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Royse SK, Snitz BE, Hill AV, Reese AC, Roush RE, Kamboh MI, Bertolet M, Saeed A, Lopresti BJ, Villemagne VL, Lopez OL, Reis SE, Becker JT, Cohen AD. Apolipoprotein E and Alzheimer's disease pathology in African American older adults. Neurobiol Aging 2024; 139:11-19. [PMID: 38582070 DOI: 10.1016/j.neurobiolaging.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 12/08/2023] [Revised: 03/07/2024] [Accepted: 03/22/2024] [Indexed: 04/08/2024]
Abstract
The apolipoprotein-E4 (APOE*4) and apolipoprotein-E2 (APOE*2) alleles are more common in African American versus non-Hispanic white populations, but relationships of both alleles with Alzheimer's disease (AD) pathology among African American individuals are unclear. We measured APOE allele and β-amyloid (Aβ) and tau using blood samples and positron emission tomography (PET) images, respectively. Individual regression models tested associations of each APOE allele with Aβ or tau PET overall, stratified by racialized group, and with a racialized group interaction. We included 358 older adults (42% African American) with Aβ PET, 134 (29% African American) of whom had tau PET. APOE*4 was associated with higher Aβ in non-Hispanic white (P < 0.0001), but not African American (P = 0.64) participants; racialized group modified the association between APOE*4 and Aβ (P < 0.0001). There were no other racialized group differences. These results suggest that the association of APOE*4 and Aβ differs between African American and non-Hispanic white populations. Other drivers of AD pathology in African American populations should be identified as potential therapeutic targets.
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Affiliation(s)
- Sarah K Royse
- University of Pittsburgh Department of Epidemiology, 130 De Soto Street, Pittsburgh, PA 15261, USA; University of Pittsburgh Department of Radiology, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
| | - Beth E Snitz
- University of Pittsburgh Department of Neurology, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA
| | - Ashley V Hill
- University of Pittsburgh Department of Epidemiology, 130 De Soto Street, Pittsburgh, PA 15261, USA
| | - Alexandria C Reese
- University of Pittsburgh Department of Radiology, 200 Lothrop Street, Pittsburgh, PA 15213, USA
| | - Rebecca E Roush
- University of Pittsburgh Department of Neurology, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA
| | - M Ilyas Kamboh
- University of Pittsburgh Department of Epidemiology, 130 De Soto Street, Pittsburgh, PA 15261, USA; University of Pittsburgh Department of Psychiatry, 3811 O'Hara Street, Pittsburgh, PA 15213, USA; University of Pittsburgh Department of Human Genetics, 130 De Soto Street, Pittsburgh, PA 15213, USA
| | - Marnie Bertolet
- University of Pittsburgh Department of Epidemiology, 130 De Soto Street, Pittsburgh, PA 15261, USA; University of Pittsburgh Department of Biostatistics, 130 De Soto Street, Pittsburgh, PA 15213, USA
| | - Anum Saeed
- University of Pittsburgh Heart and Vascular Institute, University of Pittsburgh, 200 Lothrop Street, Pittsburgh, PA 15213, USA
| | - Brian J Lopresti
- University of Pittsburgh Department of Radiology, 200 Lothrop Street, Pittsburgh, PA 15213, USA
| | - Victor L Villemagne
- University of Pittsburgh Department of Psychiatry, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - Oscar L Lopez
- University of Pittsburgh Department of Neurology, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA; University of Pittsburgh Department of Psychiatry, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - Steven E Reis
- University of Pittsburgh Heart and Vascular Institute, University of Pittsburgh, 200 Lothrop Street, Pittsburgh, PA 15213, USA
| | - James T Becker
- University of Pittsburgh Department of Neurology, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA; University of Pittsburgh Department of Psychiatry, 3811 O'Hara Street, Pittsburgh, PA 15213, USA; University of Pittsburgh Department of Psychology, 210 South Bouquet Street, Pittsburgh, PA 15260, USA
| | - Ann D Cohen
- University of Pittsburgh Department of Psychiatry, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
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Royse SK, Snitz BE, Hengenius JB, Huppert TJ, Roush RE, Ehrenkranz RE, Wilson JD, Bertolet M, Reese AC, Cisneros G, Potopenko K, Becker JT, Cohen AD, Shaaban CE. Unhealthy white matter connectivity, cognition, and racialization in older adults. Alzheimers Dement 2024; 20:1483-1496. [PMID: 37828730 PMCID: PMC10947965 DOI: 10.1002/alz.13494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 09/06/2023] [Accepted: 09/10/2023] [Indexed: 10/14/2023]
Abstract
