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Spelta LEW, Real CC, Bruno V, Buchpiguel CA, Garcia RCT, Torres LH, de Paula Faria D, Marcourakis T. Impact of cannabidiol on brain glucose metabolism of C57Bl/6 male mice previously exposed to cocaine. J Neurosci Res 2024; 102:e25327. [PMID: 38588037 DOI: 10.1002/jnr.25327] [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: 11/27/2023] [Revised: 03/04/2024] [Accepted: 03/24/2024] [Indexed: 04/10/2024]
Abstract
Despite evidence of the beneficial effects of cannabidiol (CBD) in animal models of cocaine use disorder (CUD), CBD neuronal mechanisms remain poorly understood. This study investigated the effects of CBD treatment on brain glucose metabolism, in a CUD animal model, using [18F]FDG positron emission tomography (PET). Male C57Bl/6 mice were injected with cocaine (20 mg/kg, i.p.) every other day for 9 days, followed by 8 days of CBD administration (30 mg/kg, i.p.). After 48 h, animals were challenged with cocaine. Control animals received saline/vehicle. [18F]FDG PET was performed at four time points: baseline, last day of sensitization, last day of withdrawal/CBD treatment, and challenge. Subsequently, the animals were euthanized and immunohistochemistry was performed on the hippocampus and amygdala to assess the CB1 receptors, neuronal nuclear protein, microglia (Iba1), and astrocytes (GFAP). Results showed that cocaine administration increased [18F]FDG uptake following sensitization. CBD treatment also increased [18F]FDG uptake in both saline and cocaine groups. However, animals that were sensitized and challenged with cocaine, and those receiving only an acute cocaine injection during the challenge phase, did not exhibit increased [18F]FDG uptake when treated with CBD. Furthermore, CBD induced modifications in the integrated density of NeuN, Iba, GFAP, and CB1R in the hippocampus and amygdala. This is the first study addressing the impact of CBD on brain glucose metabolism in a preclinical model of CUD using PET. Our findings suggest that CBD disrupts cocaine-induced changes in brain energy consumption and activity, which might be correlated with alterations in neuronal and glial function.
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Affiliation(s)
- Lidia Emmanuela Wiazowski Spelta
- Laboratory of Neurotoxicology, Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
- Laboratory of Nuclear Medicine, Department of Radiology and Oncology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Caroline Cristiano Real
- Laboratory of Nuclear Medicine, Department of Radiology and Oncology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
- Department of Clinical Medicine, Nuclear Medicine and PET Centre, Aarhus University, Aarhus, Denmark
| | - Vitor Bruno
- Laboratory of Neurotoxicology, Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Carlos Alberto Buchpiguel
- Laboratory of Nuclear Medicine, Department of Radiology and Oncology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Larissa Helena Torres
- Department of Food and Drugs, School of Pharmaceutical Sciences, Federal University of Alfenas, Alfenas, Brazil
| | - Daniele de Paula Faria
- Laboratory of Nuclear Medicine, Department of Radiology and Oncology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Tania Marcourakis
- Laboratory of Neurotoxicology, Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
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Putra M, Hamidi OP, Driver C, Peek EE, Bolt MA, Gumina D, Reeves SA, Hobbins JC. Corpus Callosum Length and Cerebellar Vermian Height in Fetal Growth Restriction. Fetal Diagn Ther 2024; 51:255-266. [PMID: 38461813 DOI: 10.1159/000538123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 01/14/2024] [Indexed: 03/12/2024]
Abstract
INTRODUCTION Growth-restricted fetuses may have changes in their neuroanatomical structures that can be detected in prenatal imaging. We aim to compare corpus callosal length (CCL) and cerebellar vermian height (CVH) measurements between fetal growth restriction (FGR) and control fetuses and to correlate them with cerebral Doppler velocimetry in growth-restricted fetuses. METHODS This was a prospective cohort of FGR after 20 weeks of gestation with ultrasound measurements of CCL and CVH. Control cohort was assembled from fetuses without FGR who had growth ultrasound after 20 weeks of gestation. We compared differences of CCL or CVH between FGR and controls. We also tested for the correlations of CCL and CVH with middle cerebral artery (MCA) pulsatility index (PI) and vertebral artery (VA) PI in the FGR group. CCL and CVH measurements were adjusted by head circumference (HC). RESULTS CCL and CVH were obtained in 68 and 55 fetuses, respectively. CCL/HC was smaller in FGR fetuses when compared to control fetuses (difference = 0.03, 95% CI: [0.02, 0.04], p < 0.001). CVH/HC was larger in FGR fetuses compared to NG fetuses (difference = 0.1, 95% CI: [-0.01, 0.02], p = < 0.001). VA PI multiples of the median were inversely correlated with CVH/HC (rho = -0.53, p = 0.007), while CCL/HC was not correlated with VA PI. Neither CCL/HC nor CVH/HC was correlated with MCA PI. CONCLUSIONS CCL/HC and CVH/HC measurements show differences in growth-restricted fetuses compared to a control cohort. We also found an inverse relationship between VA PI and CVH/HC. The potential use of neurosonography assessment in FGR assessment requires continued explorations.
