| | - Nicolas Tournier
- From the Université Paris-Saclay (M.C., C.L., M.B., N.T.); BioMAPS (S.R., F.C., F.L.B.); Bicetre University Hospital (D.T., A.M.P.), Paris; and Imagerie Moléculaire In Vivo (V.B.), SHFJ, CEA, Orsay, France
| | - Florent L Besson
- From the Université Paris-Saclay (M.C., C.L., M.B., N.T.); BioMAPS (S.R., F.C., F.L.B.); Bicetre University Hospital (D.T., A.M.P.), Paris; and Imagerie Moléculaire In Vivo (V.B.), SHFJ, CEA, Orsay, France
| | - Claire Leroy
- From the Université Paris-Saclay (M.C., C.L., M.B., N.T.); BioMAPS (S.R., F.C., F.L.B.); Bicetre University Hospital (D.T., A.M.P.), Paris; and Imagerie Moléculaire In Vivo (V.B.), SHFJ, CEA, Orsay, France
| | - Viviane Bouilleret
- From the Université Paris-Saclay (M.C., C.L., M.B., N.T.); BioMAPS (S.R., F.C., F.L.B.); Bicetre University Hospital (D.T., A.M.P.), Paris; and Imagerie Moléculaire In Vivo (V.B.), SHFJ, CEA, Orsay, France
| |
Collapse
|
4
|
Gallus M, Roll W, Dik A, Barca C, Zinnhardt B, Hicking G, Mueller C, Naik VN, Anstötz M, Krämer J, Rolfes L, Wachsmuth L, Pitsch J, van Loo KM, Räuber S, Okada H, Wimberley C, Strippel C, Golombeck KS, Johnen A, Kovac S, Groß CC, Backhaus P, Seifert R, Lewerenz J, Surges R, Elger CE, Wiendl H, Ruck T, Becker AJ, Faber C, Jacobs AH, Bauer J, Meuth SG, Schäfers M, Melzer N. Translational imaging of TSPO reveals pronounced innate inflammation in human and murine CD8 T cell-mediated limbic encephalitis. SCIENCE ADVANCES 2023; 9:eabq7595. [PMID: 37294768 PMCID: PMC10256169 DOI: 10.1126/sciadv.abq7595] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 05/08/2023] [Indexed: 06/11/2023]
Abstract
Autoimmune limbic encephalitis (ALE) presents with new-onset mesial temporal lobe seizures, progressive memory disturbance, and other behavioral and cognitive changes. CD8 T cells are considered to play a key role in those cases where autoantibodies (ABs) target intracellular antigens or no ABs were found. Assessment of such patients presents a clinical challenge, and novel noninvasive imaging biomarkers are urgently needed. Here, we demonstrate that visualization of the translocator protein (TSPO) with [18F]DPA-714-PET-MRI reveals pronounced microglia activation and reactive gliosis in the hippocampus and amygdala of patients suspected with CD8 T cell ALE, which correlates with FLAIR-MRI and EEG alterations. Back-translation into a preclinical mouse model of neuronal antigen-specific CD8 T cell-mediated ALE allowed us to corroborate our preliminary clinical findings. These translational data underline the potential of [18F]DPA-714-PET-MRI as a clinical molecular imaging method for the direct assessment of innate immunity in CD8 T cell-mediated ALE.
Collapse
Affiliation(s)
- Marco Gallus
- Department of Neurology Institute of Translational Neurology, University of Münster, Münster, Germany
- Department of Neurosurgery, University of Münster, Münster, Germany
- Department of Neurosurgery, University of California, San Francisco, San Francisco, CA, USA
| | - Wolfgang Roll
- Department of Nuclear Medicine, University of Münster, Münster, Germany
| | - Andre Dik
- Department of Neurology Institute of Translational Neurology, University of Münster, Münster, Germany
- Department of Neurology, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
| | - Cristina Barca
- European Institute for Molecular Imaging, University of Münster, Münster, Germany
| | - Bastian Zinnhardt
- European Institute for Molecular Imaging, University of Münster, Münster, Germany
- Biomarkers and Translational Technologies (BTT), Pharma Research and Early Development (pRED), F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Gordon Hicking
- Department of Neurology Institute of Translational Neurology, University of Münster, Münster, Germany
| | - Christoph Mueller
- Department of Neurology Institute of Translational Neurology, University of Münster, Münster, Germany
| | - Venu Narayanan Naik
- Department of Neurology Institute of Translational Neurology, University of Münster, Münster, Germany
| | - Max Anstötz
- Institute of Anatomy II, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
| | - Julia Krämer
- Department of Neurology Institute of Translational Neurology, University of Münster, Münster, Germany
| | - Leoni Rolfes
- Department of Neurology Institute of Translational Neurology, University of Münster, Münster, Germany
- Department of Neurology, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
| | - Lydia Wachsmuth
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - Julika Pitsch
- Department of Epileptology, University of Bonn, Bonn, Germany
| | - Karen M. J. van Loo
- Section for Translational Epilepsy Research, Department of Neuropathology, University of Bonn, Bonn, Germany
- Department of Epileptology and Neurology, RWTH Aachen University, Aachen, Germany
| | - Saskia Räuber
- Department of Neurology Institute of Translational Neurology, University of Münster, Münster, Germany
- Department of Neurology, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
| | - Hideho Okada
- Department of Neurosurgery, University of California, San Francisco, San Francisco, CA, USA
| | | | - Christine Strippel
- Department of Neurology Institute of Translational Neurology, University of Münster, Münster, Germany
| | - Kristin S. Golombeck
- Department of Neurology Institute of Translational Neurology, University of Münster, Münster, Germany
- Department of Neurology, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
| | - Andreas Johnen
- Department of Neurology Institute of Translational Neurology, University of Münster, Münster, Germany
| | - Stjepana Kovac
- Department of Neurology Institute of Translational Neurology, University of Münster, Münster, Germany
| | - Catharina C. Groß
- Department of Neurology Institute of Translational Neurology, University of Münster, Münster, Germany
| | - Philipp Backhaus
- Department of Nuclear Medicine, University of Münster, Münster, Germany
- European Institute for Molecular Imaging, University of Münster, Münster, Germany
| | - Robert Seifert
- Department of Nuclear Medicine, University of Münster, Münster, Germany
- European Institute for Molecular Imaging, University of Münster, Münster, Germany
| | - Jan Lewerenz
- Department of Neurology, University of Ulm, Ulm, Germany
| | - Rainer Surges
- Department of Epileptology, University of Bonn, Bonn, Germany
| | | | - Heinz Wiendl
- Department of Neurology Institute of Translational Neurology, University of Münster, Münster, Germany
| | - Tobias Ruck
- Department of Neurology Institute of Translational Neurology, University of Münster, Münster, Germany
- Department of Neurology, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
| | - Albert J. Becker
- Section for Translational Epilepsy Research, Department of Neuropathology, University of Bonn, Bonn, Germany
| | - Cornelius Faber
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - Andreas H. Jacobs
- European Institute for Molecular Imaging, University of Münster, Münster, Germany
| | - Jan Bauer
- Department of Neuroimmunology, Centre for Brain Research, Medical University of Vienna, Vienna, Austria
| | - Sven G. Meuth
- Department of Neurology Institute of Translational Neurology, University of Münster, Münster, Germany
- Department of Neurology, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
| | - Michael Schäfers
- Department of Nuclear Medicine, University of Münster, Münster, Germany
- European Institute for Molecular Imaging, University of Münster, Münster, Germany
| | - Nico Melzer
- Department of Neurology Institute of Translational Neurology, University of Münster, Münster, Germany
- Department of Neurology, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
| |
Collapse
|
5
|
Ricigliano VAG, Louapre C, Poirion E, Colombi A, Yazdan Panah A, Lazzarotto A, Morena E, Martin E, Bottlaender M, Bodini B, Seilhean D, Stankoff B. Imaging Characteristics of Choroid Plexuses in Presymptomatic Multiple Sclerosis: A Retrospective Study. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2022; 9:9/6/e200026. [PMID: 36229188 PMCID: PMC9562043 DOI: 10.1212/nxi.0000000000200026] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 07/18/2022] [Indexed: 11/06/2022]
Abstract
Background and Objectives Recent imaging studies have suggested a possible involvement of the choroid plexus (CP) in multiple sclerosis (MS). Here, we investigated whether CP changes are already detectable at the earliest stage of MS, preceding symptom onset. Methods This study is a retrospective analysis of 27 patients with presymptomatic MS, 97 patients with clinically definite MS (CDMS), and 53 healthy controls (HCs) who underwent a cross-sectional 3T-MRI acquisition; of which, 22 MS, 19 HCs, and 1 presymptomatic MS (evaluated 8 months before conversion to CDMS) also underwent translocator protein (TSPO) 18F-DPA-714 PET and were included in the analysis. CPs were manually segmented on 3D T1-weighted images for volumetric analysis. CP 18F-DPA-714 uptake, reflecting inflammation, was calculated as the average standardized uptake value (SUV). Multivariable regressions adjusted for age, sex, and ventricular and brain volume were fitted to test CP volume differences between presymptomatic patients and MS or HCs. For the presymptomatic case who also had 18F-DPA-714 PET, CP SUV differences with MS and HCs were assessed through Crawford-Howell tests. To provide further insight into the interpretation of 18F-DPA-714-PET uptake at the CP level, a postmortem analysis of CPs in MS vs HCs was performed to characterize the cellular localization of TSPO expression. Results Compared with HCs, patients with presymptomatic MS had 32% larger CPs (β = 0.38, p = 0.001), which were not dissimilar to MS CPs (p = 0.69). Moreover, in the baseline scan of the presymptomatic case who later on developed MS, TSPO PET showed 33% greater CP inflammation vs HCs (p = 0.04), although no differences in 18F-DPA-714 uptake were found in parenchymal regions vs controls. CP postmortem analysis identified a population of CD163+ mononuclear phagocytes expressing TSPO in MS, possibly contributing to the increased 18F-DPA-714 uptake. Discussion We identified an imaging signature in CPs at the presymptomatic MS stage using MRI; in addition, we found an increased CP inflammation with PET in a single presymptomatic patient. These findings suggest a role of CP imaging as an early biomarker and argue for the involvement of the blood-CSF barrier dysfunction in disease development. Trial Registration Information APHP-20210727144630, EudraCT-Number: 2008-004174-40; ClinicalTrials.gov: NCT02305264, NCT01651520, and NCT02319382.