INTRODUCTION White matter hyperintensities (WMH) may promote clinical Alzheimer's disease (AD) disparities between Black American (BA) and non-Hispanic White (nHW) populations. Using a novel measurement, unhealthy white matter connectivity (UWMC), we interrogated racialized group differences in associations between WMH in AD pathology-affected regions and cognition. METHODS UWMC is the proportion of white matter fibers that pass through WMH for every pair of brain regions. Individual regression models tested associations of UWMC in beta-amyloid (Aβ) or tau pathology-affected regions with cognition overall, stratified by racialized group, and with a racialized group interaction. RESULTS In 201 older adults ranging from cognitively unimpaired to AD, BA participants exhibited greater UWMC and worse cognition than nHW participants. UWMC was negatively associated with cognition in 17 and 5 Aβ- and tau-affected regions, respectively. Racialization did not modify these relationships. DISCUSSION Differential UWMC burden, not differential UWMC-and-cognition associations, may drive clinical AD disparities between racialized groups. HIGHLIGHTS Unhealthy white matter connectivity (UWMC) in Alzheimer's disease (AD) pathology-affected brain regions is associated with cognition. Relationships between UWMC and cognition are similar between Black American (BA) and non-Hispanic White (nHW) individuals. More UWMC may partially drive higher clinical AD burden in BA versus nHW populations. UWMC risk factors, particularly social and environmental, should be identified.
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Affiliation(s)
- Sarah K. Royse
- Department of EpidemiologyUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of RadiologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Beth E. Snitz
- Department of NeurologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - James B. Hengenius
- Department of EpidemiologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Theodore J. Huppert
- Department of Electrical EngineeringUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Rebecca E. Roush
- Department of NeurologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | | | - James D. Wilson
- Department of Mathematics and StatisticsUniversity of San FranciscoSan FranciscoCaliforniaUSA
| | - Marnie Bertolet
- Department of EpidemiologyUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of BiostatisticsUniversity of PittsburghPittsburghPennsylvaniaUSA
| | | | - Geraldine Cisneros
- Department of PsychologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Katey Potopenko
- Department of PsychologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - James T. Becker
- Department of NeurologyUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of BiostatisticsUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Ann D. Cohen
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvaniaUSA
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Royse SK, Lopresti BJ, Mathis CA, Tollefson S, Narendran R. Beyond monoamines: II. Novel applications for PET imaging in psychiatric disorders. J Neurochem 2023; 164:401-443. [PMID: 35716057 DOI: 10.1111/jnc.15657] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 04/11/2022] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 11/27/2022]
Abstract
Early applications of positron emission tomography (PET) in psychiatry sought to identify derangements of cerebral blood flow and metabolism. The need for more specific neurochemical imaging probes was soon evident, and these probes initially targeted the sites of action of neuroleptic (dopamine D2 receptors) and psychoactive (serotonin receptors) drugs. For nearly 30 years, the centrality of monoamine dysfunction in psychiatric disorders drove the development of an armamentarium of monoaminergic PET radiopharmaceuticals and imaging methodologies. However, continued investments in monoamine-enhancing drug development realized only modest gains in efficacy and tolerability. As patent protection for many widely prescribed and profitable psychiatric drugs lapsed, drug development pipelines shifted away from monoamines in search of novel targets with the promises of improved efficacy, or abandoned altogether. Over this period, PET radiopharmaceutical development activities closely parallelled drug development priorities, resulting in the development of new PET imaging agents for non-monoamine targets. In part two of this review, we survey clinical research studies using the novel targets and radiotracers described in part one across major psychiatric application areas such as substance use disorders, anxiety disorders, eating disorders, personality disorders, mood disorders, and schizophrenia. Important limitations of the studies described are discussed, as well as key methodologic issues, challenges to the field, and the status of clinical trials seeking to exploit these targets for novel therapeutics.
