1
|
Lu M, Pontecorvo MJ, Devous MD, Arora AK, Galante N, McGeehan A, Devadanam C, Salloway SP, Doraiswamy PM, Curtis C, Truocchio SP, Flitter M, Locascio T, Devine M, Zimmer JA, Fleisher AS, Mintun MA. Aggregated Tau Measured by Visual Interpretation of Flortaucipir Positron Emission Tomography and the Associated Risk of Clinical Progression of Mild Cognitive Impairment and Alzheimer Disease: Results From 2 Phase III Clinical Trials. JAMA Neurol 2021; 78:445-453. [PMID: 33587110 PMCID: PMC7885097 DOI: 10.1001/jamaneurol.2020.5505] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Questions What is the association between flortaucipir positron emission tomography (PET) imaging
visual classification using a clinically applicable and US Food and Drug
Administration–approved method and 18-month cognitive and functional decline in
patients with clinically diagnosed mild cognitive impairment and dementia owing to
Alzheimer disease (AD)? Findings In this analysis of 2 open-label clinical trials, visual read of an advanced
flortaucipir PET AD pattern was associated with an increased risk of 18-month cognitive
and functional decline compared with other scan patterns. Meaning Clinically applicable visual reads of flortaucipir PET scans may provide valuable
information regarding the risk of near-term clinical deterioration among patients with
clinically diagnosed mild cognitive impairment or dementia owing to AD. Importance Flortaucipir positron emission tomography (PET) scans, rated with a novel, US Food and
Drug Administration–approved, clinically applicable visual interpretation method,
provide valuable information regarding near-term clinical progression of patients with
Alzheimer disease (AD) or mild cognitive impairment (MCI). Objective To evaluate the association between flortaucipir PET visual interpretation and
patients’ near-term clinical progression. Design/Setting/Participants Two prospective, open-label, longitudinal studies were conducted from December 2014 to
September 2019. Study 1 screened 298 patients and enrolled 160 participants who had a
flortaucipir scan at baseline visit. Study 2 selected 205 participants from the AMARANTH
trial, which was terminated after futility analysis. Out of the 2218 AMARANTH
participants, 424 had a flortaucipir scan around randomization, but 219 did not complete
18-month clinical dementia rating (CDR) assessments and thus were excluded. In both
studies, all participants were diagnosed as clinically impaired, and they were
longitudinally followed up for approximately 18 months after baseline. Main Outcomes and Measures Flortaucipir scans were rated as either advanced or nonadvanced AD pattern using a
predetermined visual interpretation method. The CDR sum of box (CDR-SB) score was used
as primary clinical end point measurement in both studies. Results Of the 364 study participants who had readable scans, 48% were female
(n = 174 of 364), and the mean (SD) age was 71.8 (8.7) years. Two hundred
forty participants were rated as having an advanced AD pattern. At 18 months follow-up,
70% of those with an advanced AD pattern (n = 147 of 210) had 1 point or
more increase in CDR-SB, an event predefined as clinically meaningful deterioration. In
contrast, only 46% of those with a nonadvanced AD pattern scan (n = 48 of
105) experienced the same event (risk ratio [RR], 1.40; 95% CI, 1.11-1.76;
P = .005). The adjusted mean CDR-SB changes were 2.28 and
0.98 for advanced and nonadvanced AD pattern groups, respectively
(P < .001). Analyses with other clinical end point
assessments, as well as analyses with each individual study’s data, consistently
indicated a higher risk of clinical deterioration associated with an advanced AD scan
pattern. Conclusions and Relevance These results suggest that flortaucipir PET scans, when interpreted with an US Food and
Drug Administration–approved, clinically applicable visual interpretation method,
may provide valuable information regarding the risk of clinical deterioration over 18
months among patients with AD and MCI. Trial Registration ClinicalTrials.gov Identifier: NCT02016560
and NCT03901105
Collapse
Affiliation(s)
- Ming Lu
- Avid Radiopharmaceuticals, A Wholly Owned Subsidiary of Eli Lilly and Co, Philadelphia, Pennsylvania
| | - Michael J Pontecorvo
- Avid Radiopharmaceuticals, A Wholly Owned Subsidiary of Eli Lilly and Co, Philadelphia, Pennsylvania
| | - Michael D Devous