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Affiliation(s)
- Manesha Putra
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Odessa P Hamidi
- St. Luke's University Health Network, Bethlehem, Pennsylvania, USA
| | - Camille Driver
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Emma E Peek
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Matthew A Bolt
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado-Denver Anschutz Medical Campus, Aurora, Colorado, USA
| | - Diane Gumina
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Shane A Reeves
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - John C Hobbins
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Khandalavala KR, Marinelli JP, Lohse CM, Przybelski SA, Petersen RC, Vassilaki M, Vemuri P, Carlson ML. Neuroimaging Characteristics of Hearing Loss in the Mayo Clinic Study of Aging. Otolaryngol Head Neck Surg 2024; 170:886-895. [PMID: 38018509 PMCID: PMC10922536 DOI: 10.1002/ohn.583] [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: 08/17/2023] [Revised: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 11/30/2023]
Abstract
OBJECTIVE To investigate the association between standard pure tone and speech audiometry with neuroimaging characteristics reflective of aging and dementia in older adults. STUDY DESIGN Prospective population-based study. SETTING Single tertiary care referral center. METHODS Participants from the Mayo Clinic Study of aging 60 years old or older with normal cognition or mild cognitive impairment, baseline neuroimaging, and a behavioral audiogram associated with neuroimaging were eligible for study. Imaging modalities included structural MRI (sMRI) and fluid-attenuated inversion recovery MRI (FLAIR-MRI; N = 605), diffusion tensor imaging MRI (DTI-MRI; N = 444), and fluorodeoxyglucose-positron emission tomography (FDG-PET; N = 413). Multivariable logistic and linear regression models were used to evaluate associations with neuroimaging outcomes. RESULTS Mean (SD) pure tone average (PTA) was 33 (15) dB HL and mean (SD) word recognition score (WRS) was 91% (14). There were no significant associations between audiometric performance and cortical thinning assessed by sMRI. Each 10-dB increase in PTA was associated with increased likelihood of abnormal white-matter hyperintensity (WMH) from FLAIR-MRI (odds ratio 1.26, P = .02). From DTI-MRI, participants with <100% WRSs had significantly lower fractional anisotropy in the genu of the corpus callosum (parameter estimate [PE] -0.012, P = .008) compared to those with perfect WRSs. From FDG-PET, each 10% decrease in WRSs was associated with decreased uptake in the anterior cingulate cortex (PE -0.013, P = .001). CONCLUSION Poorer audiometric performance was not significantly associated with cortical thinning but was associated with white matter damage relevant to cerebrovascular disease (increased abnormal WMH, decreased corpus callosum diffusion). These neuroimaging results suggest a pathophysiologic link between hearing loss and cerebrovascular disease.