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Affiliation(s)
- Sarah K Royse
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Brian J Lopresti
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Chester A Mathis
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Savannah Tollefson
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Rajesh Narendran
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.,Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Lopresti BJ, Royse SK, Mathis CA, Tollefson SA, Narendran R. Beyond monoamines: I. Novel targets and radiotracers for Positron emission tomography imaging in psychiatric disorders. J Neurochem 2023; 164:364-400. [PMID: 35536762 DOI: 10.1111/jnc.15615] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 02/08/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 10/18/2022]
Abstract
With the emergence of positron emission tomography (PET) in the late 1970s, psychiatry had access to a tool capable of non-invasive assessment of human brain function. Early applications in psychiatry focused on identifying characteristic brain blood flow and metabolic derangements using radiotracers such as [15 O]H2 O and [18 F]FDG. Despite the success of these techniques, it became apparent that more specific probes were needed to understand the neurochemical bases of psychiatric disorders. The first neurochemical PET imaging probes targeted sites of action of neuroleptic (dopamine D2 receptors) and psychoactive (serotonin receptors) drugs. Based on the centrality of monoamine dysfunction in psychiatric disorders and the measured success of monoamine-enhancing drugs in treating them, the next 30 years witnessed the development of an armamentarium of PET radiopharmaceuticals and imaging methodologies for studying monoamines. Continued development of monoamine-enhancing drugs over this time however was less successful, realizing only modest gains in efficacy and tolerability. As patent protection for many widely prescribed and profitable psychiatric drugs lapsed, drug development pipelines shifted away from monoamines in search of novel targets with the promises of improved efficacy, or abandoned altogether. Over this period, PET radiopharmaceutical development activities closely paralleled drug development priorities resulting in the development of new PET imaging agents for non-monoamine targets. Part one of this review will briefly survey novel PET imaging targets with relevance to the field of psychiatry, which include the metabotropic glutamate receptor type 5 (mGluR5), purinergic P2 X7 receptor, type 1 cannabinoid receptor (CB1 ), phosphodiesterase 10A (PDE10A), and describe radiotracers developed for these and other targets that have matured to human subject investigations. Current limitations of the targets and techniques will also be discussed.
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Affiliation(s)
- Brian J Lopresti
- Departments of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Sarah K Royse
- Departments of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Chester A Mathis
- Departments of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Savannah A Tollefson
- Departments of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Rajesh Narendran
- Departments of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.,Departments of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Royse SK, Costacou T, Nunley KA, Orchard TJ, Rosano C. Neural correlates of slower gait in middle-aged persons with childhood-onset type 1 diabetes mellitus: The impact of accelerated brain aging. J Diabetes Complications 2022; 36:108084. [PMID: 34838449 PMCID: PMC8818038 DOI: 10.1016/j.jdiacomp.2021.108084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 11/05/2021] [Accepted: 11/06/2021] [Indexed: 02/03/2023]
Abstract
AIMS We aimed to determine if neuroimaging characteristics of gray and white matter are associated with gait speed in middle-aged individuals with childhood-onset type 1 diabetes (T1D), and whether associations are independent of diabetic peripheral neuropathy (DPN) status. METHODS In a cohort of 100 middle-aged adults with childhood-onset T1D (aged 49.2 ± 7.0 years, 50F/50M), we assessed cross-sectional associations of DPN, severity of white matter hyperintensities (WMH; Fazekas score), and regional gray matter volume (GMV) with gait speed. Associations were tested separately and combined in linear regression models adjusted for diabetes duration and locomotor risk factors. RESULTS Average gait speed was 1.3 m/s, with 52% of participants walking below the age-appropriate range of 1.3-1.5 m/s. In separate models, higher WMH severity (β = -0.27, p = 0.01) and smaller caudate GMV (β = -0.21, p = 0.04), but not DPN (β = -0.20, p = 0.08) were associated with slower gait speed. When combined, only WMH severity remained significant (β = -0.22, p = 0.04). CONCLUSIONS More than half of participants walked more slowly than expected based on age. Gait speed was slower among those with more severe WMH independent of locomotor risk factors. Gait slowing in middle-aged persons with T1D may reflect brain changes, and thus, deserve further attention.