Collapse
Affiliation(s)
- Vito A G Ricigliano
- From the Sorbonne Université (V.A.G.R., C.L., E.P., A.C., A.Y.P., A.L., Emanuele Morena, Elodie Martin, B.B., D.S., B.S.), Paris Brain Institute, ICM, CNRS, Inserm; Neurology Department (V.A.G.R., A.L., B.B., B.S.), St Antoine Hospital, APHP-Sorbonne, Paris; Neurology Department (C.L.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris; Service D'Imagerie Médicale (E.P.), Hôpital Fondation Adolphe de Rothschild, Paris; Université Paris-Saclay (M.B.), CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, Orsay; and Neuropathology Department (D.S.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris, France
| | - Céline Louapre
- From the Sorbonne Université (V.A.G.R., C.L., E.P., A.C., A.Y.P., A.L., Emanuele Morena, Elodie Martin, B.B., D.S., B.S.), Paris Brain Institute, ICM, CNRS, Inserm; Neurology Department (V.A.G.R., A.L., B.B., B.S.), St Antoine Hospital, APHP-Sorbonne, Paris; Neurology Department (C.L.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris; Service D'Imagerie Médicale (E.P.), Hôpital Fondation Adolphe de Rothschild, Paris; Université Paris-Saclay (M.B.), CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, Orsay; and Neuropathology Department (D.S.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris, France
| | - Emilie Poirion
- From the Sorbonne Université (V.A.G.R., C.L., E.P., A.C., A.Y.P., A.L., Emanuele Morena, Elodie Martin, B.B., D.S., B.S.), Paris Brain Institute, ICM, CNRS, Inserm; Neurology Department (V.A.G.R., A.L., B.B., B.S.), St Antoine Hospital, APHP-Sorbonne, Paris; Neurology Department (C.L.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris; Service D'Imagerie Médicale (E.P.), Hôpital Fondation Adolphe de Rothschild, Paris; Université Paris-Saclay (M.B.), CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, Orsay; and Neuropathology Department (D.S.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris, France
| | - Annalisa Colombi
- From the Sorbonne Université (V.A.G.R., C.L., E.P., A.C., A.Y.P., A.L., Emanuele Morena, Elodie Martin, B.B., D.S., B.S.), Paris Brain Institute, ICM, CNRS, Inserm; Neurology Department (V.A.G.R., A.L., B.B., B.S.), St Antoine Hospital, APHP-Sorbonne, Paris; Neurology Department (C.L.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris; Service D'Imagerie Médicale (E.P.), Hôpital Fondation Adolphe de Rothschild, Paris; Université Paris-Saclay (M.B.), CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, Orsay; and Neuropathology Department (D.S.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris, France
| | - Arya Yazdan Panah
- From the Sorbonne Université (V.A.G.R., C.L., E.P., A.C., A.Y.P., A.L., Emanuele Morena, Elodie Martin, B.B., D.S., B.S.), Paris Brain Institute, ICM, CNRS, Inserm; Neurology Department (V.A.G.R., A.L., B.B., B.S.), St Antoine Hospital, APHP-Sorbonne, Paris; Neurology Department (C.L.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris; Service D'Imagerie Médicale (E.P.), Hôpital Fondation Adolphe de Rothschild, Paris; Université Paris-Saclay (M.B.), CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, Orsay; and Neuropathology Department (D.S.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris, France
| | - Andrea Lazzarotto
- From the Sorbonne Université (V.A.G.R., C.L., E.P., A.C., A.Y.P., A.L., Emanuele Morena, Elodie Martin, B.B., D.S., B.S.), Paris Brain Institute, ICM, CNRS, Inserm; Neurology Department (V.A.G.R., A.L., B.B., B.S.), St Antoine Hospital, APHP-Sorbonne, Paris; Neurology Department (C.L.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris; Service D'Imagerie Médicale (E.P.), Hôpital Fondation Adolphe de Rothschild, Paris; Université Paris-Saclay (M.B.), CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, Orsay; and Neuropathology Department (D.S.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris, France
| | - Emanuele Morena
- From the Sorbonne Université (V.A.G.R., C.L., E.P., A.C., A.Y.P., A.L., Emanuele Morena, Elodie Martin, B.B., D.S., B.S.), Paris Brain Institute, ICM, CNRS, Inserm; Neurology Department (V.A.G.R., A.L., B.B., B.S.), St Antoine Hospital, APHP-Sorbonne, Paris; Neurology Department (C.L.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris; Service D'Imagerie Médicale (E.P.), Hôpital Fondation Adolphe de Rothschild, Paris; Université Paris-Saclay (M.B.), CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, Orsay; and Neuropathology Department (D.S.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris, France
| | - Elodie Martin
- From the Sorbonne Université (V.A.G.R., C.L., E.P., A.C., A.Y.P., A.L., Emanuele Morena, Elodie Martin, B.B., D.S., B.S.), Paris Brain Institute, ICM, CNRS, Inserm; Neurology Department (V.A.G.R., A.L., B.B., B.S.), St Antoine Hospital, APHP-Sorbonne, Paris; Neurology Department (C.L.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris; Service D'Imagerie Médicale (E.P.), Hôpital Fondation Adolphe de Rothschild, Paris; Université Paris-Saclay (M.B.), CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, Orsay; and Neuropathology Department (D.S.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris, France
| | - Michel Bottlaender
- From the Sorbonne Université (V.A.G.R., C.L., E.P., A.C., A.Y.P., A.L., Emanuele Morena, Elodie Martin, B.B., D.S., B.S.), Paris Brain Institute, ICM, CNRS, Inserm; Neurology Department (V.A.G.R., A.L., B.B., B.S.), St Antoine Hospital, APHP-Sorbonne, Paris; Neurology Department (C.L.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris; Service D'Imagerie Médicale (E.P.), Hôpital Fondation Adolphe de Rothschild, Paris; Université Paris-Saclay (M.B.), CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, Orsay; and Neuropathology Department (D.S.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris, France
| | - Benedetta Bodini
- From the Sorbonne Université (V.A.G.R., C.L., E.P., A.C., A.Y.P., A.L., Emanuele Morena, Elodie Martin, B.B., D.S., B.S.), Paris Brain Institute, ICM, CNRS, Inserm; Neurology Department (V.A.G.R., A.L., B.B., B.S.), St Antoine Hospital, APHP-Sorbonne, Paris; Neurology Department (C.L.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris; Service D'Imagerie Médicale (E.P.), Hôpital Fondation Adolphe de Rothschild, Paris; Université Paris-Saclay (M.B.), CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, Orsay; and Neuropathology Department (D.S.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris, France
| | - Danielle Seilhean
- From the Sorbonne Université (V.A.G.R., C.L., E.P., A.C., A.Y.P., A.L., Emanuele Morena, Elodie Martin, B.B., D.S., B.S.), Paris Brain Institute, ICM, CNRS, Inserm; Neurology Department (V.A.G.R., A.L., B.B., B.S.), St Antoine Hospital, APHP-Sorbonne, Paris; Neurology Department (C.L.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris; Service D'Imagerie Médicale (E.P.), Hôpital Fondation Adolphe de Rothschild, Paris; Université Paris-Saclay (M.B.), CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, Orsay; and Neuropathology Department (D.S.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris, France
| | - Bruno Stankoff
- From the Sorbonne Université (V.A.G.R., C.L., E.P., A.C., A.Y.P., A.L., Emanuele Morena, Elodie Martin, B.B., D.S., B.S.), Paris Brain Institute, ICM, CNRS, Inserm; Neurology Department (V.A.G.R., A.L., B.B., B.S.), St Antoine Hospital, APHP-Sorbonne, Paris; Neurology Department (C.L.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris; Service D'Imagerie Médicale (E.P.), Hôpital Fondation Adolphe de Rothschild, Paris; Université Paris-Saclay (M.B.), CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, Orsay; and Neuropathology Department (D.S.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris, France.
| |
Collapse
|
6
|
Fang YHD, McConathy JE, Yacoubian TA, Zhang Y, Kennedy RE, Standaert DG. Image Quantification for TSPO PET with a Novel Image-Derived Input Function Method. Diagnostics (Basel) 2022; 12:1161. [PMID: 35626315 PMCID: PMC9140104 DOI: 10.3390/diagnostics12051161] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/02/2022] [Accepted: 05/03/2022] [Indexed: 01/27/2023] Open
Abstract
There is a growing interest in using 18F-DPA-714 PET to study neuroinflammation and microglial activation through imaging the 18-kDa translocator protein (TSPO). Although quantification of 18F-DPA-714 binding can be achieved through kinetic modeling analysis with an arterial input function (AIF) measured with blood sampling procedures, the invasiveness of such procedures has been an obstacle for wide application. To address these challenges, we developed an image-derived input function (IDIF) that noninvasively estimates the arterial input function from the images acquired for 18F-DPA-714 quantification. Methods: The method entails three fully automatic steps to extract the IDIF, including a segmentation of voxels with highest likelihood of being the arterial blood over the carotid artery, a model-based matrix factorization to extract the arterial blood signal, and a scaling optimization procedure to scale the extracted arterial blood signal into the activity concentration unit. Two cohorts of human subjects were used to evaluate the extracted IDIF. In the first cohort of five subjects, arterial blood sampling was performed, and the calculated IDIF was validated against the measured AIF through the comparison of distribution volumes from AIF (VT,AIF) and IDIF (VT,IDIF). In the second cohort, PET studies from twenty-eight healthy controls without arterial blood sampling were used to compare VT,IDIF with VT,REF measured using a reference region-based analysis to evaluate whether it can distinguish high-affinity (HAB) and mixed-affinity (MAB) binders. Results: In the arterial blood-sampling cohort, VT derived from IDIF was found to be an accurate surrogate of the VT from AIF. The bias of VT, IDIF was −5.8 ± 7.8% when compared to VT,AIF, and the linear mixed effect model showed a high correlation between VT,AIF and VT, IDIF (p < 0.001). In the nonblood-sampling cohort, VT, IDIF showed a significance difference between the HAB and MAB healthy controls. VT, IDIF and standard uptake values (SUV) showed superior results in distinguishing HAB from MAB subjects than VT,REF. Conclusions: A novel IDIF method for 18F-DPA-714 PET quantification was developed and evaluated in this study. This IDIF provides a noninvasive alternative measurement of VT to quantify the TSPO binding of 18F-DPA-714 in the human brain through dynamic PET scans.
Collapse
Affiliation(s)
- Yu-Hua Dean Fang
- Department of Radiology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
- Center for Neurodegeneration and Experimental Therapeutics, Department of Neurology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (T.A.Y.); (D.G.S.)
| | - Jonathan E. McConathy
- Department of Radiology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - Talene A. Yacoubian
- Center for Neurodegeneration and Experimental Therapeutics, Department of Neurology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (T.A.Y.); (D.G.S.)
| | - Yue Zhang
- Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (Y.Z.); (R.E.K.)
| | - Richard E. Kennedy
- Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (Y.Z.); (R.E.K.)
| | - David G. Standaert
- Center for Neurodegeneration and Experimental Therapeutics, Department of Neurology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (T.A.Y.); (D.G.S.)
| |
Collapse
|
7
|
Gouilly D, Saint-Aubert L, Ribeiro MJ, Salabert AS, Tauber C, Péran P, Arlicot N, Pariente J, Payoux P. Neuroinflammation PET imaging of the translocator protein (TSPO) in Alzheimer's disease: an update. Eur J Neurosci 2022; 55:1322-1343. [PMID: 35083791 DOI: 10.1111/ejn.15613] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 11/28/2022]
Abstract
Neuroinflammation is a significant contributor to Alzheimer's disease (AD). Until now, PET imaging of the translocator protein (TSPO) has been widely used to depict the neuroimmune endophenotype of AD. The aim of this review was to provide an update to the results from 2018 and to advance the characterization of the biological basis of TSPO imaging in AD by re-examining TSPO function and expression and the methodological aspects of interest. Although the biological basis of the TSPO PET signal is obviously related to microglia and astrocytes in AD, the observed process remains uncertain and might not be directly related to neuroinflammation. Further studies are required to re-examine the cellular significance underlying a variation in the PET signal in AD and how it can be impacted by a disease-modifying treatment.
Collapse
Affiliation(s)
- Dominique Gouilly
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
| | - Laure Saint-Aubert
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
| | - Maria-Joao Ribeiro
- Department of Nuclear Medicine, CHU, Tours, France.,UMR 1253, iBrain, Université de Tours, France.,Inserm CIC 1415, CHRU, Tours, France
| | - Anne-Sophie Salabert
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France.,Department of Nuclear Medicine, CHU, Toulouse, France
| | | | - Patrice Péran
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
| | - Nicolas Arlicot
- UMR 1253, iBrain, Université de Tours, France.,Inserm CIC 1415, CHRU, Tours, France
| | - Jérémie Pariente
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France.,Department of Cognitive Neurology, Epilepsy and Movement Disorders, CHU, Toulouse, France.,Center of Clinical Investigations (CIC1436), CHU, Toulouse, France
| | - Pierre Payoux
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France.,Department of Nuclear Medicine, CHU, Toulouse, France
| |
Collapse
|
8
|
Schubert J, Tonietto M, Turkheimer F, Zanotti-Fregonara P, Veronese M. Supervised clustering for TSPO PET imaging. Eur J Nucl Med Mol Imaging 2021; 49:257-268. [PMID: 33779770 PMCID: PMC8712290 DOI: 10.1007/s00259-021-05309-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/08/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE This technical note seeks to act as a practical guide for implementing a supervised clustering algorithm (SVCA) reference region approach and to explain the main strengths and limitations of the technique in the context of 18-kilodalton translocator protein (TSPO) positron emission tomography (PET) studies in experimental medicine. BACKGROUND TSPO PET is the most widely used imaging technique for studying neuroinflammation in vivo in humans. Quantifying neuroinflammation with PET can be a challenging and invasive procedure, especially in frail patients, because it often requires blood sampling from an arterial catheter. A widely used alternative to arterial sampling is SVCA, which identifies the voxels with minimal specific binding in the PET images, thus extracting a pseudo-reference region for non-invasive quantification. Unlike other reference region approaches, SVCA does not require specification of an anatomical reference region a priori, which alleviates the limitation of TSPO contamination in anatomically-defined reference regions in individuals with underlying inflammatory processes. Furthermore, SVCA can be applied to any TSPO PET tracer across different neurological and neuropsychiatric conditions, providing noninvasivequantification of TSPO expression. METHODS We provide an overview of the development of SVCA as well as step-by-step instructions for implementing SVCA with suggestions for specific settings. We review the literature on SVCAapplications using first- and second- generation TSPO PET tracers and discuss potential clinically relevant limitations and applications. CONCLUSIONS The correct implementation of SVCA can provide robust and reproducible estimates of brain TSPO expression. This review encourages the standardisation of SVCA methodology in TSPO PET analysis, ultimately aiming to improve replicability and comparability across study sites.