- Avid Radiopharmaceuticals, A Wholly Owned Subsidiary of Eli Lilly and Co, Philadelphia, Pennsylvania
| | - Anupa K Arora
- Avid Radiopharmaceuticals, A Wholly Owned Subsidiary of Eli Lilly and Co, Philadelphia, Pennsylvania
| | - Nicholas Galante
- Avid Radiopharmaceuticals, A Wholly Owned Subsidiary of Eli Lilly and Co, Philadelphia, Pennsylvania
| | - Anne McGeehan
- Avid Radiopharmaceuticals, A Wholly Owned Subsidiary of Eli Lilly and Co, Philadelphia, Pennsylvania
| | - Catherine Devadanam
- Avid Radiopharmaceuticals, A Wholly Owned Subsidiary of Eli Lilly and Co, Philadelphia, Pennsylvania
| | - Stephen P Salloway
- Butler Hospital, Providence, Rhode Island.,Brown University, Providence, Rhode Island
| | - P Murali Doraiswamy
- Duke University School of Medicine and the Duke Institute of Brian Science Center, Durham, North Carolina
| | | | - Stephen P Truocchio
- Avid Radiopharmaceuticals, A Wholly Owned Subsidiary of Eli Lilly and Co, Philadelphia, Pennsylvania
| | - Matthew Flitter
- Avid Radiopharmaceuticals, A Wholly Owned Subsidiary of Eli Lilly and Co, Philadelphia, Pennsylvania
| | - Tricia Locascio
- Avid Radiopharmaceuticals, A Wholly Owned Subsidiary of Eli Lilly and Co, Philadelphia, Pennsylvania
| | - Marybeth Devine
- Avid Radiopharmaceuticals, A Wholly Owned Subsidiary of Eli Lilly and Co, Philadelphia, Pennsylvania
| | | | | | - Mark A Mintun
- Avid Radiopharmaceuticals, A Wholly Owned Subsidiary of Eli Lilly and Co, Philadelphia, Pennsylvania.,Eli Lilly and Company, Indianapolis, Indiana
| | | |
Collapse
|
2
|
Fleisher AS, Pontecorvo MJ, Devous MD, Lu M, Arora AK, Truocchio SP, Aldea P, Flitter M, Locascio T, Devine M, Siderowf A, Beach TG, Montine TJ, Serrano GE, Curtis C, Perrin A, Salloway S, Daniel M, Wellman C, Joshi AD, Irwin DJ, Lowe VJ, Seeley WW, Ikonomovic MD, Masdeu JC, Kennedy I, Harris T, Navitsky M, Southekal S, Mintun MA. Positron Emission Tomography Imaging With [18F]flortaucipir and Postmortem Assessment of Alzheimer Disease Neuropathologic Changes. JAMA Neurol 2020; 77:829-839. [PMID: 32338734 PMCID: PMC7186920 DOI: 10.1001/jamaneurol.2020.0528] [Citation(s) in RCA: 208] [Impact Index Per Article: 52.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 01/10/2020] [Indexed: 01/05/2023]
Abstract
Importance Positron emission tomography (PET) may increase the diagnostic accuracy and confirm the underlying neuropathologic changes of Alzheimer disease (AD). Objective To determine the accuracy of antemortem [18F]flortaucipir PET images for predicting the presence of AD-type tau pathology at autopsy. Design, Setting, and Participants This diagnostic study (A16 primary cohort) was conducted from October 2015 to June 2018 at 28 study sites (27 in US sites and 1 in Australia). Individuals with a terminal illness who were older than 50 years and had a projected life expectancy of less than 6 months were enrolled. All participants underwent [18F]flortaucipir PET imaging, and scans were interpreted by 5 independent nuclear medicine physicians or radiologists. Supplemental autopsy [18F]flortaucipir images and pathological samples were also collected from 16 historically collected cases. A second study (FR01 validation study) was conducted from March 26 to April 26, 2019, in which 5 new readers assessed the original PET images for comparison to autopsy. Main Outcomes and Measures [18F]flortaucipir PET images were visually assessed and compared with immunohistochemical tau pathology. An AD tau pattern of flortaucipir retention was assessed for correspondence with a postmortem B3-level (Braak stage V or VI) pathological pattern of tau accumulation and to the presence of amyloid-β plaques sufficient to meet the criteria for high levels of AD neuropathological change. Success was defined as having at least 3 of the 5 readers above the lower bounds of the 95% CI for both sensitivity and specificity of 50% or greater. Results A total of 156 patients were enrolled in the A16 study and underwent [18F]flortaucipir PET imaging. Of these, 73 died during the study, and valid autopsies were performed for 67 of these patients. Three autopsies were evaluated as test cases and removed from the primary cohort (n = 64). Of the 64 primary cohort patients, 34 (53%) were women and 62 (97%) were white; mean (SD) age was 82.5 (9.6) years; and 49 (77%) had dementia, 1 (2%) had mild cognitive impairment, and 14 (22%) had normal