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Affiliation(s)
- Sarah K Royse
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Tina Costacou
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Karen A Nunley
- Chronic Disease Epidemiology Branch, Community Health Improvement Division, Texas Department of State Health Services, Austin, TX, USA
| | - Trevor J Orchard
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Caterina Rosano
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
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Shaaban CE, Snitz BE, Tudorascu DL, Lopresti BJ, Royse SK, Yu Z, Aizenstein HJ, Klunk WE, Cohen AD. Sex and cerebral small vessel disease‐specific longitudinal trajectories of amyloid, tau, and neurodegeneration. Alzheimers Dement 2021. [DOI: 10.1002/alz.056291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
| | - Beth E Snitz
- University of Pittsburgh Pittsburgh PA USA
- Alzheimer's Disease Research Center Pittsburgh PA USA
| | | | | | - Sarah K Royse
- University of Pittsburgh School of Medicine Pittsburgh PA USA
| | - Zheming Yu
- University of Pittsburgh Pittsburgh PA USA
| | - Howard J Aizenstein
- University of Pittsburgh Pittsburgh PA USA
- Alzheimer's Disease Research Center Pittsburgh PA USA
| | - William E Klunk
- University of Pittsburgh Pittsburgh PA USA
- Alzheimer's Disease Research Center Pittsburgh PA USA
| | - Ann D Cohen
- University of Pittsburgh Pittsburgh PA USA
- Alzheimer's Disease Research Center Pittsburgh PA USA
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Royse SK, Cohen AD, Snitz BE, Rosano C. Differences in Alzheimer's Disease and Related Dementias Pathology Among African American and Hispanic Women: A Qualitative Literature Review of Biomarker Studies. Front Syst Neurosci 2021; 15:685957. [PMID: 34366799 PMCID: PMC8334184 DOI: 10.3389/fnsys.2021.685957] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/28/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction The population of older adults with Alzheimer’s disease and Related Dementias (ADRD) is growing larger and more diverse. Prevalence of ADRD is higher in African American (AA) and Hispanic populations relative to non-Hispanic whites (nHW), with larger differences for women compared to men of the same race. Given the public health importance of this issue, we sought to determine if AA and Hispanic women exhibit worse ADRD pathology compared to men of the same race and nHW women. We hypothesized that such differences may explain the discrepancy in ADRD prevalence. Methods We evaluated 932 articles that measured at least one of the following biomarkers of ADRD pathology in vivo and/or post-mortem: beta-amyloid (Aß), tau, neurodegeneration, and cerebral small vessel disease (cSVD). Criteria for inclusion were: (1) mean age of participants >65 years; (2) inclusion of nHW participants and either AA or Hispanics or both; (3) direct comparison of ADRD pathology between racial groups. Results We included 26 articles (Aß = 9, tau = 6, neurodegeneration = 16, cSVD = 18), with seven including sex-by-race comparisons. Studies differed by sampling source (e.g., clinic or population), multivariable analytical approach (e.g., adjusted for risk factors for AD), and cognitive status of participants. Aß burden did not differ by race or sex. Tau differed by race (AA < nHW), and by sex (women > men). Both severity of neurodegeneration and cSVD differed by race (AA > nHW; Hispanics < nHW) and sex (women < men). Among the studies that tested sex-by-race interactions, results were not significant. Conclusion Few studies have examined the burden of ADRD pathology by both race and sex. The higher prevalence of ADRD in women compared to men of the same race may be due to both higher tau load and more vulnerability to cognitive decline in the presence of similar Aß and cSVD burden. AA women may also exhibit more neurodegeneration and cSVD relative to nHW populations. Studies suggest that between-group differences in ADRD pathology are complex, but they are too sparse to completely explain why minority women have the highest ADRD prevalence. Future work should recruit diverse cohorts, compare ADRD biomarkers by both race and sex, and collect relevant risk factor and cognitive data.