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Affiliation(s)
| | - John P. Marinelli
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN
| | | | | | - Ronald C. Petersen
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
- Department of Neurology, Mayo Clinic, Rochester, MN
| | - Maria Vassilaki
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | | | - Matthew L. Carlson
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN
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Cerina V, Crivellaro C, Morzenti S, Pozzi FE, Bigiogera V, Jonghi-Lavarini L, Moresco RM, Basso G, De Bernardi E. A ROI-based quantitative pipeline for 18F-FDG PET metabolism and pCASL perfusion joint analysis: Validation of the 18F-FDG PET line. Heliyon 2024; 10:e23340. [PMID: 38163125 PMCID: PMC10755331 DOI: 10.1016/j.heliyon.2023.e23340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/01/2023] [Indexed: 01/03/2024] Open
Abstract
In Mild Cognitive Impairment (MCI), the study of brain metabolism, provided by 18F-FluoroDeoxyGlucose Positron Emission Tomography (18F-FDG PET) can be integrated with brain perfusion through pseudo-Continuous Arterial Spin Labeling Magnetic Resonance sequences (MR pCASL). Cortical hypometabolism identification generally relies on wide control group datasets; pCASL control groups are instead not publicly available yet, due to lack of standardization in the acquisition parameters. This study presents a quantitative pipeline to be applied to PET and pCASL data to coherently analyze metabolism and perfusion inside 16 matching cortical regions of interest (ROIs) derived from the AAL3 atlas. The PET line is tuned on 36 MCI patients and 107 healthy control subjects, to agree in identifying hypometabolic regions with clinical reference methods (visual analysis supported by a vendor tool and Statistical Parametric Mapping, SPM, with two parametrizations here identified as SPM-A and SPM-B). The analysis was conducted for each ROI separately. The proposed PET analysis pipeline obtained accuracy 78 % and Cohen's к 60 % vs visual analysis, accuracy 79 % and Cohen's к 58 % vs SPM-A, accuracy 77 % and Cohen's к 54 % vs SPM-B. Cohen's к resulted not significantly different from SPM-A and SPM-B Cohen's к when assuming visual analysis as reference method (p-value 0.61 and 0.31 respectively). Considering SPM-A as reference method, Cohen's к is not significantly different from SPM-B Cohen's к as well (p-value = 1.00). The complete PET-pCASL pipeline was then preliminarily applied on 5 MCI patients and metabolism-perfusion regional correlations were assessed. The proposed approach can be considered as a promising tool for PET-pCASL joint analyses in MCI, even in the absence of a pCASL control group, to perform metabolism-perfusion regional correlation studies, and to assess and compare perfusion in hypometabolic or normo-metabolic areas.
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Affiliation(s)
- Valeria Cerina
- PhD program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Italy
| | - Cinzia Crivellaro
- Nuclear Medicine, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italia
| | - Sabrina Morzenti
- Medical Physics, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italia
| | - Federico E. Pozzi
- PhD program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Italy
- Neurology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italia
- Milan center for Neuroscience (NeuroMI), University of Milano-Bicocca, Italy
| | | | | | - Rosa M. Moresco
- School of Medicine and Surgery, University of Milano-Bicocca, Italy
| | - Gianpaolo Basso
- Milan center for Neuroscience (NeuroMI), University of Milano-Bicocca, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Italy
- Neuroradiology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italia
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Yu J, Cao X, Zhou R, Chen Q, Wang Y. Abnormal brain glucose metabolism patterns in patients with advanced non-small-cell lung cancer after chemotherapy:A retrospective PET study. Brain Res Bull 2023; 202:110751. [PMID: 37625525 DOI: 10.1016/j.brainresbull.2023.110751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/24/2023] [Accepted: 08/23/2023] [Indexed: 08/27/2023]
Abstract
PURPOSE This study was designed to investigate the acute or chronic post-chemotherapy effect and different chemotherapy cycles effect on brain glucose metabolism. METHODS A total of seventy-three patients who received chemotherapy after being diagnosed with advanced non-small-cell lung cancer (NSCLC) and underwent 18F-Fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) scan at Nuclear Medicine Department of the Fifth Hospital of Sun Yat-sen University between September 2017 and August 2022 were included. Seventy-two healthy control patients who underwent whole-body 18F-FDG PET/CT scans at our department, without any evidence of malignancy and confirmed by follow-up visits, were included. Advanced NSCLC patients were classified into six arms: short-to-long course (chemotherapy cycles under 4, between 5 and 8 and more than 8) in acute chemotherapy effect (AC) group (scanned 18F-FDG PET/CT within 6 months post-chemotherapy) or chronic chemotherapy effect (CC) group (the interval between scanning and the last chemotherapy session more than six months). Statistical Parametric Mapping (SPM) analysis between patients' groups and healthy controls' brain 18F-FDG PET was performed (uncorrected p ˂ 0.001 with cluster size above 20 contiguous voxels). RESULTS There were no significant differences between patients' groups and healthy controls in age, gender and body mass index (BMI). SPM PET analyses revealed anomalous brain metabolic activity in different groups (p ˂ 0.001). Short-course + AC group exhibited hypermetabolism in the cerebellum and widespread hypometabolism in bilateral frontal lobe predominantly. Only hypometabolic brain regions were observed in middle-course + AC patients. Long-course + AC group displayed a greater number of abnormalities. Notably, these metabolic abnormalities tended to decrease in CC groups versus AC groups across all courses. CONCLUSION Our study revealed that patients with advanced NSCLC who underwent chemotherapy exhibited persistent abnormal brain metabolism patterns during continuous chemotherapy and these abnormalities tended to recover after completion of chemotherapy over time, but without correlation to an increasing number of chemotherapy cycles. 18F-FDG PET/CT may serve as a possible modality for evaluating brain function and guiding appropriate treatment timing.