cognition. Prespecified success criteria were met for the A16 primary cohort. The flortaucipir PET scans predicted a B3 level of tau pathology, with sensitivity ranging from 92.3% (95% CI, 79.7%-97.3%) to 100.0% (95% CI, 91.0%-100.0%) and specificity ranging from 52.0% (95% CI, 33.5%-70.0%) to 92.0% (95% CI, 75.0%-97.8%). A high level of AD neuropathological change was predicted with sensitivity of 94.7% (95% CI, 82.7%-98.5%) to 100.0% (95% CI, 90.8%-100.0%) and specificity of 50.0% (95% CI, 32.1%-67.9%) to 92.3% (95% CI, 75.9%-97.9%). The FR01 validation study also met prespecified success criteria. Addition of the supplemental autopsy data set and 3 test cases, which comprised a total of 82 patients and autopsies for both the A16 and FR01 studies, resulted in improved specificity and comparable overall accuracy. Among the 156 enrolled participants, 14 (9%) experienced at least 1 treatment-emergent adverse event. Conclusions and Relevance This study's findings suggest that PET imaging with [18F]flortaucipir could be used to identify the density and distribution of AD-type tau pathology and the presence of high levels of AD neuropathological change, supporting a neuropathological diagnosis of AD.
Collapse
Affiliation(s)
| | | | | | - Ming Lu
- Avid Radiopharmaceuticals, Philadelphia, Pennsylvania
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Joseph C. Masdeu
- Houston Methodist Institute for Academic Medicine, Houston, Texas
| | - Ian Kennedy
- Avid Radiopharmaceuticals, Philadelphia, Pennsylvania
| | - Thomas Harris
- Avid Radiopharmaceuticals, Philadelphia, Pennsylvania
| | | | | | | |
Collapse
|
3
|
Pontecorvo MJ, Keene CD, Beach TG, Montine TJ, Arora AK, Devous MD, Navitsky M, Kennedy I, Joshi AD, Lu M, Serrano GE, Sue LI, Intorcia AJ, Rose SE, Wilson A, Hellstern L, Coleman N, Flitter M, Aldea P, Fleisher AS, Mintun MA, Siderowf A. Comparison of regional flortaucipir PET with quantitative tau immunohistochemistry in three subjects with Alzheimer's disease pathology: a clinicopathological study. EJNMMI Res 2020; 10:65. [PMID: 32542468 PMCID: PMC7295920 DOI: 10.1186/s13550-020-00653-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 06/03/2020] [Indexed: 01/16/2023] Open
Abstract
Background The objective of this study was to make a quantitative comparison of flortaucipir PET retention with pathological tau and β-amyloid across a range of brain regions at autopsy. Methods Patients with dementia (two with clinical diagnosis of AD, one undetermined), nearing the end of life, underwent 20-min PET, beginning 80 min after an injection of ~370 mBq flortaucipir [18F]. Neocortical, basal ganglia, and limbic tissue samples were obtained bilaterally from 19 regions at autopsy and subject-specific PET regions of interest corresponding to the 19 sampled target tissue regions in each hemisphere were hand drawn on the PET images. SUVr values were calculated for each region using a cerebellar reference region. Abnormally phosphorylated tau (Ptau) and amyloid-β (Aβ) tissue concentrations were measured for each tissue region with an antibody capture assay (Histelide) using AT8 and H31L21 antibodies respectively. Results The imaging-to-autopsy interval ranged from 4–29 days. All three subjects had intermediate to high levels of AD neuropathologic change at autopsy. Mean cortical SUVr averaged across all three subjects correlated significantly with the Ptau immunoassay (Pearson r = 0.81; p < 0.0001). When Ptau and Aβ1-42 were both included in the model, the Ptau correlation with flortaucipir SUVr was preserved but there was no correlation of Aβ1-42 with flortaucipir. There was also a modest correlation between limbic (hippocampal/entorhinal and amygdala) flortaucipir SUVr and Ptau (Pearson r = 0.52; p < 0.080). There was no significant correlation between SUVr and Ptau in basal ganglia. Conclusions The results of this pilot study support a quantitative relationship between cortical flortaucipir SUVr values and quantitative measures of Ptau at autopsy. Additional research including more cases is needed to confirm the generalizability of these results. Trial registration, NIH Clinicaltrials.gov NCT # 02516046. Registered August 27, 2015. https://clinicaltrials.gov/ct2/show/NCT02516046?term=02516046&draw=2&rank=1
Collapse
Affiliation(s)
- Michael J Pontecorvo
- Avid Radiopharmaceuticals, 3711 Market St., 7th floor, Philadelphia, PA, 19104, USA.