Collapse
Affiliation(s)
- Julia Schubert
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Matteo Tonietto
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, Orsay, France
| | - Federico Turkheimer
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Paolo Zanotti-Fregonara
- Molecular Imaging Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Mattia Veronese
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| |
Collapse
|
9
|
Positron emission tomography in multiple sclerosis - straight to the target. Nat Rev Neurol 2021; 17:663-675. [PMID: 34545219 DOI: 10.1038/s41582-021-00537-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2021] [Indexed: 02/08/2023]
Abstract
Following the impressive progress in the treatment of relapsing-remitting multiple sclerosis (MS), the major challenge ahead is the development of treatments to prevent or delay the irreversible accumulation of clinical disability in progressive forms of the disease. The substrate of clinical progression is neuro-axonal degeneration, and a deep understanding of the mechanisms that underlie this process is a precondition for the development of therapies for progressive MS. PET imaging involves the use of radiolabelled compounds that bind to specific cellular and metabolic targets, thereby enabling direct in vivo measurement of several pathological processes. This approach can provide key insights into the clinical relevance of these processes and their chronological sequence during the disease course. In this Review, we focus on the contribution that PET is making to our understanding of extraneuronal and intraneuronal mechanisms that are involved in the pathogenesis of irreversible neuro-axonal damage in MS. We consider the major challenges with the use of PET in MS and the steps necessary to realize clinical benefits of the technique. In addition, we discuss the potential of emerging PET tracers and future applications of existing compounds to facilitate the identification of effective neuroprotective treatments for patients with MS.
Collapse
|
10
|
Veronese M, Tuosto M, Marques TR, Howes O, Pascual B, Yu M, Masdeu JC, Turkheimer F, Bertoldo A, Zanotti-Fregonara P. Parametric Mapping for TSPO PET Imaging with Spectral Analysis Impulsive Response Function. Mol Imaging Biol 2021; 23:560-571. [PMID: 33475944 PMCID: PMC8277653 DOI: 10.1007/s11307-020-01575-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 11/27/2020] [Accepted: 12/21/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to investigate the use of spectral analysis (SA) for voxel-wise analysis of TSPO PET imaging studies. TSPO PET quantification is methodologically complicated by the heterogeneity of TSPO expression and its cell-dependent modulation during neuroinflammatory response. Compartmental models to account for this complexity exist, but they are unreliable at the high noise typical of voxel data. On the contrary, SA is noise-robust for parametric mapping and provides useful information about tracer kinetics with a free compartmental structure. PROCEDURES SA impulse response function (IRF) calculated at 90 min after tracer injection was used as main parameter of interest in 3 independent PET imaging studies to investigate its sensitivity to (1) a TSPO genetic polymorphism (rs6971) known to affect tracer binding in a cross-sectional analysis of healthy controls scanned with [11C]PBR28 PET; (2) TSPO density with [11C]PBR28 in a competitive blocking study with a TSPO blocker, XBD173; and (3) the higher affinity of a second radiotracer for TSPO, by using data from a head-to-head comparison between [11C]PBR28 and [11C]ER176 scans. RESULTS SA-IRF produced parametric maps of visually good quality. These were sensitive to TSPO genotype (mean relative difference between high- and mixed-affinity binders = 25 %) and TSPO availability (mean signal displacement after 90 mg oral administration of XBD173 = 39 %). Regional averages of voxel-wise IRF estimates were strongly associated with regional total distribution volume (VT) estimated with a 2-tissue compartmental model with vascular compartment (Pearson's r = 0.86 ± 0.11) but less strongly with standard 2TCM-VT (Pearson's r = 0.76 ± 0.32). Finally, SA-IRF estimates for [11C]ER176 were significantly higher than [11C]PBR28 ones, consistent with the higher amount of specific binding of the former tracer. CONCLUSIONS SA-IRF can be used for voxel-wise quantification of TSPO PET data because it generates high-quality parametric maps, it is sensitive to TSPO availability and genotype, and it accounts for the complexity of TSPO tracer kinetics with no additional assumptions.
Collapse
Affiliation(s)
- Mattia Veronese
- Department of Neuroimaging, IoPPN, King's College London, London, UK.
| | - Marcello Tuosto
- Department of Information Engineering, Padova University, Padova, Italy
| | - Tiago Reis Marques
- Department of Psychosis Studies, IoPPN, King's College London, London, UK
| | - Oliver Howes
- Department of Psychosis Studies, IoPPN, King's College London, London, UK
- MRC London Institute of Medical Sciences, Hammersmith Hospital, London, UK
- Institute of Clinical Sciences (ICS), Faculty of Medicine, Imperial College London, London, UK
| | - Belen Pascual
- Nantz National Alzheimer Center and Houston Methodist Research Neurological Institute, and Weill Cornell Medicine, 6670 Bertner Ave, Houston, TX, 77030, USA
| | - Meixiang Yu
- Nantz National Alzheimer Center and Houston Methodist Research Neurological Institute, and Weill Cornell Medicine, 6670 Bertner Ave, Houston, TX, 77030, USA
| | - Joseph C Masdeu
- Nantz National Alzheimer Center and Houston Methodist Research Neurological Institute, and Weill Cornell Medicine, 6670 Bertner Ave, Houston, TX, 77030, USA
| | | | - Alessandra Bertoldo
- Department of Information Engineering, Padova University, Padova, Italy
- Padova Neuroscience Centre, Padova University, Padova, Italy
| | - Paolo Zanotti-Fregonara
- Nantz National Alzheimer Center and Houston Methodist Research Neurological Institute, and Weill Cornell Medicine, 6670 Bertner Ave, Houston, TX, 77030, USA
| |
Collapse
|
11
|
Ricigliano VAG, Morena E, Colombi A, Tonietto M, Hamzaoui M, Poirion E, Bottlaender M, Gervais P, Louapre C, Bodini B, Stankoff B. Choroid Plexus Enlargement in Inflammatory Multiple Sclerosis: 3.0-T MRI and Translocator Protein PET Evaluation. Radiology 2021; 301:166-177. [PMID: 34254858 DOI: 10.1148/radiol.2021204426] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Choroid plexuses (CPs) have been suggested as a key gateway for inflammation in experimental autoimmune encephalitis, but in vivo evidence of their involvement in multiple sclerosis (MS) is lacking. Purpose To assess CP volumetric and inflammatory changes in patients with MS versus healthy control participants. Materials and Methods This was a secondary analysis of 97 patients (61 with relapsing-remitting MS [RRMS] and 36 with progressive MS) and 44 healthy control participants who participated in three prospective 3.0-T brain MRI studies between May 2009 and September 2017. A subgroup of 37 patients and 19 healthy control participants also underwent translocator protein fluorine 18 (18F)-DPA-714 PET for neuroinflammation. Relapses and disability scores were collected at baseline and over 2 years. CPs were manually segmented on three-dimensional T1-weighted images; other brain volumes were additionally segmented. Volumes were expressed as a ratio of intracranial volume. The 18F-DPA-714 distribution volume ratio was quantified in parenchymal regions, whereas standardized uptake value was used for CP inflammation. Multivariable linear regression analyses were performed to assess CP volumetric and inflammatory differences between patients with MS and healthy control participants and correlations between CP volume and lesion load, brain volumes, 18F-DPA-714 uptake, and annualized relapse rate. Results Ninety-seven patients with MS (mean age, 42 years ± 12 [standard deviation]; 49 women) and 44 healthy control participants (mean age, 39 years ± 14; 23 women) underwent MRI. Thirty-seven patients with MS and 19 healthy control participants underwent PET. CPs were 35% larger in patients with MS (mean value, 15.9 × 10-4 ± 4.5) than in healthy control participants (mean value, 11.8 × 10-4 ± 3.8; P = .004). Subgroup analysis confirmed greater CP volume in patients with RRMS (mean value, 15.5 × 10-4 ± 4.6; P = .008) than in healthy control participants. CP enlargement was greater in patients with active lesions at MRI (mean volume, 18.2 × 10-4 ± 4.9 in patients with lesions that enhanced with gadolinium vs 14.9 × 10-4 ± 4 in patients with lesions that did not enhance with gadolinium; P < .001) and correlated with white matter lesion load (r = 0.39; 95% CI: 0.20, 0.55; P < .001) and 18F-DPA-714 binding in the thalami (r = 0.44; 95% CI: 0.22, 0.72; P = .04) and normal-appearing white matter (r = 0.5; 95% CI: 0.20, 0.71; P = .005). Moreover, it correlated with annualized relapse rate in patients with RRMS (r = 0.37; 95% CI: 0.1, 0.55; P = .005). Finally, patients with MS showed 18.5% higher CP 18F-DPA-714 uptake than control participants (mean value, 0.778 ± 0.23 vs 0.635 ± 0.15, respectively; P = .01). CP volume in patients with RRMS (r = 0.57; 95% CI: 0.37, 0.73; P = .009) correlated with higher 18F-DPA-714 uptake. Conclusion Choroid plexuses (CPs) are enlarged and inflamed in patients with multiple sclerosis (MS), particularly in those with relapsing-remitting MS with inflammatory profiles; CP volumetric analysis could represent an MS imaging marker. © RSNA, 2021 EudraCT no. 2008-004174-40; clinical trial registration nos. NCT02305264 and NCT01651520 Online supplemental material is available for this article.