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Affiliation(s)
- Jie Yu
- Department of Nuclear Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Xiaoling Cao
- Department of Nuclear Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Renwei Zhou
- Department of Nuclear Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Qingling Chen
- Department of Nuclear Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Ying Wang
- Department of Nuclear Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Zhuhai, Guangdong, China.
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Rus T, Mlakar J, Jamšek J, Trošt M. Metabolic Brain Changes Can Predict the Underlying Pathology in Neurodegenerative Brain Disorders: A Case Report of Sporadic Creutzfeldt-Jakob Disease with Concomitant Parkinson's Disease. Int J Mol Sci 2023; 24:13081. [PMID: 37685887 PMCID: PMC10488131 DOI: 10.3390/ijms241713081] [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: 08/08/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
The co-occurrence of multiple proteinopathies is being increasingly recognized in neurodegenerative disorders and poses a challenge in differential diagnosis and patient selection for clinical trials. Changes in brain metabolism captured by positron emission tomography (PET) with 18 F-fluorodeoxyglucose (FDG) allow us to differentiate between different neurodegenerative disorders either by visual exploration or by studying disease-specific metabolic networks in individual patients. However, the impact of multiple proteinopathies on brain metabolism and metabolic networks remains unknown due to the absence of pathological studies. In this case study, we present a 67-year-old patient with rapidly progressing dementia clinically diagnosed with probable sporadic Creutzfeldt-Jakob disease (sCJD). However, in addition to the expected pronounced cortical and subcortical hypometabolism characteristic of sCJD, the brain FDG PET revealed an intriguing finding of unexpected relative hypermetabolism in the bilateral putamina, raising suspicions of coexisting Parkinson's disease (PD). Additional investigation of disease-specific metabolic brain networks revealed elevated expression of both CJD-related pattern (CJDRP) and PD-related pattern (PDRP) networks. The patient eventually developed akinetic mutism and passed away seven weeks after symptom onset. Neuropathological examination confirmed neuropathological changes consistent with sCJD and the presence of Lewy bodies confirming PD pathology. Additionally, hyperphosphorylated tau and TDP-43 pathology were observed, a combination of four proteinopathies that had not been previously reported. Overall, this case provides valuable insights into the complex interplay of neurodegenerative pathologies and their impact on metabolic brain changes, emphasizing the role of metabolic brain imaging in evaluating potential presence of multiple proteinopathies.
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Affiliation(s)
- Tomaž Rus
- Department of Neurology, University Medical Center Ljubljana, Zaloška cesta 2a, 1000 Ljubljana, Slovenia;
| | - Jernej Mlakar
- Institute of Pathology, Medical Faculty, University of Ljubljana, Korytkova ulica 2, 1000 Ljubljana, Slovenia;
| | - Jan Jamšek
- Department of Nuclear Medicine, University Medical Center Ljubljana, Zaloška cesta 7, 1000 Ljubljana, Slovenia;
| | - Maja Trošt
- Department of Neurology, University Medical Center Ljubljana, Zaloška cesta 2a, 1000 Ljubljana, Slovenia;
- Department of Nuclear Medicine, University Medical Center Ljubljana, Zaloška cesta 7, 1000 Ljubljana, Slovenia;
- Medical Faculty, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
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Rachid A, Chen B, Zhu G. A preliminary study on the effect of renal function on the metabolism of 18F-FDG in the human cerebellum. Quant Imaging Med Surg 2023; 13:5034-5042. [PMID: 37581043 PMCID: PMC10423388 DOI: 10.21037/qims-22-917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 05/12/2023] [Indexed: 08/16/2023]
Abstract
Background The cerebellum is less affected by normal aging or neurodegenerative diseases, the aim of this paper is to investigate the effect of renal function status on uptake of 2-deoxy-2-[18F]fluoro-D-glucose (18F-FDG) in human cerebellum based on independent creatinine (CRE) or blood urea nitrogen (BUN) levels. Methods A total of 253 patients who underwent 18F-FDG PET/CT scans were included. The patients were divided into groups according to renal function status: 201 patients with normal renal function, 16 patients with increase CRE, 36 patients with decrease CRE, and 31 patients with abnormal BUN. The maximum standardized uptake values were obtained in regions of interest (ROIs) for multiple tissue types (right cerebellum, right lobe of liver, right lung, bone marrow and psoas muscle at the level of the fourth lumbar vertebra). Moreover, the selected normal CRE groups were pair-matched with CRE decrease group with respect to age, sex, body mass index and glucose, respectively. Results Among 253 patients who met the inclusion/exclusion criteria, the final analysis included 967 ROIs (244 cerebellum, 191 lungs, 230 muscles, 145 bone marrow, and 157 liver) from 18F-FDG PET/CT scans. Among patients grouped by CRE or BUN levels, the uptake of 18F-FDG by cerebellum was significantly decreased in patients with CRE decrease level (P=0.001). There were no statistically significant differences between the other groups. Matched-pair analysis indicated there were no significant changes in outcomes between the CRE decrease group and the age-, sex-, BMI-, and glucose-matched controls compared to pre-matching. Conclusions In patients with normal renal function and reduced CRE concentration, decrease cerebellar glucose metabolism was observed; however, no abnormal uptake of 18F-FDG was found in the cerebellum and other normal tissues of patients with impaired renal function. Consequently, in the study of cerebellar 18F-FDG metabolism, it may be necessary to consider the influence of blood CRE level.