| | - C Dirk Keene
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Thomas G Beach
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Phoenix, AZ, USA
| | | | - Anupa K Arora
- Avid Radiopharmaceuticals, 3711 Market St., 7th floor, Philadelphia, PA, 19104, USA
| | - Michael D Devous
- Avid Radiopharmaceuticals, 3711 Market St., 7th floor, Philadelphia, PA, 19104, USA
| | - Michael Navitsky
- Avid Radiopharmaceuticals, 3711 Market St., 7th floor, Philadelphia, PA, 19104, USA
| | - Ian Kennedy
- Avid Radiopharmaceuticals, 3711 Market St., 7th floor, Philadelphia, PA, 19104, USA
| | - Abhinay D Joshi
- Avid Radiopharmaceuticals, 3711 Market St., 7th floor, Philadelphia, PA, 19104, USA.,Present Address: Medpace Holdings, Inc., Cincinnati, Ohio, USA
| | - Ming Lu
- Avid Radiopharmaceuticals, 3711 Market St., 7th floor, Philadelphia, PA, 19104, USA
| | - Geidy E Serrano
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Phoenix, AZ, USA
| | - Lucia I Sue
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Phoenix, AZ, USA
| | - Anthony J Intorcia
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Phoenix, AZ, USA
| | - Shannon E Rose
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Angela Wilson
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Leanne Hellstern
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Natalie Coleman
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Matthew Flitter
- Avid Radiopharmaceuticals, 3711 Market St., 7th floor, Philadelphia, PA, 19104, USA
| | - Patricia Aldea
- Avid Radiopharmaceuticals, 3711 Market St., 7th floor, Philadelphia, PA, 19104, USA
| | - Adam S Fleisher
- Avid Radiopharmaceuticals, 3711 Market St., 7th floor, Philadelphia, PA, 19104, USA
| | - Mark A Mintun
- Avid Radiopharmaceuticals, 3711 Market St., 7th floor, Philadelphia, PA, 19104, USA
| | - Andrew Siderowf
- Avid Radiopharmaceuticals, 3711 Market St., 7th floor, Philadelphia, PA, 19104, USA.,Present Address: Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
4
|
Pontecorvo MJ, Siderowf A, Dubois B, Doraiswamy PM, Frisoni GB, Grundman M, Nobili F, Sadowsky CH, Salloway S, Arora AK, Chevrette A, Deberdt W, Dell'Agnello G, Flitter M, Galante N, Lowrey MJ, Lu M, McGeehan A, Devous Sr. MD, Mintun MA. Effectiveness of Florbetapir PET Imaging in Changing Patient Management. Dement Geriatr Cogn Disord 2017; 44:129-143. [PMID: 28787712 PMCID: PMC5806476 DOI: 10.1159/000478007] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/05/2017] [Indexed: 12/24/2022] Open
Abstract
AIMS To evaluate the impact of amyloid PET imaging on diagnosis and patient management in a multicenter, randomized, controlled study. METHODS Physicians identified patients seeking a diagnosis for mild cognitive impairment or dementia, possibly due to Alzheimer disease (AD), and recorded a working diagnosis and a management plan. The patients underwent florbetapir PET scanning and were randomized to either immediate or delayed (1-year) feedback regarding amyloid status. At the 3-month visit, the physician updated the diagnosis and recorded a summary of the actual patient management since the post-scan visit. The study examined the impact of immediate versus delayed feedback on patient diagnosis/management at 3 and 12 months. RESULTS A total of 618 subjects were randomized (1:1) to immediate or delayed feedback arms, and 602 subjects completed the 3-month primary endpoint visit. A higher proportion of patients in the immediate feedback arm showed a change in diagnosis compared to the controls (32.6 vs. 6.4%; p = 0.0001). Similarly, a higher proportion of patients receiving immediate feedback had a change in management plan (68 vs. 55.5%; p < 0.002), mainly driven by changes in AD medication. Specifically, acetylcholinesterase inhibitors were prescribed to 67% of the amyloid-positive and 27% of the amyloid-negative subjects in the information group compared with 56 and 43%, respectively, in the control group (p < 0.0001). These between-group differences persisted until the 12-month visit. CONCLUSION Knowledge of the amyloid status affects the diagnosis and alters patient management.
