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Benvenutto A, Giusiano B, Koric L, Gueriot C, Didic M, Felician O, Guye M, Guedj E, Ceccaldi M. Imaging Biomarkers of Neurodegeneration in Alzheimer's Disease: Distinct Contributions of Cortical MRI Atrophy and FDG-PET Hypometabolism. J Alzheimers Dis 2019; 65:1147-1157. [PMID: 30124446 DOI: 10.3233/jad-180292] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Neurodegeneration biomarkers are routinely used in the diagnosis of Alzheimer's disease (AD). OBJECTIVE To evaluate the respective contributions of two neuroimaging biomarkers, structural MRI and 18FDG-PET, in the assessment of neurodegeneration in AD dementia. METHODS Patients with mild AD dementia diagnosed based on clinical and cerebrospinal fluid criteria and cognitively healthy subjects, from the Marseille cohort ADAge with cognitive, structural MRI and 18FDG-PET assessments, were included. Extent of atrophy on MRI and of hypometabolism on 18FDG-PET were individually evaluated in each patient using a voxel-based analysis on whole-brain approach and compared to healthy subjects. Patients were divided in distinct groups according to their atrophy extent on the one hand and to their hypometabolism extent on the other, then, to their imaging profile combining the extent of the two biomarkers. RESULTS Fifty-two patients were included. The MMSE score was significantly lower in the "Extensive hypometabolism" group than in the "Limited hypometabolism" group (respectively 19.5/30 versus 23/30). A lower Innotest Amyloid Tau Index was associated with an extensive hypometabolism (p = 0.04). There were more patients with low educational level in the "Extensive atrophy" group, while a higher educational level was more found in the "Limited atrophy" group (p = 0.005). CONCLUSION 18FDG-PET hypometabolism extent is associated with the pathological processes and clinical severity of AD, while MRI atrophy seems to be influenced by the cognitive reserve. In the context of mild AD dementia, these two biomarkers of neurodegeneration are thus not interchangeable and require to be considered in combination rather than in isolation.
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Affiliation(s)
- Agnès Benvenutto
- Neurology and Neuropsychology Department and CMMR PACA Ouest, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Bernard Giusiano
- Department of Public Health, Assistance Publique-Hôpitaux de Marseille, Marseille, France.,Institut de Neurosciences des Systèmes, Aix-Marseille Univ, INSERM UMR 1106, Marseille, France
| | - Lejla Koric
- Neurology and Neuropsychology Department and CMMR PACA Ouest, Assistance Publique-Hôpitaux de Marseille, Marseille, France.,Aix Marseille Univ, CNRS, Centrale Marseille, Institut Fresnel, Marseille, France
| | - Claude Gueriot
- Neurology and Neuropsychology Department and CMMR PACA Ouest, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Mira Didic
- Neurology and Neuropsychology Department and CMMR PACA Ouest, Assistance Publique-Hôpitaux de Marseille, Marseille, France.,Institut de Neurosciences des Systèmes, Aix-Marseille Univ, INSERM UMR 1106, Marseille, France
| | - Olivier Felician
- Neurology and Neuropsychology Department and CMMR PACA Ouest, Assistance Publique-Hôpitaux de Marseille, Marseille, France.,Institut de Neurosciences des Systèmes, Aix-Marseille Univ, INSERM UMR 1106, Marseille, France
| | - Maxime Guye
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France.,AP-HM, Timone University Hospital, CEMEREM, Marseille, France
| | - Eric Guedj
- Aix Marseille Univ, CNRS, Centrale Marseille, Institut Fresnel, Marseille, France.,Department of Nuclear Medecine, Assistance Publique-Hôpitaux de Marseille, Marseille, France.,CERIMED, Aix-Marseille Univ, Marseille, France
| | - Mathieu Ceccaldi
- Neurology and Neuropsychology Department and CMMR PACA Ouest, Assistance Publique-Hôpitaux de Marseille, Marseille, France.,Institut de Neurosciences des Systèmes, Aix-Marseille Univ, INSERM UMR 1106, Marseille, France
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