Collapse
Affiliation(s)
- Vito A G Ricigliano
- From the Sorbonne Université, Paris Brain Institute, Institut du Cerveau, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, Paris, France (V.A.G.R., E.M., A.C., M.T., M.H., E.P., C.L., B.B., B.S.); Université Paris-Saclay, Commissariat à l'énergie atomique et aux énergies alternatives, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, BioMaps, Service Hospitalier Frédéric Joliot, Orsay, France (M.T., M.B., P.G.); Service d'Imagerie Médicale, Hôpital Fondation Adolphe de Rothschild, Paris, France (E.P.); Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France (C.L.); and Department of Neurology, St Antoine Hospital, 184, rue du Faubourg St Antoine, Assistance Publique des Hôpitaux de Paris, 75571 Paris, France (B.B., B.S.)
| | - Emanuele Morena
- From the Sorbonne Université, Paris Brain Institute, Institut du Cerveau, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, Paris, France (V.A.G.R., E.M., A.C., M.T., M.H., E.P., C.L., B.B., B.S.); Université Paris-Saclay, Commissariat à l'énergie atomique et aux énergies alternatives, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, BioMaps, Service Hospitalier Frédéric Joliot, Orsay, France (M.T., M.B., P.G.); Service d'Imagerie Médicale, Hôpital Fondation Adolphe de Rothschild, Paris, France (E.P.); Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France (C.L.); and Department of Neurology, St Antoine Hospital, 184, rue du Faubourg St Antoine, Assistance Publique des Hôpitaux de Paris, 75571 Paris, France (B.B., B.S.)
| | - Annalisa Colombi
- From the Sorbonne Université, Paris Brain Institute, Institut du Cerveau, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, Paris, France (V.A.G.R., E.M., A.C., M.T., M.H., E.P., C.L., B.B., B.S.); Université Paris-Saclay, Commissariat à l'énergie atomique et aux énergies alternatives, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, BioMaps, Service Hospitalier Frédéric Joliot, Orsay, France (M.T., M.B., P.G.); Service d'Imagerie Médicale, Hôpital Fondation Adolphe de Rothschild, Paris, France (E.P.); Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France (C.L.); and Department of Neurology, St Antoine Hospital, 184, rue du Faubourg St Antoine, Assistance Publique des Hôpitaux de Paris, 75571 Paris, France (B.B., B.S.)
| | - Matteo Tonietto
- From the Sorbonne Université, Paris Brain Institute, Institut du Cerveau, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, Paris, France (V.A.G.R., E.M., A.C., M.T., M.H., E.P., C.L., B.B., B.S.); Université Paris-Saclay, Commissariat à l'énergie atomique et aux énergies alternatives, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, BioMaps, Service Hospitalier Frédéric Joliot, Orsay, France (M.T., M.B., P.G.); Service d'Imagerie Médicale, Hôpital Fondation Adolphe de Rothschild, Paris, France (E.P.); Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France (C.L.); and Department of Neurology, St Antoine Hospital, 184, rue du Faubourg St Antoine, Assistance Publique des Hôpitaux de Paris, 75571 Paris, France (B.B., B.S.)
| | - Mariem Hamzaoui
- From the Sorbonne Université, Paris Brain Institute, Institut du Cerveau, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, Paris, France (V.A.G.R., E.M., A.C., M.T., M.H., E.P., C.L., B.B., B.S.); Université Paris-Saclay, Commissariat à l'énergie atomique et aux énergies alternatives, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, BioMaps, Service Hospitalier Frédéric Joliot, Orsay, France (M.T., M.B., P.G.); Service d'Imagerie Médicale, Hôpital Fondation Adolphe de Rothschild, Paris, France (E.P.); Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France (C.L.); and Department of Neurology, St Antoine Hospital, 184, rue du Faubourg St Antoine, Assistance Publique des Hôpitaux de Paris, 75571 Paris, France (B.B., B.S.)
| | - Emilie Poirion
- From the Sorbonne Université, Paris Brain Institute, Institut du Cerveau, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, Paris, France (V.A.G.R., E.M., A.C., M.T., M.H., E.P., C.L., B.B., B.S.); Université Paris-Saclay, Commissariat à l'énergie atomique et aux énergies alternatives, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, BioMaps, Service Hospitalier Frédéric Joliot, Orsay, France (M.T., M.B., P.G.); Service d'Imagerie Médicale, Hôpital Fondation Adolphe de Rothschild, Paris, France (E.P.); Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France (C.L.); and Department of Neurology, St Antoine Hospital, 184, rue du Faubourg St Antoine, Assistance Publique des Hôpitaux de Paris, 75571 Paris, France (B.B., B.S.)
| | - Michel Bottlaender
- From the Sorbonne Université, Paris Brain Institute, Institut du Cerveau, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, Paris, France (V.A.G.R., E.M., A.C., M.T., M.H., E.P., C.L., B.B., B.S.); Université Paris-Saclay, Commissariat à l'énergie atomique et aux énergies alternatives, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, BioMaps, Service Hospitalier Frédéric Joliot, Orsay, France (M.T., M.B., P.G.); Service d'Imagerie Médicale, Hôpital Fondation Adolphe de Rothschild, Paris, France (E.P.); Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France (C.L.); and Department of Neurology, St Antoine Hospital, 184, rue du Faubourg St Antoine, Assistance Publique des Hôpitaux de Paris, 75571 Paris, France (B.B., B.S.)
| | - Philippe Gervais
- From the Sorbonne Université, Paris Brain Institute, Institut du Cerveau, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, Paris, France (V.A.G.R., E.M., A.C., M.T., M.H., E.P., C.L., B.B., B.S.); Université Paris-Saclay, Commissariat à l'énergie atomique et aux énergies alternatives, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, BioMaps, Service Hospitalier Frédéric Joliot, Orsay, France (M.T., M.B., P.G.); Service d'Imagerie Médicale, Hôpital Fondation Adolphe de Rothschild, Paris, France (E.P.); Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France (C.L.); and Department of Neurology, St Antoine Hospital, 184, rue du Faubourg St Antoine, Assistance Publique des Hôpitaux de Paris, 75571 Paris, France (B.B., B.S.)
| | - Céline Louapre
- From the Sorbonne Université, Paris Brain Institute, Institut du Cerveau, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, Paris, France (V.A.G.R., E.M., A.C., M.T., M.H., E.P., C.L., B.B., B.S.); Université Paris-Saclay, Commissariat à l'énergie atomique et aux énergies alternatives, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, BioMaps, Service Hospitalier Frédéric Joliot, Orsay, France (M.T., M.B., P.G.); Service d'Imagerie Médicale, Hôpital Fondation Adolphe de Rothschild, Paris, France (E.P.); Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France (C.L.); and Department of Neurology, St Antoine Hospital, 184, rue du Faubourg St Antoine, Assistance Publique des Hôpitaux de Paris, 75571 Paris, France (B.B., B.S.)
| | - Benedetta Bodini
- From the Sorbonne Université, Paris Brain Institute, Institut du Cerveau, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, Paris, France (V.A.G.R., E.M., A.C., M.T., M.H., E.P., C.L., B.B., B.S.); Université Paris-Saclay, Commissariat à l'énergie atomique et aux énergies alternatives, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, BioMaps, Service Hospitalier Frédéric Joliot, Orsay, France (M.T., M.B., P.G.); Service d'Imagerie Médicale, Hôpital Fondation Adolphe de Rothschild, Paris, France (E.P.); Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France (C.L.); and Department of Neurology, St Antoine Hospital, 184, rue du Faubourg St Antoine, Assistance Publique des Hôpitaux de Paris, 75571 Paris, France (B.B., B.S.)
| | - Bruno Stankoff
- From the Sorbonne Université, Paris Brain Institute, Institut du Cerveau, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, Paris, France (V.A.G.R., E.M., A.C., M.T., M.H., E.P., C.L., B.B., B.S.); Université Paris-Saclay, Commissariat à l'énergie atomique et aux énergies alternatives, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, BioMaps, Service Hospitalier Frédéric Joliot, Orsay, France (M.T., M.B., P.G.); Service d'Imagerie Médicale, Hôpital Fondation Adolphe de Rothschild, Paris, France (E.P.); Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France (C.L.); and Department of Neurology, St Antoine Hospital, 184, rue du Faubourg St Antoine, Assistance Publique des Hôpitaux de Paris, 75571 Paris, France (B.B., B.S.)
| |
Collapse
|
12
|
Chaney AM, Lopez-Picon FR, Serrière S, Wang R, Bochicchio D, Webb SD, Vandesquille M, Harte MK, Georgiadou C, Lawrence C, Busson J, Vercouillie J, Tauber C, Buron F, Routier S, Reekie T, Snellman A, Kassiou M, Rokka J, Davies KE, Rinne JO, Salih DA, Edwards FA, Orton LD, Williams SR, Chalon S, Boutin H. Prodromal neuroinflammatory, cholinergic and metabolite dysfunction detected by PET and MRS in the TgF344-AD transgenic rat model of AD: a collaborative multi-modal study. Am J Cancer Res 2021; 11:6644-6667. [PMID: 34093845 PMCID: PMC8171096 DOI: 10.7150/thno.56059] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 02/15/2021] [Indexed: 12/25/2022] Open
Abstract
Mouse models of Alzheimer's disease (AD) are valuable but do not fully recapitulate human AD pathology, such as spontaneous Tau fibril accumulation and neuronal loss, necessitating the development of new AD models. The transgenic (TG) TgF344-AD rat has been reported to develop age-dependent AD features including neuronal loss and neurofibrillary tangles, despite only expressing APP and PSEN1 mutations, suggesting an improved modelling of AD hallmarks. Alterations in neuronal networks as well as learning performance and cognition tasks have been reported in this model, but none have combined a longitudinal, multimodal approach across multiple centres, which mimics the approaches commonly taken in clinical studies. We therefore aimed to further characterise the progression of AD-like pathology and cognition in the TgF344-AD rat from young-adults (6 months (m)) to mid- (12 m) and advanced-stage (18 m, 25 m) of the disease. Methods: TgF344-AD rats and wild-type (WT) littermates were imaged at 6 m, 12 m and 18 m with [18F]DPA-714 (TSPO, neuroinflammation), [18F]Florbetaben (Aβ) and [18F]ASEM (α7-nicotinic acetylcholine receptor) and with magnetic resonance spectroscopy (MRS) and with (S)-[18F]THK5117 (Tau) at 15 and 25 m. Behaviour tests were also performed at 6 m, 12 m and 18 m. Immunohistochemistry (CD11b, GFAP, Aβ, NeuN, NeuroChrom) and Tau (S)-[18F]THK5117 autoradiography, immunohistochemistry and Western blot were also performed. Results: [18F]DPA-714 positron emission tomography (PET) showed an increase in neuroinflammation in TG vs wildtype animals from 12 m in the hippocampus (+11%), and at the advanced-stage AD in the hippocampus (+12%), the thalamus (+11%) and frontal cortex (+14%). This finding coincided with strong increases in brain microgliosis (CD11b) and astrogliosis (GFAP) at these time-points as assessed by immunohistochemistry. In vivo [18F]ASEM PET revealed an age-dependent increase uptake in the striatum and pallidum/nucleus basalis of Meynert in WT only, similar to that observed with this tracer in humans, resulting in TG being significantly lower than WT by 18 m. In vivo [18F]Florbetaben PET scanning detected Aβ accumulation at 18 m, and (S)-[18F]THK5117 PET revealed subsequent Tau accumulation at 25m in hippocampal and cortical regions. Aβ plaques were low but detectable by immunohistochemistry from 6 m, increasing further at 12 and 18 m with Tau-positive neurons adjacent to Aβ plaques at 18 m. NeuroChrom (a pan neuronal marker) immunohistochemistry revealed a loss of neuronal staining at the Aβ plaques locations, while NeuN labelling revealed an age-dependent decrease in hippocampal neuron number in both genotypes. Behavioural assessment using the novel object recognition task revealed that both WT & TgF344-AD animals discriminated the novel from familiar object at 3 m and 6 m of age. However, low levels of exploration observed in both genotypes at later time-points resulted in neither genotype successfully completing the task. Deficits in social interaction were only observed at 3 m in the TgF344-AD animals. By in vivo MRS, we showed a decrease in neuronal marker N-acetyl-aspartate in the hippocampus at 18 m (-18% vs age-matched WT, and -31% vs 6 m TG) and increased Taurine in the cortex of TG (+35% vs age-matched WT, and +55% vs 6 m TG). Conclusions: This multi-centre multi-modal study demonstrates, for the first time, alterations in brain metabolites, cholinergic receptors and neuroinflammation in vivo in this model, validated by robust ex vivo approaches. Our data confirm that, unlike mouse models, the TgF344-AD express Tau pathology that can be detected via PET, albeit later than by ex vivo techniques, and is a useful model to assess and longitudinally monitor early neurotransmission dysfunction and neuroinflammation in AD.