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Affiliation(s)
- Sarah K Royse
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Ann D Cohen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Beth E Snitz
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Caterina Rosano
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
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Laymon CM, Minhas DS, Royse SK, Aizenstein HJ, Cohen AD, Tudorascu DL, Klunk WE. Characterization of point-spread function specification error on Geometric Transfer Matrix partial volume correction in [ 11C]PiB amyloid imaging. EJNMMI Phys 2021; 8:54. [PMID: 34283320 PMCID: PMC8292473 DOI: 10.1186/s40658-021-00403-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 03/08/2021] [Accepted: 07/05/2021] [Indexed: 11/29/2022] Open
Abstract
Purpose Partial-volume correction (PVC) using the Geometric Transfer Matrix (GTM) method is used in positron emission tomography (PET) to compensate for the effects of spatial resolution on quantitation. We evaluate the effect of misspecification of scanner point-spread function (PSF) on GTM results in amyloid imaging, including the effect on amyloid status classification (positive or negative). Methods Twenty-nine subjects with Pittsburgh Compound B ([11C]PiB) PET and structural T1 MR imaging were analyzed. FreeSurfer 5.3 (FS) was used to parcellate MR images into regions-of-interest (ROIs) that were used to extract radioactivity concentration values from the PET images. GTM PVC was performed using our “standard” PSF parameterization [3D Gaussian, full-width at half-maximum (w) of approximately 5 mm]. Additional GTM PVC was performed with “incorrect” parameterizations, taken around the correct value. The result is a set of regional activity values for each of the GTM applications. For each case, activity values from various ROIs were combined and normalized to produce standardized uptake value ratios (SUVRs) for nine standard [11C]PiB quantitation ROIs and a global region. GTM operating-point characteristics were determined from the slope of apparent SUVR versus w curves. Results Errors in specification of w on the order of 1 mm (3D) mainly produce only modest errors of up to a few percent. An exception was the anterior ventral striatum in which fractional errors of up to 0.29 per millimeter (3D) of error in w were observed. Conclusion While this study does not address all the issues regarding the quantitative strengths and weakness of GTM PVC, we find that with reasonable caution, the unavoidable inaccuracies associated with PSF specification do not preclude its use in amyloid quantitation. Supplementary Information The online version contains supplementary material available at 10.1186/s40658-021-00403-5.
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Affiliation(s)
- Charles M Laymon
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA. .,Department of Bioengineering, University of Pittsburgh, PET Center, PUH B930, 200 Lothrop St, Pittsburgh, PA, 15213, USA.