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Affiliation(s)
- Abdoul Rachid
- Department of Nuclear Medicine, First Affiliated Hospital, Dalian Medical University, Dalian, China
- College of International Education, Dalian Medical University, Dalian, China
| | - Bo Chen
- Department of Nuclear Medicine, First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Guangwen Zhu
- Department of Nuclear Medicine, First Affiliated Hospital, Dalian Medical University, Dalian, China
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Alves de Araujo Junior D, Sair HI, Peters ME, Carvalho AF, Yedavalli V, Solnes LB, Luna LP. The association between post-traumatic stress disorder (PTSD) and cognitive impairment: A systematic review of neuroimaging findings. J Psychiatr Res 2023; 164:259-269. [PMID: 37390621 DOI: 10.1016/j.jpsychires.2023.06.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 06/08/2023] [Accepted: 06/15/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND Accumulating evidence suggests that post-traumatic stress disorder (PTSD) may increase the risk of various types of dementia. Despite the large number of studies linking these critical conditions, the underlying mechanisms remain unclear. The past decade has witnessed an exponential increase in interest on brain imaging research to assess the neuroanatomical underpinnings of PTSD. This systematic review provides a critical assessment of available evidence of neuroimaging correlates linking PTSD to a higher risk of dementia. METHODS The EMBASE, PubMed/MEDLINE, and SCOPUS electronic databases were systematically searched from 1980 to May 22, 2021 for original references on neuroimaging correlates of PTSD and risk of dementia. Literature search, screening of references, methodological quality appraisal of included articles as well as data extractions were independently conducted by at least two investigators. Eligibility criteria included: 1) a clear PTSD definition; 2) a subset of included participants must have developed dementia or cognitive impairment at any time point after the diagnosis of PTSD through any diagnostic criteria; and 3) brain imaging protocols [structural, molecular or functional], including whole-brain morphologic and functional MRI, and PET imaging studies linking PTSD to a higher risk of cognitive impairment/dementia. RESULTS Overall, seven articles met eligibility criteria, comprising findings from 366 participants with PTSD. Spatially convergent structural abnormalities in individuals with PTSD and co-occurring cognitive dysfunction involved primarily the bilateral frontal (e.g., prefrontal, orbitofrontal, cingulate cortices), temporal (particularly in those with damage to the hippocampi), and parietal (e.g., superior and precuneus) regions. LIMITATIONS A meta-analysis could not be performed due to heterogeneity and paucity of measurable data in the eligible studies. CONCLUSIONS Our systematic review provides putative neuroimaging correlates associated with PTSD and co-occurring dementia/cognitive impairment particularly involving the hippocampi. Further research examining neuroimaging features linking PTSD to dementia are clearly an unmet need of the field. Future imaging studies should provide a better control for relevant confounders, such as the selection of more homogeneous samples (e.g., age, race, education), a proper control for co-occurring disorders (e.g., co-occurring major depressive and anxiety disorders) as well as the putative effects of psychotropic medication use. Furthermore, prospective studies examining imaging biomarkers associated with a higher rate of conversion from PTSD to dementia could aid in the stratification of people with PTSD at higher risk for developing dementia for whom putative preventative interventions could be especially beneficial.
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Affiliation(s)
| | - Haris I Sair
- Johns Hopkins University School of Medicine, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD, USA
| | - Matthew E Peters
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, MD, USA
| | - André F Carvalho
- IMPACT (Innovation in Mental and Physical Health and Clinical Treatment) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Vivek Yedavalli
- Johns Hopkins University School of Medicine, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD, USA
| | - Lilja B Solnes
- Johns Hopkins University School of Medicine, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD, USA
| | - Licia P Luna
- Johns Hopkins University School of Medicine, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD, USA.