Collapse
|
13
|
Poirion E, Tonietto M, Lejeune FX, Ricigliano VAG, Boudot de la Motte M, Benoit C, Bera G, Kuhnast B, Bottlaender M, Bodini B, Stankoff B. Structural and Clinical Correlates of a Periventricular Gradient of Neuroinflammation in Multiple Sclerosis. Neurology 2021; 96:e1865-e1875. [PMID: 33737372 PMCID: PMC8105971 DOI: 10.1212/wnl.0000000000011700] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 01/04/2021] [Indexed: 11/27/2022] Open
Abstract
Objectives To explore in vivo innate immune cell activation as a function of the distance from ventricular CSF in patients with multiple sclerosis (MS) using [18F]-DPA714 PET and to investigate its relationship with periventricular microstructural damage, evaluated by magnetization transfer ratio (MTR), and with trajectories of disability worsening. Methods Thirty-seven patients with MS and 19 healthy controls underwent MRI and [18F]-DPA714 TSPO dynamic PET, from which individual maps of voxels characterized by innate immune cell activation (DPA+) were generated. White matter (WM) was divided in 3-mm-thick concentric rings radiating from the ventricular surface toward the cortex, and the percentage of DPA+ voxels and mean MTR were extracted from each ring. Two-year trajectories of disability worsening were collected to identify patients with and without recent disability worsening. Results The percentage of DPA+ voxels was higher in patients compared to controls in the periventricular WM (p = 6.10e-6) and declined with increasing distance from ventricular surface, with a steeper gradient in patients compared to controls (p = 0.001). This gradient was found in both periventricular lesions and normal-appearing WM. In the total WM, it correlated with a gradient of microstructural tissue damage measured by MTR (rs = −0.65, p = 1.0e-3). Compared to clinically stable patients, patients with disability worsening were characterized by a higher percentage of DPA+ voxels in the periventricular normal-appearing WM (p = 0.025). Conclusions Our results demonstrate that in MS the innate immune cell activation predominates in periventricular regions and is associated with microstructural damage and disability worsening. This could result from the diffusion of proinflammatory CSF-derived factors into surrounding tissues.
Collapse
Affiliation(s)
- Emilie Poirion
- From the Sorbonne University (E.P., M.T., F.-X.L., V.A.G.R., M.B.d.l.M., C.B., G.B., B.B., B.S.), Paris Brain Institute; Imaging Department (E.P.), Foundation A. de Rothschild Hospital, Paris; Paris-Saclay University (M.T., B.K., M.B.), CEA, Orsay; and Assistance Publique des Hôpitaux de Paris (B.B., B.S.), France
| | - Matteo Tonietto
- From the Sorbonne University (E.P., M.T., F.-X.L., V.A.G.R., M.B.d.l.M., C.B., G.B., B.B., B.S.), Paris Brain Institute; Imaging Department (E.P.), Foundation A. de Rothschild Hospital, Paris; Paris-Saclay University (M.T., B.K., M.B.), CEA, Orsay; and Assistance Publique des Hôpitaux de Paris (B.B., B.S.), France
| | - François-Xavier Lejeune
- From the Sorbonne University (E.P., M.T., F.-X.L., V.A.G.R., M.B.d.l.M., C.B., G.B., B.B., B.S.), Paris Brain Institute; Imaging Department (E.P.), Foundation A. de Rothschild Hospital, Paris; Paris-Saclay University (M.T., B.K., M.B.), CEA, Orsay; and Assistance Publique des Hôpitaux de Paris (B.B., B.S.), France
| | - Vito A G Ricigliano
- From the Sorbonne University (E.P., M.T., F.-X.L., V.A.G.R., M.B.d.l.M., C.B., G.B., B.B., B.S.), Paris Brain Institute; Imaging Department (E.P.), Foundation A. de Rothschild Hospital, Paris; Paris-Saclay University (M.T., B.K., M.B.), CEA, Orsay; and Assistance Publique des Hôpitaux de Paris (B.B., B.S.), France
| | - Marine Boudot de la Motte
- From the Sorbonne University (E.P., M.T., F.-X.L., V.A.G.R., M.B.d.l.M., C.B., G.B., B.B., B.S.), Paris Brain Institute; Imaging Department (E.P.), Foundation A. de Rothschild Hospital, Paris; Paris-Saclay University (M.T., B.K., M.B.), CEA, Orsay; and Assistance Publique des Hôpitaux de Paris (B.B., B.S.), France
| | - Charline Benoit
- From the Sorbonne University (E.P., M.T., F.-X.L., V.A.G.R., M.B.d.l.M., C.B., G.B., B.B., B.S.), Paris Brain Institute; Imaging Department (E.P.), Foundation A. de Rothschild Hospital, Paris; Paris-Saclay University (M.T., B.K., M.B.), CEA, Orsay; and Assistance Publique des Hôpitaux de Paris (B.B., B.S.), France
| | - Géraldine Bera
- From the Sorbonne University (E.P., M.T., F.-X.L., V.A.G.R., M.B.d.l.M., C.B., G.B., B.B., B.S.), Paris Brain Institute; Imaging Department (E.P.), Foundation A. de Rothschild Hospital, Paris; Paris-Saclay University (M.T., B.K., M.B.), CEA, Orsay; and Assistance Publique des Hôpitaux de Paris (B.B., B.S.), France
| | - Bertrand Kuhnast
- From the Sorbonne University (E.P., M.T., F.-X.L., V.A.G.R., M.B.d.l.M., C.B., G.B., B.B., B.S.), Paris Brain Institute; Imaging Department (E.P.), Foundation A. de Rothschild Hospital, Paris; Paris-Saclay University (M.T., B.K., M.B.), CEA, Orsay; and Assistance Publique des Hôpitaux de Paris (B.B., B.S.), France
| | - Michel Bottlaender
- From the Sorbonne University (E.P., M.T., F.-X.L., V.A.G.R., M.B.d.l.M., C.B., G.B., B.B., B.S.), Paris Brain Institute; Imaging Department (E.P.), Foundation A. de Rothschild Hospital, Paris; Paris-Saclay University (M.T., B.K., M.B.), CEA, Orsay; and Assistance Publique des Hôpitaux de Paris (B.B., B.S.), France
| | - Benedetta Bodini
- From the Sorbonne University (E.P., M.T., F.-X.L., V.A.G.R., M.B.d.l.M., C.B., G.B., B.B., B.S.), Paris Brain Institute; Imaging Department (E.P.), Foundation A. de Rothschild Hospital, Paris; Paris-Saclay University (M.T., B.K., M.B.), CEA, Orsay; and Assistance Publique des Hôpitaux de Paris (B.B., B.S.), France
| | - Bruno Stankoff
- From the Sorbonne University (E.P., M.T., F.-X.L., V.A.G.R., M.B.d.l.M., C.B., G.B., B.B., B.S.), Paris Brain Institute; Imaging Department (E.P.), Foundation A. de Rothschild Hospital, Paris; Paris-Saclay University (M.T., B.K., M.B.), CEA, Orsay; and Assistance Publique des Hôpitaux de Paris (B.B., B.S.), France.
| |
Collapse
|
14
|
Dinesh AA, Islam J, Khan J, Turkheimer F, Vernon AC. Effects of Antipsychotic Drugs: Cross Talk Between the Nervous and Innate Immune System. CNS Drugs 2020; 34:1229-1251. [PMID: 32975758 DOI: 10.1007/s40263-020-00765-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/29/2020] [Indexed: 12/11/2022]
Abstract
Converging lines of evidence suggest that activation of microglia (innate immune cells in the central nervous system [CNS]) is present in a subset of patients with schizophrenia. The extent to which antipsychotic drug treatment contributes to or combats this effect remains unclear. To address this question, we reviewed the literature for evidence that antipsychotic exposure influences brain microglia as indexed by in vivo neuroimaging and post-mortem studies in patients with schizophrenia and experimental animal models. We found no clear evidence from clinical studies for an effect of antipsychotics on either translocator protein (TSPO) radioligand binding (an in vivo neuroimaging measure of putative gliosis) or markers of brain microglia in post-mortem studies. In experimental animals, where drug and illness effects may be differentiated, we also found no clear evidence for consistent effects of antipsychotic drugs on TSPO radioligand binding. By contrast, we found evidence that chronic antipsychotic exposure may influence central microglia density and morphology. However, these effects were dependent on the dose and duration of drug exposure and whether an immune stimulus was present or not. In the latter case, antipsychotics were generally reported to suppress expression of inflammatory cytokines and inducible inflammatory enzymes such as cyclooxygenase and microglia activation. No clear conclusions could be drawn with regard to any effect of antipsychotics on brain microglia from current clinical data. There is evidence to suggest that antipsychotic drugs influence brain microglia in experimental animals, including possible anti-inflammatory actions. However, we lack detailed information on how these drugs influence brain microglia function at the molecular level. The clinical relevance of the animal data with regard to beneficial treatment effects and detrimental side effects of antipsychotic drugs also remains unknown, and further studies are warranted.
Collapse
Affiliation(s)
- Ayushi Anna Dinesh
- School of Medicine, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Juned Islam
- School of Medicine, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Javad Khan
- School of Medicine, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Federico Turkheimer
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Centre for Neuroimaging Sciences, De Crespigny Park, London, SE5 8AF, United Kingdom
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, SE1 1UL, United Kingdom
| | - Anthony C Vernon
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, SE1 1UL, United Kingdom.
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Maurice Wohl Clinical Neuroscience Institute, 5 Cutcombe Road, London, SE5 9RT, United Kingdom.
| |
Collapse
|
15
|
Lavisse S, Goutal S, Wimberley C, Tonietto M, Bottlaender M, Gervais P, Kuhnast B, Peyronneau MA, Barret O, Lagarde J, Sarazin M, Hantraye P, Thiriez C, Remy P. Increased microglial activation in patients with Parkinson disease using [ 18F]-DPA714 TSPO PET imaging. Parkinsonism Relat Disord 2020; 82:29-36. [PMID: 33242662 DOI: 10.1016/j.parkreldis.2020.11.011] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/18/2020] [Accepted: 11/11/2020] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Increasing evidence suggests that neuroinflammation is active in Parkinson disease (PD) and contributes to neurodegeneration. This process can be studied in vivo with PET and radioligands targeting TSPO, upregulated in activated microglia. Initial PET studies investigating microglial activation in PD with the [11C]-PK11195 have provided inconclusive results. Here we assess the presence and distribution of neuroinflammatory response in PD patients using [18F]-DPA714 and to correlate imaging biomarkers to dopamine transporter imaging and clinical status. METHODS PD patients (n = 24, Hoehn and Yahr I-III) and 28 healthy controls were scanned with [18F]-DPA714 and [11C]-PE2I and analyzed. They were all genotyped for TSPO polymorphism. Regional binding parameters were estimated (reference Logan graphical approach with supervised cluster analysis). Impact of TSPO genotype was analyzed using Wilcoxon signed-rank test. Differences between groups were investigated using a two-way ANOVA and Tukey post hoc tests. RESULTS PD patients showed significantly higher [18F]-DPA714 binding compared to healthy controls bilaterally in the midbrain (p < 0.001), the frontal cortex (p = 0.001), and the putamen contralateral to the more clinically affected hemibody (p = 0.038). Microglial activation in these regions did not correlate with the severity of motor symptoms, disease duration nor putaminal [11C]-PE2I uptake. However, there was a trend toward a correlation between cortical TSPO binding and disease duration (p = 0.015 uncorrected, p = 0.07 after Bonferroni correction). CONCLUSION [18F]-DPA714 binding confirmed that there is a specific topographic pattern of microglial activation in the nigro-striatal pathway and the frontal cortex of PD patients. TRIAL REGISTRATION Trial registration: INFLAPARK, NCT02319382. Registered 18 December 2014- Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02319382.