| | - Davneet S Minhas
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sarah K Royse
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Howard J Aizenstein
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Bioengineering, University of Pittsburgh, PET Center, PUH B930, 200 Lothrop St, Pittsburgh, PA, 15213, USA
| | - Ann D Cohen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Dana L Tudorascu
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - William E Klunk
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
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Royse SK, Minhas DS, Lopresti BJ, Murphy A, Ward T, Koeppe RA, Bullich S, DeSanti S, Jagust WJ, Landau SM. Validation of amyloid PET positivity thresholds in centiloids: a multisite PET study approach. Alzheimers Res Ther 2021; 13:99. [PMID: 33971965 PMCID: PMC8111744 DOI: 10.1186/s13195-021-00836-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 04/26/2021] [Indexed: 11/16/2022]
Abstract
Background Inconsistent positivity thresholds, image analysis pipelines, and quantitative outcomes are key challenges of multisite studies using more than one β-amyloid (Aβ) radiotracer in positron emission tomography (PET). Variability related to these factors contributes to disagreement and lack of replicability in research and clinical trials. To address these problems and promote Aβ PET harmonization, we used [18F]florbetaben (FBB) and [18F]florbetapir (FBP) data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) to derive (1) standardized Centiloid (CL) transformations and (2) internally consistent positivity thresholds based on separate young control samples. Methods We analyzed Aβ PET data using a native-space, automated image processing pipeline that is used for PET quantification in many large, multisite AD studies and trials and made available to the research community. With this pipeline, we derived SUVR-to-CL transformations using the Global Alzheimer’s Association Interactive Network data; we used reference regions for cross-sectional (whole cerebellum) and longitudinal (subcortical white matter, brain stem, whole cerebellum) analyses. Finally, we developed a FBB positivity threshold using an independent young control sample (N=62) with methods parallel to our existing FBP positivity threshold and validated the FBB threshold using a data-driven approach in ADNI participants (N=295). Results The FBB threshold based on the young sample (1.08; 18 CL) was consistent with that of the data-driven approach (1.10; 21 CL), and the existing FBP threshold converted to CL with the derived transformation (1.11; 20 CL). The following equations can be used to convert whole cerebellum- (cross-sectional) and composite- (longitudinal) normalized FBB and FBP data quantified with the native-space pipeline to CL units: [18F]FBB: CLwhole cerebellum = 157.15 × SUVRFBB − 151.87; threshold=1.08, 18 CL [18F]FBP: CLwhole cerebellum = 188.22 × SUVRFBP − 189.16; threshold=1.11, 20 CL [18F]FBB: CLcomposite = 244.20 × SUVRFBB − 170.80 [18F]FBP: CLcomposite = 300.66 × SUVRFBP − 208.84 Conclusions FBB and FBP positivity thresholds derived from independent young control samples and quantified using an automated, native-space approach result in similar CL values. These findings are applicable to thousands of available and anticipated outcomes analyzed using this pipeline and shared with the scientific community. This work demonstrates the feasibility of harmonized PET acquisition and analysis in multisite PET studies and internal consistency of positivity thresholds in standardized units. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-021-00836-1.
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Affiliation(s)
- Sarah K Royse
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Davneet S Minhas
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brian J Lopresti
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Alice Murphy
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA, USA
| | - Tyler Ward
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA, USA
| | - Robert A Koeppe
- Division of Nuclear Medicine, University of Michigan, Ann Arbor, MI, USA
| | | | | | - William J Jagust
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA, USA
| | - Susan M Landau
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA, USA
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Flanigan MR, Royse SK, Cenkner DP, Kozinski KM, Stoughton CJ, Himes ML, Minhas DS, Lopresti B, Butters MA, Narendran R. Imaging beta-amyloid (Aβ) burden in the brains of middle-aged individuals with alcohol-use disorders: a [ 11C]PIB PET study. Transl Psychiatry 2021; 11:257. [PMID: 33934110 PMCID: PMC8088438 DOI: 10.1038/s41398-021-01374-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/13/2021] [Accepted: 04/07/2021] [Indexed: 02/03/2023] Open
Abstract
No in vivo human studies have examined the prevalence of Alzheimer's disease (AD) neuropathology in individuals with alcohol-use disorder (AUD), although recent research suggests that a relationship between the two exists. Therefore, this study used Pittsburgh Compound-B ([11C]PiB) PET imaging to test the hypothesis that AUD is associated with greater brain amyloid (Aβ) burden in middle-aged adults compared to healthy controls. Twenty healthy participants (14M and 6F) and 19 individuals with AUD (15M and 4F), all aged 40-65 years, underwent clinical assessment, MRI, neurocognitive testing, and positron emission tomography (PET) imaging. Global [11C]PiB standard uptake value ratios (SUVRs), cortical thickness, gray matter volumes (GMVs), and neurocognitive function in subjects with AUD were compared to healthy controls. These measures were selected because they are considered markers of risk for future AD and other types of neurocognitive dysfunction. The results of this study showed no significant differences in % global Aβ positivity or subthreshold Aβ loads between AUD and controls. However, relative to controls, we observed a significant 6.1% lower cortical thickness in both AD-signature regions and in regions not typically associated with AD, lower GMV in the hippocampus, and lower performance on tests of attention as well as immediate and delayed memory in individuals with AUD. This suggest that Aβ accumulation is not greater in middle-aged individuals with AUD. However, other markers of neurodegeneration, such as impaired memory, cortical thinning, and reduced hippocampal GMV, are present. Further studies are needed to elucidate the patterns and temporal staging of AUD-related pathophysiology and cognitive impairment. Imaging β-amyloid in middle age alcoholics as a mechanism that increases their risk for Alzheimer's disease; Registration Number: NCT03746366 .