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Okrzeja J, Garkowski A, Kubas B, Moniuszko-Malinowska A. Imaging and neuropathological findings in patients with Post COVID-19 Neurological Syndrome-A review. Front Neurol 2023; 14:1136348. [PMID: 36846139 PMCID: PMC9947471 DOI: 10.3389/fneur.2023.1136348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 01/25/2023] [Indexed: 02/11/2023] Open
Abstract
Post COVID-19 syndrome is determined as signs and symptoms that appear during or after an infection consistent with SARS-CoV-2 disease, persist for more than 12 weeks and are not explained by an alternative diagnosis. This review presents the neuropathological findings and imaging findings in Post COVID-19 Neurological Syndrome: the focal point is on the manifestations of involvement evident on brain and spine imaging.
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Affiliation(s)
- Jakub Okrzeja
- Medical University of Białystok, Białystok, Poland,*Correspondence: Jakub Okrzeja ✉
| | - Adam Garkowski
- Department of Radiology, Medical University of Białystok, Białystok, Poland
| | - Bożena Kubas
- Department of Radiology, Medical University of Białystok, Białystok, Poland
| | - Anna Moniuszko-Malinowska
- Department of Infectious Diseases and Neuroinfections, Medical University of Białystok, Białystok, Poland
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PET imaging of animal models with depressive-like phenotypes. Eur J Nucl Med Mol Imaging 2023; 50:1564-1584. [PMID: 36642759 PMCID: PMC10119194 DOI: 10.1007/s00259-022-06073-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 12/03/2022] [Indexed: 01/17/2023]
Abstract
Major depressive disorder is a growing and poorly understood pathology. Due to technical and ethical limitations, a significant proportion of the research on depressive disorders cannot be performed on patients, but needs to be investigated in animal paradigms. Over the years, animal studies have provided new insight in the mechanisms underlying depression. Several of these studies have used PET imaging for the non-invasive and longitudinal investigation of the brain physiology. This review summarises the findings of preclinical PET imaging in different experimental paradigms of depression and compares these findings with observations from human studies. Preclinical PET studies in animal models of depression can be divided into three main different approaches: (a) investigation of glucose metabolism as a biomarker for regional and network involvement, (b) evaluation of the availability of different neuroreceptor populations associated with depressive phenotypes, and (c) monitoring of the inflammatory response in phenotypes of depression. This review also assesses the relevance of the use of PET imaging techniques in animal paradigms for the understanding of specific aspects of the depressive-like phenotypes, in particular whether it might contribute to achieve a more detailed characterisation of the clinical depressive phenotypes for the development of new therapies for depression.
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dos Santos AAC, Rodrigues LE, Alecrim-Zeza AL, de Araújo Ferreira L, Trettel CDS, Gimenes GM, da Silva AF, Sousa-Filho CPB, Serdan TDA, Levada-Pires AC, Hatanaka E, Borges FT, de Barros MP, Cury-Boaventura MF, Bertolini GL, Cassolla P, Marzuca-Nassr GN, Vitzel KF, Pithon-Curi TC, Masi LN, Curi R, Gorjao R, Hirabara SM. Molecular and cellular mechanisms involved in tissue-specific metabolic modulation by SARS-CoV-2. Front Microbiol 2022; 13:1037467. [PMID: 36439786 PMCID: PMC9684198 DOI: 10.3389/fmicb.2022.1037467] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 10/26/2022] [Indexed: 09/09/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is triggered by the SARS-CoV-2, which is able to infect and cause dysfunction not only in lungs, but also in multiple organs, including central nervous system, skeletal muscle, kidneys, heart, liver, and intestine. Several metabolic disturbances are associated with cell damage or tissue injury, but the mechanisms involved are not yet fully elucidated. Some potential mechanisms involved in the COVID-19-induced tissue dysfunction are proposed, such as: (a) High expression and levels of proinflammatory cytokines, including TNF-α IL-6, IL-1β, INF-α and INF-β, increasing the systemic and tissue inflammatory state; (b) Induction of oxidative stress due to redox imbalance, resulting in cell injury or death induced by elevated production of reactive oxygen species; and (c) Deregulation of the renin-angiotensin-aldosterone system, exacerbating the inflammatory and oxidative stress responses. In this review, we discuss the main metabolic disturbances observed in different target tissues of SARS-CoV-2 and the potential mechanisms involved in these changes associated with the tissue dysfunction.