Collapse
Affiliation(s)
- Sonia Lavisse
- Université Paris-Saclay, CEA, CNRS, MIRCen, Laboratoire des Maladies Neurodégénératives, 92265, Fontenay-aux-Roses, France.
| | - Sébastien Goutal
- Université Paris-Saclay, CEA, CNRS, MIRCen, Laboratoire des Maladies Neurodégénératives, 92265, Fontenay-aux-Roses, France.
| | - Catriona Wimberley
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, 4, Place du Général Leclerc, Orsay, 91401, France.
| | - Mattéo Tonietto
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, 4, Place du Général Leclerc, Orsay, 91401, France.
| | - Michel Bottlaender
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, 4, Place du Général Leclerc, Orsay, 91401, France; Université Paris-Saclay, UNIACT, Neurospin, CEA, 91191, Gif-sur-Yvette, France.
| | - Philippe Gervais
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, 4, Place du Général Leclerc, Orsay, 91401, France.
| | - Bertrand Kuhnast
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, 4, Place du Général Leclerc, Orsay, 91401, France.
| | - Marie-Anne Peyronneau
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, 4, Place du Général Leclerc, Orsay, 91401, France.
| | - Olivier Barret
- Université Paris-Saclay, CEA, CNRS, MIRCen, Laboratoire des Maladies Neurodégénératives, 92265, Fontenay-aux-Roses, France.
| | - Julien Lagarde
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, 4, Place du Général Leclerc, Orsay, 91401, France; Department of Neurology of Memory and Language, GHU Paris Psychiatrie & Neurosciences, Sainte-Anne Hospital, Paris, 75014, France; Université de Paris, F-75006, France.
| | - Marie Sarazin
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, 4, Place du Général Leclerc, Orsay, 91401, France; Department of Neurology of Memory and Language, GHU Paris Psychiatrie & Neurosciences, Sainte-Anne Hospital, Paris, 75014, France; Université de Paris, F-75006, France.
| | - Philippe Hantraye
- Université Paris-Saclay, CEA, CNRS, MIRCen, Laboratoire des Maladies Neurodégénératives, 92265, Fontenay-aux-Roses, France.
| | - Claire Thiriez
- Centre Expert Parkinson, Neurologie, CHU Henri Mondor, AP-HP, 51 Avenue du Maréchal de Lattre de Tassigny, Créteil, France.
| | - Philippe Remy
- Université Paris-Saclay, CEA, CNRS, MIRCen, Laboratoire des Maladies Neurodégénératives, 92265, Fontenay-aux-Roses, France; Centre Expert Parkinson, Neurologie, CHU Henri Mondor, AP-HP, 51 Avenue du Maréchal de Lattre de Tassigny, Créteil, France; IMRB, INSERM, Université Paris Est Créteil and NeurATRIS, France.
| |
Collapse
|
16
|
Wright P, Veronese M, Mazibuko N, Turkheimer FE, Rabiner EA, Ballard CG, Williams SCR, Hari Narayanan AK, Osrah B, Williams R, Marques TR, Howes OD, Roncaroli F, O'Sullivan MJ. Patterns of Mitochondrial TSPO Binding in Cerebral Small Vessel Disease: An in vivo PET Study With Neuropathological Comparison. Front Neurol 2020; 11:541377. [PMID: 33178101 PMCID: PMC7596201 DOI: 10.3389/fneur.2020.541377] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 08/20/2020] [Indexed: 12/11/2022] Open
Abstract
Small vessel disease (SVD) is associated with cognitive impairment in older age and be implicated in vascular dementia. Post-mortem studies show proliferation of activated microglia in the affected white matter. However, the role of inflammation in SVD pathogenesis is incompletely understood and better biomarkers are needed. We hypothesized that expression of the 18 kDa translocator protein (TSPO), a marker of microglial activation, would be higher in SVD. Positron emission tomography (PET) was performed with the second-generation TSPO ligand [11C]PBR28 in 11 participants with SVD. TSPO binding was evaluated by a two-tissue compartment model, with and without a vascular binding component, in white matter hyperintensities (WMH) and normal-appearing white matter (NAWM). In post-mortem tissue, in a separate cohort of individuals with SVD, immunohistochemistry was performed for TSPO and a pan-microglial marker Iba1. Kinetic modeling showed reduced tracer volume and blood volume fraction in WMH compared with NAWM, but a significant increase in vascular binding. Vascular [11C]PBR28 binding was also increased compared with normal-appearing white matter of healthy participants free of SVD. Immunohistochemistry showed a diffuse increase in microglial staining (with Iba1) in sampled tissue in SVD compared with control samples, but with only a subset of microglia staining positively for TSPO. Intense TSPO staining was observed in the vicinity of damaged small blood vessels, which included perivascular macrophages. The results suggest an altered phenotype of activated microglia, with reduced TSPO expression, in the areas of greatest white matter ischemia in SVD, with implications for the interpretation of TSPO PET studies in older individuals or those with vascular risk factors.
Collapse
Affiliation(s)
- Paul Wright
- Department of Neuroimaging, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Mattia Veronese
- Department of Neuroimaging, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Ndabezinhle Mazibuko
- Department of Neuroimaging, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Federico E. Turkheimer
- Department of Neuroimaging, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Eugenii A. Rabiner
- Department of Neuroimaging, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, United Kingdom
- Invicro, London, United Kingdom
| | - Clive G. Ballard
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Steven C. R. Williams
- Department of Neuroimaging, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Avinash Kumar Hari Narayanan
- Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Manchester Centre for Clinical Neuroscience, Salford Royal Foundation Trust, Salford, United Kingdom
| | - Bahiya Osrah
- Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Manchester Centre for Clinical Neuroscience, Salford Royal Foundation Trust, Salford, United Kingdom
| | - Ricky Williams
- Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Manchester Centre for Clinical Neuroscience, Salford Royal Foundation Trust, Salford, United Kingdom
| | - Tiago R. Marques
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Oliver D. Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Federico Roncaroli
- Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Manchester Centre for Clinical Neuroscience, Salford Royal Foundation Trust, Salford, United Kingdom
| | - Michael J. O'Sullivan
- Department of Neuroimaging, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, United Kingdom
- University of Queensland Centre for Clinical Research, Brisbane, QLD, Australia
- Department of Neurology, The Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| |
Collapse
|
17
|
Van Camp N, Balbastre Y, Herard AS, Lavisse S, Tauber C, Wimberley C, Guillermier M, Berniard A, Gipchtein P, Jan C, Badin RA, Delzescaux T, Hantraye P, Bonvento G. Assessment of simplified methods for quantification of [ 18F]-DPA-714 using 3D whole-brain TSPO immunohistochemistry in a non-human primate. J Cereb Blood Flow Metab 2020; 40:1103-1116. [PMID: 31238764 PMCID: PMC7181080 DOI: 10.1177/0271678x19859034] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The 18 kDa translocator protein (TSPO) is the main molecular target to image neuroinflammation by positron emission tomography (PET). However, TSPO-PET quantification is complex and none of the kinetic modelling approaches has been validated using a voxel-by-voxel comparison of TSPO-PET data with the actual TSPO levels of expression. Here, we present a single case study of binary classification of in vivo PET data to evaluate the statistical performance of different TSPO-PET quantification methods. To that end, we induced a localized and adjustable increase of TSPO levels in a non-human primate brain through a viral-vector strategy. We then performed a voxel-wise comparison of the different TSPO-PET quantification approaches providing parametric [18F]-DPA-714 PET images, with co-registered in vitro three-dimensional TSPO immunohistochemistry (3D-IHC) data. A data matrix was extracted from each brain hemisphere, containing the TSPO-IHC and TSPO-PET data for each voxel position. Each voxel was then classified as false or true, positive or negative after comparison of the TSPO-PET measure to the reference 3D-IHC method. Finally, receiver operating characteristic curves (ROC) were calculated for each TSPO-PET quantification method. Our results show that standard uptake value ratios using cerebellum as a reference region (SUVCBL) has the most optimal ROC score amongst all non-invasive approaches.
Collapse
Affiliation(s)
- Nadja Van Camp
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Département de la Recherche Fondamentale, Institut François Jacob, Molecular Imaging Center (MIRCen), CNRS UMR 9199, Université Paris-Sud, Université Paris-Saclay, Fontenay-aux-Roses, France
| | - Yaël Balbastre
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Département de la Recherche Fondamentale, Institut François Jacob, Molecular Imaging Center (MIRCen), CNRS UMR 9199, Université Paris-Sud, Université Paris-Saclay, Fontenay-aux-Roses, France
| | - Anne-Sophie Herard
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Département de la Recherche Fondamentale, Institut François Jacob, Molecular Imaging Center (MIRCen), CNRS UMR 9199, Université Paris-Sud, Université Paris-Saclay, Fontenay-aux-Roses, France
| | - Sonia Lavisse
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Département de la Recherche Fondamentale, Institut François Jacob, Molecular Imaging Center (MIRCen), CNRS UMR 9199, Université Paris-Sud, Université Paris-Saclay, Fontenay-aux-Roses, France
| | - Clovis Tauber
- UMR Inserm U 1253 - Imagerie et Cerveau (iBrain) - University of Tours, Tours, France
| | - Catriona Wimberley
- Edinburgh Imaging Facility QMRI, The University of Edinburgh, Edinburgh, UK
| | - Martine Guillermier
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Département de la Recherche Fondamentale, Institut François Jacob, Molecular Imaging Center (MIRCen), CNRS UMR 9199, Université Paris-Sud, Université Paris-Saclay, Fontenay-aux-Roses, France
| | - Aurélie Berniard
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Département de la Recherche Fondamentale, Institut François Jacob, Molecular Imaging Center (MIRCen), CNRS UMR 9199, Université Paris-Sud, Université Paris-Saclay, Fontenay-aux-Roses, France
| | - Pauline Gipchtein
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Département de la Recherche Fondamentale, Institut François Jacob, Molecular Imaging Center (MIRCen), CNRS UMR 9199, Université Paris-Sud, Université Paris-Saclay, Fontenay-aux-Roses, France
| | - Caroline Jan
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Département de la Recherche Fondamentale, Institut François Jacob, Molecular Imaging Center (MIRCen), CNRS UMR 9199, Université Paris-Sud, Université Paris-Saclay, Fontenay-aux-Roses, France
| | - Romina Aron Badin
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Département de la Recherche Fondamentale, Institut François Jacob, Molecular Imaging Center (MIRCen), CNRS UMR 9199, Université Paris-Sud, Université Paris-Saclay, Fontenay-aux-Roses, France
| | - Thierry Delzescaux
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Département de la Recherche Fondamentale, Institut François Jacob, Molecular Imaging Center (MIRCen), CNRS UMR 9199, Université Paris-Sud, Université Paris-Saclay, Fontenay-aux-Roses, France
| | - Philippe Hantraye
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Département de la Recherche Fondamentale, Institut François Jacob, Molecular Imaging Center (MIRCen), CNRS UMR 9199, Université Paris-Sud, Université Paris-Saclay, Fontenay-aux-Roses, France
| | - Gilles Bonvento
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Département de la Recherche Fondamentale, Institut François Jacob, Molecular Imaging Center (MIRCen), CNRS UMR 9199, Université Paris-Sud, Université Paris-Saclay, Fontenay-aux-Roses, France
| |
Collapse
|
18
|
Bodini B, Poirion E, Tonietto M, Benoit C, Palladino R, Maillart E, Portera E, Battaglini M, Bera G, Kuhnast B, Louapre C, Bottlaender M, Stankoff B. Individual Mapping of Innate Immune Cell Activation Is a Candidate Marker of Patient-Specific Trajectories of Worsening Disability in Multiple Sclerosis. J Nucl Med 2020; 61:1043-1049. [PMID: 32005777 DOI: 10.2967/jnumed.119.231340] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 11/19/2019] [Indexed: 11/16/2022] Open
Abstract
Our objective was to develop a novel approach to generate individual maps of white matter (WM) innate immune cell activation using 18F-DPA-714 translocator protein PET and to explore the relationship between these maps and individual trajectories of worsening disability in patients with multiple sclerosis (MS). Methods: Patients with MS (n = 37), whose trajectories of worsening disability over the 2 y preceding study entry were calculated, and healthy controls (n = 19) underwent MRI and 18F-DPA-714 PET. A threshold for significant activation of 18F-DPA-714 binding was calculated with a voxelwise randomized permutation-based comparison between patients and controls and used to classify each WM voxel in all subjects as characterized by a significant activation of innate immune cells (DPA+) or not. Individual maps of innate immune cell activation in the WM were used to calculate the extent of activation in WM regions of interests and to classify each WM lesion as DPA-active, DPA-inactive, or unclassified. Results: Compared with the WM of healthy controls, patients with MS had a significantly higher percentage of DPA+ voxels in the normal-appearing WM (NAWM) (NAWM in patients, 24.6% ± 1.4%; WM in controls, 14.6% ± 2.0%; P < 0.001). In patients with MS, the percentage of DPA+ voxels increased significantly from the NAWM to the perilesional areas, T2 hyperintense lesions, and T1 hypointense lesions (38.1% ± 2.6%, 45.0% ± 2.6%, 51.8% ± 2.6%, respectively; P < 0.001). Among the 1,379 T2 lesions identified, 512 were defined as DPA-active and 258 as DPA-inactive. A higher number of lesions classified as DPA-active (odds ratio, 1.13; P = 0.009), a higher percentage of DPA+ voxels in the NAWM (odds ratio, 1.16; P = 0.009), and a higher percentage of DPA+ voxels in T1 spin-echo lesions (odds ratio, 1.06; P = 0.036) were significantly associated with a retrospectively more severe clinical trajectory in patients with MS. Conclusion: A more severe trajectory of disability worsening in MS is associated with innate immune cell activation inside and around WM lesions. 18F-DPA-714 PET may provide a promising biomarker to identify patients at risk of a severe clinical trajectory.