Collapse
Affiliation(s)
- Michael J. Pontecorvo
- Avid Radiopharmaceuticals (a wholly owned subsidiary of Eli Lilly and Company), Philadelphia, Pennsylvania, USA,*Michael J. Pontecorvo, PhD, Avid Radiopharmaceuticals (a wholly owned subsidiary of Eli Lilly and Company), 3711 Market Street, Philadelphia, PA 19104 (USA), E-Mail
| | - Andrew Siderowf
- Avid Radiopharmaceuticals (a wholly owned subsidiary of Eli Lilly and Company), Philadelphia, Pennsylvania, USA
| | - Bruno Dubois
- Dementia Research Center (IM2A), Institut du Cerveau et de la Moelle épinière (ICM), UMR-S975, Université Pierre et Marie Curie-Paris 6, AP-HP, Hôpital de la Salpêtrière, Paris, France
| | - P. Murali Doraiswamy
- Department of Psychiatry, Duke University Health System and the Duke Institute for Brain Sciences, Durham, North Carolina, USA
| | - Giovanni B. Frisoni
- Department of Psychiatry, University Hospitals and University of Geneva, Geneva, Switzerland,Department of Internal Medicine, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Michael Grundman
- Global R&D Partners, LLC, California, USA,University of California, San Diego, California, USA
| | - Flavio Nobili
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | | | | | - Anupa K. Arora
- Avid Radiopharmaceuticals (a wholly owned subsidiary of Eli Lilly and Company), Philadelphia, Pennsylvania, USA
| | - Antoine Chevrette
- Avid Radiopharmaceuticals (a wholly owned subsidiary of Eli Lilly and Company), Philadelphia, Pennsylvania, USA
| | | | | | - Matthew Flitter
- Avid Radiopharmaceuticals (a wholly owned subsidiary of Eli Lilly and Company), Philadelphia, Pennsylvania, USA
| | - Nick Galante
- Avid Radiopharmaceuticals (a wholly owned subsidiary of Eli Lilly and Company), Philadelphia, Pennsylvania, USA
| | - Mark J. Lowrey
- Avid Radiopharmaceuticals (a wholly owned subsidiary of Eli Lilly and Company), Philadelphia, Pennsylvania, USA
| | - Ming Lu
- Avid Radiopharmaceuticals (a wholly owned subsidiary of Eli Lilly and Company), Philadelphia, Pennsylvania, USA
| | - Anne McGeehan
- Avid Radiopharmaceuticals (a wholly owned subsidiary of Eli Lilly and Company), Philadelphia, Pennsylvania, USA
| | - Michael D. Devous Sr.