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Affiliation(s)
| | - Luiz Eduardo Rodrigues
- Programa de Pós-graduação Interdisciplinar em Ciências da Saúde, Universidade Cruzeiro do Sul, São Paulo, São Paulo, Brazil
| | - Amanda Lins Alecrim-Zeza
- Programa de Pós-graduação Interdisciplinar em Ciências da Saúde, Universidade Cruzeiro do Sul, São Paulo, São Paulo, Brazil
| | - Liliane de Araújo Ferreira
- Programa de Pós-graduação Interdisciplinar em Ciências da Saúde, Universidade Cruzeiro do Sul, São Paulo, São Paulo, Brazil
| | - Caio dos Santos Trettel
- Programa de Pós-graduação Interdisciplinar em Ciências da Saúde, Universidade Cruzeiro do Sul, São Paulo, São Paulo, Brazil
| | - Gabriela Mandú Gimenes
- Programa de Pós-graduação Interdisciplinar em Ciências da Saúde, Universidade Cruzeiro do Sul, São Paulo, São Paulo, Brazil
| | - Adelson Fernandes da Silva
- Programa de Pós-graduação Interdisciplinar em Ciências da Saúde, Universidade Cruzeiro do Sul, São Paulo, São Paulo, Brazil
| | | | - Tamires Duarte Afonso Serdan
- Programa de Pós-graduação Interdisciplinar em Ciências da Saúde, Universidade Cruzeiro do Sul, São Paulo, São Paulo, Brazil
- Department of Molecular Pathobiology, University of New York, New York, NY, United States
| | - Adriana Cristina Levada-Pires
- Programa de Pós-graduação Interdisciplinar em Ciências da Saúde, Universidade Cruzeiro do Sul, São Paulo, São Paulo, Brazil
| | - Elaine Hatanaka
- Programa de Pós-graduação Interdisciplinar em Ciências da Saúde, Universidade Cruzeiro do Sul, São Paulo, São Paulo, Brazil
| | - Fernanda Teixeira Borges
- Programa de Pós-graduação Interdisciplinar em Ciências da Saúde, Universidade Cruzeiro do Sul, São Paulo, São Paulo, Brazil
- Divisão de Nefrologia, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Marcelo Paes de Barros
- Programa de Pós-graduação Interdisciplinar em Ciências da Saúde, Universidade Cruzeiro do Sul, São Paulo, São Paulo, Brazil
| | - Maria Fernanda Cury-Boaventura
- Programa de Pós-graduação Interdisciplinar em Ciências da Saúde, Universidade Cruzeiro do Sul, São Paulo, São Paulo, Brazil
| | - Gisele Lopes Bertolini
- Department of Physiological Sciences, Biological Science Center, State University of Londrina, Londrina, PR, Brazil
| | - Priscila Cassolla
- Department of Physiological Sciences, Biological Science Center, State University of Londrina, Londrina, PR, Brazil
| | | | - Kaio Fernando Vitzel
- School of Health Sciences, College of Health, Massey University, Auckland, New Zealand
| | - Tania Cristina Pithon-Curi
- Programa de Pós-graduação Interdisciplinar em Ciências da Saúde, Universidade Cruzeiro do Sul, São Paulo, São Paulo, Brazil
| | - Laureane Nunes Masi
- Programa de Pós-graduação Interdisciplinar em Ciências da Saúde, Universidade Cruzeiro do Sul, São Paulo, São Paulo, Brazil
| | - Rui Curi
- Programa de Pós-graduação Interdisciplinar em Ciências da Saúde, Universidade Cruzeiro do Sul, São Paulo, São Paulo, Brazil
- Instituto Butantan, São Paulo, Brazil
| | - Renata Gorjao
- Programa de Pós-graduação Interdisciplinar em Ciências da Saúde, Universidade Cruzeiro do Sul, São Paulo, São Paulo, Brazil
| | - Sandro Massao Hirabara
- Programa de Pós-graduação Interdisciplinar em Ciências da Saúde, Universidade Cruzeiro do Sul, São Paulo, São Paulo, Brazil
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12
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Zheng F, Pang Y, Li L, Pang Y, Zhang J, Wang X, Raes G. Applications of nanobodies in brain diseases. Front Immunol 2022; 13:978513. [PMID: 36426363 PMCID: PMC9679430 DOI: 10.3389/fimmu.2022.978513] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 09/30/2022] [Indexed: 03/31/2024] Open
Abstract
Nanobodies are antibody fragments derived from camelids, naturally endowed with properties like low molecular weight, high affinity and low immunogenicity, which contribute to their effective use as research tools, but also as diagnostic and therapeutic agents in a wide range of diseases, including brain diseases. Also, with the success of Caplacizumab, the first approved nanobody drug which was established as a first-in-class medication to treat acquired thrombotic thrombocytopenic purpura, nanobody-based therapy has received increasing attention. In the current review, we first briefly introduce the characterization and manufacturing of nanobodies. Then, we discuss the issue of crossing