Collapse
Affiliation(s)
- Benedetta Bodini
- Sorbonne Universités, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital de la Pitié Salpêtrière, INSERM UMR S 1127, CNRS UMR 7225, Paris, France.,Assistance Publique des Hôpitaux de Paris, France
| | - Emilie Poirion
- Sorbonne Universités, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital de la Pitié Salpêtrière, INSERM UMR S 1127, CNRS UMR 7225, Paris, France
| | - Matteo Tonietto
- Sorbonne Universités, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital de la Pitié Salpêtrière, INSERM UMR S 1127, CNRS UMR 7225, Paris, France
| | - Charline Benoit
- Sorbonne Universités, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital de la Pitié Salpêtrière, INSERM UMR S 1127, CNRS UMR 7225, Paris, France
| | - Raffaele Palladino
- School of Public Health, Imperial College of London, London, United Kingdom.,University "Federico II" of Naples, Naples, Italy
| | - Elisabeth Maillart
- Sorbonne Universités, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital de la Pitié Salpêtrière, INSERM UMR S 1127, CNRS UMR 7225, Paris, France.,Assistance Publique des Hôpitaux de Paris, France
| | - Erika Portera
- Sorbonne Universités, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital de la Pitié Salpêtrière, INSERM UMR S 1127, CNRS UMR 7225, Paris, France
| | - Marco Battaglini
- Department of Neurological Sciences, University of Siena, Siena, Italy; and
| | - Geraldine Bera
- Sorbonne Universités, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital de la Pitié Salpêtrière, INSERM UMR S 1127, CNRS UMR 7225, Paris, France.,Assistance Publique des Hôpitaux de Paris, France
| | - Bertrand Kuhnast
- CEA, Université Paris Sud, Université Paris-Saclay, Service Hospitalier Frédéric Joliot, Orsay, France
| | - Céline Louapre
- Sorbonne Universités, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital de la Pitié Salpêtrière, INSERM UMR S 1127, CNRS UMR 7225, Paris, France.,Assistance Publique des Hôpitaux de Paris, France
| | - Michel Bottlaender
- CEA, Université Paris Sud, Université Paris-Saclay, Service Hospitalier Frédéric Joliot, Orsay, France
| | - Bruno Stankoff
- Sorbonne Universités, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital de la Pitié Salpêtrière, INSERM UMR S 1127, CNRS UMR 7225, Paris, France .,Assistance Publique des Hôpitaux de Paris, France
| |
Collapse
|
19
|
De Picker L, Morrens M. Perspective: Solving the Heterogeneity Conundrum of TSPO PET Imaging in Psychosis. Front Psychiatry 2020; 11:362. [PMID: 32425835 PMCID: PMC7206714 DOI: 10.3389/fpsyt.2020.00362] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 04/09/2020] [Indexed: 12/11/2022] Open
Abstract
Positron emission tomography using ligands targeting translocator protein 18 kDa (TSPO PET) is an innovative method to visualize and quantify glial inflammatory responses in the central nervous system in vivo. Compared to some other neuropsychiatric disorders, findings of TSPO PET in schizophrenia and related psychotic disorders have been considerably more heterogeneous. Two conflicting meta-analyses have been published on the topic within the last year: one asserting evidence for decreased TSPO uptake, while the other observed increased TSPO uptake in a selection of studies. In this paper, we review and discuss five hypotheses which may explain the observed variability of TSPO PET findings in psychotic illness, namely that (1) an inflammatory phenotype is only present in a subgroup of psychosis patients; (2) heterogeneity is caused by interference of antipsychotic medication; (3) interference of other clinical confounders in the study populations (such as age, sex, BMI, smoking, and substance use); or (4) methodological variability between studies (such as choice of tracer and kinetic model, genotyping, study power, and diurnal effects); and (5) the glial responses underlying changes in TSPO expression are themselves heterogeneous and dynamic. Finally, we propose four key recommendations for future research proposals to mitigate these different causes of heterogeneity.
Collapse
Affiliation(s)
- Livia De Picker
- Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Antwerp, Belgium.,SINAPS, University Psychiatric Hospital Campus Duffel, Duffel, Belgium
| | - Manuel Morrens
- Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Antwerp, Belgium.,SINAPS, University Psychiatric Hospital Campus Duffel, Duffel, Belgium
| |
Collapse
|
20
|
Rizzo G, Veronese M, Tonietto M, Bodini B, Stankoff B, Wimberley C, Lavisse S, Bottlaender M, Bloomfield PS, Howes O, Zanotti-Fregonara P, Turkheimer FE, Bertoldo A. Generalization of endothelial modelling of TSPO PET imaging: Considerations on tracer affinities. J Cereb Blood Flow Metab 2019; 39:874-885. [PMID: 29135382 PMCID: PMC6501510 DOI: 10.1177/0271678x17742004] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The 18 kDa translocator protein (TSPO) is a marker of microglia activation and the main target of positron emission tomography (PET) ligands for neuroinflammation. Previous works showed that accounting for TSPO endothelial binding improves PET quantification for [11C]PBR28, [18F]DPA714 and [11C]-R-PK11195. It is still unclear, however, whether the vascular signal is tracer-dependent. This work aims to explore the relationship between the TSPO vascular and tissue components for PET tracers with varying affinity, also assessing the impact of affinity towards the differentiability amongst kinetics and the ensuing ligand amenability to cluster analysis for the extraction of a reference region. First, we applied the compartmental model accounting for vascular binding to [11C]-R-PK11195 data from six healthy subjects. Then, we compared the [11C]-R-PK11195 vascular binding estimates with previously published values for [18F]DPA714 and [11C]PBR28. Finally, we determined the suitability for reference region extraction by calculating the angle between grey and white matter kinetics. Our results showed that endothelial binding is common to all TSPO tracers and proportional to their affinity. By consequence, grey and white matter kinetics were most similar for the radioligand with the highest affinity (i.e. [11C]PBR28), hence poorly suited for the extraction of a reference region using supervised clustering.
Collapse
Affiliation(s)
- Gaia Rizzo
- 1 Department of Information Engineering, Padova University, Padova, Italy
| | - Mattia Veronese
- 2 Department of Neuroimaging, King's College London, London, UK
| | - Matteo Tonietto
- 3 UPMC, Institut du Cerveau et de la Moelle épinière, Hôpital de la Pitié Salpêtrière, Sorbonne Universités, Paris, France
| | - Benedetta Bodini
- 3 UPMC, Institut du Cerveau et de la Moelle épinière, Hôpital de la Pitié Salpêtrière, Sorbonne Universités, Paris, France.,4 Assistance Publique des Hopitaux de Paris, APHP, Hôpital Saint Antoine, Paris, France
| | - Bruno Stankoff
- 3 UPMC, Institut du Cerveau et de la Moelle épinière, Hôpital de la Pitié Salpêtrière, Sorbonne Universités, Paris, France.,4 Assistance Publique des Hopitaux de Paris, APHP, Hôpital Saint Antoine, Paris, France.,5 IMIV, Inserm, CEA, Paris-Sud Univ, Université Paris Saclay, Orsay, France
| | - Catriona Wimberley
- 5 IMIV, Inserm, CEA, Paris-Sud Univ, Université Paris Saclay, Orsay, France
| | - Sonia Lavisse
- 6 Département de Recherche Fondamentale (DRF), Institut d'Imagerie Biomédicale (I2BM), Fontenay-aux-Roses, France.,7 Centre National de la Recherche Scientifique (CNRS), Université Paris-Sud, Université Paris-Saclay, Fontenay-aux-Roses, France
| | - Michel Bottlaender
- 5 IMIV, Inserm, CEA, Paris-Sud Univ, Université Paris Saclay, Orsay, France.,8 Neurospin, CEA, Gif-sur-Yvette, France
| | | | - Oliver Howes
- 9 Institute of Clinical Sciences, Imperial College London, London, UK.,10 Department of Psychosis Studies, King's College London, London, UK
| | - Paolo Zanotti-Fregonara
- 11 Houston Methodist Hospital, PET Core Facility, Research Institute, Stanley H. Appel Department of Neurology, Houston, Texas, USA
| | | | - Alessandra Bertoldo
- 1 Department of Information Engineering, Padova University, Padova, Italy.,12 Padua Neuroscience Center, University of Padova, Padova, Italy
| |
Collapse
|
21
|
Zinnhardt B, Belloy M, Fricke IB, Orije J, Guglielmetti C, Hermann S, Wagner S, Schäfers M, Van der Linden A, Jacobs AH. Molecular Imaging of Immune Cell Dynamics During De- and Remyelination in the Cuprizone Model of Multiple Sclerosis by [ 18F]DPA-714 PET and MRI. Theranostics 2019; 9:1523-1537. [PMID: 31037121 PMCID: PMC6485187 DOI: 10.7150/thno.32461] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 01/07/2019] [Indexed: 12/27/2022] Open
Abstract
Background: Activation and dysregulation of innate, adaptive and resident immune cells in response to damage determine the pathophysiology of demyelinating disorders. Among the plethora of involved cells, microglia/macrophages and astrocytes play an important role in the pathogenesis of demyelinating disorders. The in-depth investigation of the spatio-temporal profile of these cell types in vivo may inform about the exact disease state and localization as well as may allow to monitor therapeutic modulation of the components of the neuroinflammatory response during the course of multiple sclerosis (MS). In this study, we aimed to non-invasively decipher the degree and temporal profile of neuroinflammation (TSPO - [18F]DPA-714 PET) in relation to selected magnetic resonance imaging (MRI) parameters (T2 maps) in the cuprizone (CPZ)-induced model of demyelination. Methods: C57Bl6 (n=30) mice were fed with a standard chow mixed with 0.2% (w/w) CPZ for 4 (n=10; demyelination) and 6 weeks (n=10; spontaneous remyelination). The degree of neuroinflammation at de- and remyelination was assessed by [18F]DPA-714 PET, multi-echo T2 MRI, autoradiography and immunohistochemistry. Results: CPZ-induced brain alterations were confirmed by increase of T2 relaxation times in both white and grey matter after 3 and 5 weeks of CPZ. Peak [18F]DPA-714 was found in the corpus callosum (CC, white matter), the hippocampus (HC, grey matter) and thalamus (grey matter) after 4 weeks of CPZ treatment and declined after 6 weeks of CPZ. Ex vivo autoradiography and dedicated immunofluorescence showed demyelination/remyelination with corresponding increased/decreased TSPO levels in the CC and hippocampus, confirming the spatial distribution of [18F]DPA-714 in vivo. The expression of TSPO microglia and astrocytes is time-dependent in this model. Microglia predominantly express TSPO at demyelination, while the majority of astrocytes express TSPO during remyelination. The combination of PET- and MRI-based imaging biomarkers demonstrated the regional and temporal development of the CPZ model-associated neuroinflammatory response in grey and white matter regions. Conclusions: The combination of [18F]DPA-714 PET and T2 mapping may allow to further elucidate the regional and temporal profile of inflammatory signals depending on the myelination status, although the underlying inflammatory microenvironment changes. A combination of the described imaging biomarkers may facilitate the development of patient-tailored strategies for immunomodulatory and neuro-restorative therapies in MS.