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Affiliation(s)
- Margaret R. Flanigan
- grid.21925.3d0000 0004 1936 9000Department of Radiology, University of Pittsburgh, Pittsburgh, PA USA
| | - Sarah K. Royse
- grid.21925.3d0000 0004 1936 9000Department of Radiology, University of Pittsburgh, Pittsburgh, PA USA
| | - David P. Cenkner
- grid.21925.3d0000 0004 1936 9000Department of Radiology, University of Pittsburgh, Pittsburgh, PA USA
| | - Katelyn M. Kozinski
- grid.21925.3d0000 0004 1936 9000Department of Radiology, University of Pittsburgh, Pittsburgh, PA USA
| | - Clara J. Stoughton
- grid.21925.3d0000 0004 1936 9000Department of Radiology, University of Pittsburgh, Pittsburgh, PA USA
| | - Michael L. Himes
- grid.21925.3d0000 0004 1936 9000Department of Radiology, University of Pittsburgh, Pittsburgh, PA USA
| | - Davneet S. Minhas
- grid.21925.3d0000 0004 1936 9000Department of Radiology, University of Pittsburgh, Pittsburgh, PA USA
| | - Brian Lopresti
- grid.21925.3d0000 0004 1936 9000Department of Radiology, University of Pittsburgh, Pittsburgh, PA USA
| | - Meryl A. Butters
- grid.21925.3d0000 0004 1936 9000Department Psychiatry, University of Pittsburgh, Pittsburgh, PA USA
| | - Rajesh Narendran
- grid.21925.3d0000 0004 1936 9000Department of Radiology, University of Pittsburgh, Pittsburgh, PA USA ,grid.21925.3d0000 0004 1936 9000Department Psychiatry, University of Pittsburgh, Pittsburgh, PA USA
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11
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Minhas DS, Ghodadra A, Yu Z, Royse SK, Aizenstein HJ, Cohen A, Tudorascu DL, Lopresti BJ, Mathis C, Klunk WE, Laymon CM. Evaluation of amyloid and tau PET quantitation methods using a 3D‐printed anatomically accurate brain phantom. Alzheimers Dement 2020. [DOI: 10.1002/alz.045455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Anish Ghodadra
- University of Pittsburgh School of Medicine Pittsburgh PA USA
| | - Zheming Yu
- University of Pittsburgh School of Medicine Pittsburgh PA USA
| | - Sarah K Royse
- University of Pittsburgh School of Medicine Pittsburgh PA USA
| | | | - Ann Cohen
- University of Pittsburgh School of Medicine Pittsburgh PA USA
| | | | | | - Chester Mathis
- University of Pittsburgh School of Medicine Pittsburgh PA USA
| | - William E Klunk
- University of Pittsburgh School of Medicine Pittsburgh PA USA
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