- Avid Radiopharmaceuticals (a wholly owned subsidiary of Eli Lilly and Company), Philadelphia, Pennsylvania, USA
| | - Mark A. Mintun
- Avid Radiopharmaceuticals (a wholly owned subsidiary of Eli Lilly and Company), Philadelphia, Pennsylvania, USA
| |
Collapse
|
5
|
Shcherbinin S, Schwarz AJ, Joshi A, Navitsky M, Flitter M, Shankle WR, Devous MD, Mintun MA. Kinetics of the Tau PET Tracer 18F-AV-1451 (T807) in Subjects with Normal Cognitive Function, Mild Cognitive Impairment, and Alzheimer Disease. J Nucl Med 2016; 57:1535-1542. [PMID: 27151986 DOI: 10.2967/jnumed.115.170027] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 04/04/2016] [Indexed: 11/16/2022] Open
Abstract
We report kinetic modeling results of dynamic acquisition data from 0 to 100 min after injection with the tau PET tracer 18F-AV-1451 in 19 subjects. METHODS Subjects were clinically diagnosed as 4 young cognitively normal, 5 old cognitively normal, 5 mild cognitive impairment, and 5 Alzheimer disease (AD). Kinetic modeling was performed using Logan graphical analysis with the cerebellum crus as a reference region. Voxelwise binding potential ([Formula: see text]) and SUV ratio ([Formula: see text]) images were compared. RESULTS In AD subjects, slower and spatially nonuniform clearance from cortical regions was observed as compared with the controls, which led to focal uptake and elevated retention in the imaging data from 80 to 100 min after injection. BP from the dynamic data from 0 to 100 min correlated strongly (R2 > 0.86) with corresponding regional [Formula: see text] values. In the putamen, the observed kinetics (positive [Formula: see text] at the tracer delivery stage and plateauing time-SUVR curves for all diagnostic categories) may suggest either additional off-target binding or a second binding site with different kinetics. CONCLUSION The kinetics of the 18F-AV-1451 tracer in cortical areas, as examined in this small group of subjects, differed by diagnostic stage. A delayed 80- to 100-min scan provided a reasonable substitute for a dynamic 0- to 100-min acquisition for cortical regions although other windows (e.g., 75-105 min) may be useful to evaluate.
Collapse
Affiliation(s)
| | | | - Abhinay Joshi
- Avid Radiopharmaceuticals, Inc., Philadelphia, Pennsylvania
| | | | | | - William R Shankle
- Shankle Clinic and Cognitive Disorders Program, Hoag Neurosciences Institute, Newport Beach, California; and UC Irvine Cognitive Science Department, Irvine, California
| | | | - Mark A Mintun
- Avid Radiopharmaceuticals, Inc., Philadelphia, Pennsylvania
| |
Collapse
|
6
|
Sperling RA, Johnson KA, Doraiswamy PM, Reiman EM, Fleisher AS, Sabbagh MN, Sadowsky CH, Carpenter A, Davis MD, Lu M, Flitter M, Joshi AD, Clark CM, Grundman M, Mintun MA, Skovronsky DM, Pontecorvo MJ. Amyloid deposition detected with florbetapir F 18 ((18)F-AV-45) is related to lower episodic memory performance in clinically normal older individuals. Neurobiol Aging 2012; 34:822-31. [PMID: 22878163 DOI: 10.1016/j.neurobiolaging.2012.06.014] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2012] [Revised: 06/01/2012] [Accepted: 06/21/2012] [Indexed: 11/26/2022]
Abstract
The objective of this study was to evaluate the relationship of amyloid burden, as assessed by florbetapir F 18 ((18)F-AV-45) amyloid positron emission tomography, and cognition in healthy older control (HC) subjects. Seventy-eight HC subjects were assessed with a brief cognitive test battery and positron emission tomography (PET) imaging with (18)F-AV-45. A standard uptake value ratio was computed for mean data from 6 cortical regions using a whole cerebellum reference region. Scans were also visually rated as amyloid positive or amyloid negative by 3 readers. Higher standard uptake value ratio correlated with lower immediate memory (r = -0.33; p = 0.003) and delayed recall scores (r = -0.25; p = 0.027). Performance on immediate recall was also lower in the visually rated amyloid positive compared with amyloid negative HC (p = 0.04), with a similar trend observed in delayed recall (p = 0.06). These findings support the hypothesis that higher amyloid burden is associated with lower memory performance among clinically normal older subjects. Longitudinal follow-up is ongoing to determine whether (18)F-AV-45 may also predict subsequent cognitive decline.
Collapse
Affiliation(s)
- Reisa A Sperling
- Center for Alzheimer Research and Treatment, Departments of Neurology, Brigham and Women's Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Gildenberg PL, Zanes C, Flitter M, Lin PM, Lautsch EV, Truex RC. Impedance measuring device for detection of penetration of the spinal cord in anterior percutaneous cervical cordotomy. Technical note. J Neurosurg 1969; 30:87-92. [PMID: 5250269 DOI: 10.3171/jns.1969.30.1.0087] [Citation(s) in RCA: 52] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|