Collapse
Affiliation(s)
- Bastian Zinnhardt
- European Institute for Molecular Imaging (EIMI), University of Münster, Münster, Germany
- Imaging Neuroinflammation in Neurodegenerative Diseases (INMIND) EU FP7 consortium
- PET Imaging in Drug Design and Development (PET3D)
- Department of Nuclear Medicine, Universitätsklinikum Münster, Münster, Germany
| | - Michaël Belloy
- Bio-Imaging Laboratory, Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
- Imaging Neuroinflammation in Neurodegenerative Diseases (INMIND) EU FP7 consortium
| | - Inga B. Fricke
- European Institute for Molecular Imaging (EIMI), University of Münster, Münster, Germany
- Imaging Neuroinflammation in Neurodegenerative Diseases (INMIND) EU FP7 consortium
- Current affiliation: TECHNA Institute for the Advancement of Technology for Health, University Health Network; Institute of Biomaterials and Biomedical Engineering, University of Toronto; both Toronto, Ontario, Canada
| | - Jasmien Orije
- Bio-Imaging Laboratory, Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
- Imaging Neuroinflammation in Neurodegenerative Diseases (INMIND) EU FP7 consortium
| | - Caroline Guglielmetti
- Bio-Imaging Laboratory, Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
- Imaging Neuroinflammation in Neurodegenerative Diseases (INMIND) EU FP7 consortium
| | - Sven Hermann
- European Institute for Molecular Imaging (EIMI), University of Münster, Münster, Germany
| | - Stefan Wagner
- Department of Nuclear Medicine, Universitätsklinikum Münster, Münster, Germany
| | - Michael Schäfers
- European Institute for Molecular Imaging (EIMI), University of Münster, Münster, Germany
- Department of Nuclear Medicine, Universitätsklinikum Münster, Münster, Germany
| | - Annemie Van der Linden
- Bio-Imaging Laboratory, Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
- Imaging Neuroinflammation in Neurodegenerative Diseases (INMIND) EU FP7 consortium
| | - Andreas H. Jacobs
- European Institute for Molecular Imaging (EIMI), University of Münster, Münster, Germany
- Imaging Neuroinflammation in Neurodegenerative Diseases (INMIND) EU FP7 consortium
- PET Imaging in Drug Design and Development (PET3D)
- Department of Geriatrics, Johanniter Hospital, Evangelische Kliniken, Bonn, Germany
| |
Collapse
|
22
|
Zanotti-Fregonara P, Kreisl WC, Innis RB, Lyoo CH. Automatic Extraction of a Reference Region for the Noninvasive Quantification of Translocator Protein in Brain Using 11C-PBR28. J Nucl Med 2019; 60:978-984. [PMID: 30655330 DOI: 10.2967/jnumed.118.222927] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 12/10/2018] [Indexed: 01/06/2023] Open
Abstract
Brain inflammation is associated with various types of neurodegenerative diseases, including Alzheimer disease (AD). Quantifying inflammation with PET is a challenging and invasive procedure, especially in frail patients, because it requires blood sampling from an arterial catheter. A widely used alternative to arterial sampling is a supervised clustering algorithm (SVCA), which identifies the voxels with minimal specific binding in the PET images, thus extracting a reference region for noninvasive kinetic modeling. Methods: We tested this algorithm on a large population of subjects injected with the translocator protein radioligand 11C-PBR28 and compared the kinetic modeling results obtained with the gold standard of arterial input function (V T/f p) with those obtained by SVCA (distribution volume ratio [DVR] with Logan plot). The study comprised 57 participants (21 healthy controls, 11 mild cognitive impairment patients, and 25 AD patients). Results: We found that V T/f p was greater in AD patients than in controls in the inferior parietal, combined middle and inferior temporal, and entorhinal cortices. SVCA-DVR identified increased binding in the same regions and in an additional one, the parahippocampal region. We noticed however that the average amplitude of the reference curve obtained from subjects with genetic high-affinity binding for 11C-PBR28 was significantly larger than that from subjects with moderate affinity. This suggests that the reference curve extracted by SVCA was contaminated by specific binding. Conclusion: SVCA allows the noninvasive quantification of inflammatory biomarker translocator protein measured with 11C-PBR28 but without the need of arterial sampling. Although the reference curves were contaminated with specific binding, the decreased variance of the outcome measure, SVCA DVR, allowed for an apparent greater sensitivity to detect regional abnormalities in brains of patients with AD.
Collapse
Affiliation(s)
| | - William C Kreisl
- Taub Institute, Columbia University Medical Center, New York, New York
| | - Robert B Innis
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland; and
| | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| |
Collapse
|
23
|
Volume-of-interest-based supervised cluster analysis for pseudo-reference region selection in [ 18F]DPA-714 PET imaging of the rat brain. EJNMMI Res 2018; 8:112. [PMID: 30588554 PMCID: PMC6306370 DOI: 10.1186/s13550-018-0467-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 12/11/2018] [Indexed: 12/13/2022] Open
Abstract
Method Aim of this study was to automatically select a suitable pseudo-reference brain region for the accurate, non-invasive quantification of neuroinflammation in a rat brain using dynamic [18F]DPA-714 PET imaging. Procedures A supervised clustering analysis approach considering three kinetic classes (SVCA3) was used to select an appropriate pseudo-reference brain region. This pseudo-reference region was determined by selecting only brain regions with low specific tracer uptake (SVCA3low) or by taking into account all brain regions and weighting each brain region with the corresponding fraction of low specific binding (SVCA3wlow). Both SVCA3 approaches were evaluated in an animal model of neuro-inflammation induced by lipopolysaccharide injection in the right striatum of female Wistar rats. For this study setup, a population of 25 female Wistar rats received a dynamic PET scan after injection of ~ 60 MBq [18F]DPA-714. Animals were scanned at baseline (n = 3) and at different time points after inducing neuroinflammation: 1 day (n = 3), 3 days (n = 12), 7 days (n = 4), and 30 days (n = 3). Binding potential (BP) values using a simplified reference tissue model (SRTM) and the contralateral striatum as pseudo-reference region were considered as a reference method (BPL STR) and compared with SRTM BP values using a pseudo-reference region obtained by either the SVCA3low or SVCA3wlow approach for both a 90- and 120-min acquisition time interval. Results For the right striatum, SRTM BP values using a SVCA3low- or SVCA3wlow-based pseudo-reference region demonstrated a strong and highly significant correlation with SRTM BPL STR values (Spearman r ≥ 0.89, p < 0.001). For the SVCA3low approach, Friedman tests revealed no significant difference with SRTM BPL STR values for a 120-min acquisition time while small but signification differences were found for a 90-min acquisition time (p < 0.05). For the SVCA3wlow approach, highly signification differences (p < 0.001) were found with SRTM BPL STR values for both a 90- and 120-min acquisition time interval. Conclusions A SVCA3 approach using three kinetic classes allowed the automatic selection of pseudo-reference brain regions with low specific tracer binding for accurate and non-invasive quantification of rat brain PET imaging using [18F]DPA-714. A shorter acquisition time interval of 90 min can be considered with only limited impact on the SVCA3-based selection of the pseudo-reference brain regions.
Collapse
|
24
|
Stankoff B, Poirion E, Tonietto M, Bodini B. Exploring the heterogeneity of MS lesions using positron emission tomography: a reappraisal of their contribution to disability. Brain Pathol 2018; 28:723-734. [PMID: 30020560 PMCID: PMC8099240 DOI: 10.1111/bpa.12641] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Accepted: 07/09/2018] [Indexed: 12/22/2022] Open
Abstract
The biological mechanisms driving disability worsening in multiple sclerosis (MS) are only partly understood. Monitoring changes in lesion load on MRI has a limited predictive value on the progression of clinical disability, and there is an essential need for novel imaging markers specific for the main candidate mechanisms underlying neurodegeneration which include failing myelin repair, innate immune cell activation and gray matter neuronal damage. Positron Emission Tomography (PET) is an imaging technology based on the injection of radiotracers directed against specific molecular targets, which has recently allowed the selective quantification in-vivo of the key biological mechanisms relevant to MS pathophysiology. Pilot PET studies performed in patients with all forms of MS allowed to revisit the contribution of MS lesions to disability worsening and showed that the evolution of lesions toward chronic activation, together with their remyelination profile were relevant predictors of disability worsening. PET offers the opportunity to bridge a critical gap between neuropathology and in-vivo imaging. This technique provides an original approach to disentangle some of the most relevant pathological components driving MS progression, to follow-up their temporal evolution, to investigate their clinical relevance and to evaluate novel therapeutics aimed to prevent disease progression.
Collapse
Affiliation(s)
- Bruno Stankoff
- Sorbonne UniversitésUPMC Paris 06Institut du Cerveau et de la Moelle épinièreICMHôpital de la Pitié SalpêtrièreInserm UMR S 1127CNRS UMR 7225ParisFrance
- AP‐HPHôpital Saint‐AntoineParisFrance
| | - Emilie Poirion
- Sorbonne UniversitésUPMC Paris 06Institut du Cerveau et de la Moelle épinièreICMHôpital de la Pitié SalpêtrièreInserm UMR S 1127CNRS UMR 7225ParisFrance
| | - Matteo Tonietto
- Sorbonne UniversitésUPMC Paris 06Institut du Cerveau et de la Moelle épinièreICMHôpital de la Pitié SalpêtrièreInserm UMR S 1127CNRS UMR 7225ParisFrance
| | - Benedetta Bodini
- Sorbonne UniversitésUPMC Paris 06Institut du Cerveau et de la Moelle épinièreICMHôpital de la Pitié SalpêtrièreInserm UMR S 1127CNRS UMR 7225ParisFrance
- AP‐HPHôpital Saint‐AntoineParisFrance
| |
Collapse
|
25
|
Lagarde J, Sarazin M, Bottlaender M. In vivo PET imaging of neuroinflammation in Alzheimer's disease. J Neural Transm (Vienna) 2017; 125:847-867. [PMID: 28516240 DOI: 10.1007/s00702-017-1731-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 05/01/2017] [Indexed: 12/15/2022]
Abstract
Increasing evidence suggests that neuroinflammation contributes to the pathophysiology of many neurodegenerative diseases, especially Alzheimer's disease (AD). Molecular imaging by PET may be a useful tool to assess neuroinflammation in vivo, thus helping to decipher the complex role of inflammatory processes in the pathophysiology of neurodegenerative diseases and providing a potential means of monitoring the effect of new therapeutic approaches. For this objective, the main target of PET studies is the 18 kDa translocator protein (TSPO), as it is overexpressed by activated microglia. In the present review, we describe the most widely used PET tracers targeting the TSPO, the methodological issues in tracer quantification and summarize the results obtained by TSPO PET imaging in AD, as well as in neurodegenerative disorders associated with AD, in psychiatric disorders and ageing. We also briefly describe alternative PET targets and imaging modalities to study neuroinflammation. Lastly, we question the meaning of PET imaging data in the context of a highly complex and multifaceted role of neuroinflammation in neurodegenerative diseases. This overview leads to the conclusion that PET imaging of neuroinflammation is a promising way of deciphering the enigma of the pathophysiology of AD and of monitoring the effect of new therapies.
Collapse
Affiliation(s)
- Julien Lagarde
- Unit of Neurology of Memory and Language, Centre de Psychiatrie et Neurosciences, INSERM UMR S894, Centre Hospitalier Sainte-Anne and Université Paris Descartes, Sorbonne Paris Cité, 75014, Paris, France
| | - Marie Sarazin
- Unit of Neurology of Memory and Language, Centre de Psychiatrie et Neurosciences, INSERM UMR S894, Centre Hospitalier Sainte-Anne and Université Paris Descartes, Sorbonne Paris Cité, 75014, Paris, France
| | - Michel Bottlaender
- UNIACT, NeuroSpin, Institut d'Imagerie Biomédicale, Direction de la Recherche Fondamentale, Commissariat à l'Energie Atomique, 91191, Gif-sur-Yvette, France. .,Laboratoire Imagerie Moléculaire in Vivo, UMR 1023, Service Hospitalier Frédéric Joliot, Institut d'Imagerie Biomédicale, Direction de la Recherche Fondamentale, Commissariat à l'Energie Atomique, 91400, Orsay, France.
| |
Collapse
|