of the brain-blood-barrier (BBB) by nanobodies, making use of natural methods of BBB penetration, including passive diffusion, active efflux carriers (ATP-binding cassette transporters), carrier-mediated influx via solute carriers and transcytosis (including receptor-mediated transport, and adsorptive mediated transport) as well as various physical and chemical methods or even more complicated methods such as genetic methods via viral vectors to deliver nanobodies to the brain. Next, we give an extensive overview of research, diagnostic and therapeutic applications of nanobodies in brain-related diseases, with emphasis on Alzheimer's disease, Parkinson's disease, and brain tumors. Thanks to the advance of nanobody engineering and modification technologies, nanobodies can be linked to toxins or conjugated with radionuclides, photosensitizers and nanoparticles, according to different requirements. Finally, we provide several perspectives that may facilitate future studies and whereby the versatile nanobodies offer promising perspectives for advancing our knowledge about brain disorders, as well as hopefully yielding diagnostic and therapeutic solutions.
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Affiliation(s)
- Fang Zheng
- The Key Laboratory of Environment and Genes Related to Disease of Ministry of Education, Health Science Center, Xi’an Jiaotong University, Xi’an, China
| | - Yucheng Pang
- The Key Laboratory of Environment and Genes Related to Disease of Ministry of Education, Health Science Center, Xi’an Jiaotong University, Xi’an, China
| | - Luyao Li
- The Key Laboratory of Environment and Genes Related to Disease of Ministry of Education, Health Science Center, Xi’an Jiaotong University, Xi’an, China
| | - Yuxing Pang
- School of Electronic Science and Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - Jiaxin Zhang
- The Key Laboratory of Environment and Genes Related to Disease of Ministry of Education, Health Science Center, Xi’an Jiaotong University, Xi’an, China
| | - Xinyi Wang
- The Key Laboratory of Environment and Genes Related to Disease of Ministry of Education, Health Science Center, Xi’an Jiaotong University, Xi’an, China
| | - Geert Raes
- Research Group of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium
- Myeloid Cell Immunology Lab, Vlaams Instituut voor Biotechnologie (VIB) Center for Inflammation Research, Brussels, Belgium
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13
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Rus T, Perovnik M, Vo A, Nguyen N, Tang C, Jamšek J, Šurlan Popović K, Grimmer T, Yakushev I, Diehl‐Schmid J, Eidelberg D, Trošt M. Disease specific and nonspecific metabolic brain networks in behavioral variant of frontotemporal dementia. Hum Brain Mapp 2022; 44:1079-1093. [PMID: 36334269 PMCID: PMC9875921 DOI: 10.1002/hbm.26140] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 10/10/2022] [Accepted: 10/24/2022] [Indexed: 11/08/2022] Open
Abstract
Behavioral variant of frontotemporal dementia (bvFTD) is common among young-onset dementia patients. While bvFTD-specific multivariate metabolic brain pattern (bFDRP) has been identified previously, little is known about its temporal evolution, internal structure, effect of atrophy, and its relationship with nonspecific resting-state networks such as default mode network (DMN). In this multicenter study, we explored FDG-PET brain scans of 111 bvFTD, 26 Alzheimer's disease, 16 Creutzfeldt-Jakob's disease, 24 semantic variant primary progressive aphasia (PPA), 18 nonfluent variant PPA and 77 healthy control subjects (HC) from Slovenia, USA, and Germany. bFDRP was identified in a cohort of 20 bvFTD patients and age-matched HC using scaled subprofile model/principle component analysis and validated in three independent cohorts. It was characterized by hypometabolism in frontal cortex, insula, anterior/middle cingulate, caudate, thalamus, and temporal poles. Its expression in bvFTD patients was significantly higher compared to HC and other dementia syndromes (p < .0004), correlated with cognitive decline (p = .0001), and increased over time in longitudinal cohort (p = .0007). Analysis of internal network organization by graph-theory methods revealed prominent network disruption in bvFTD patients. We have further found a specific atrophy-related pattern grossly corresponding to bFDRP; however, its contribution to the metabolic pattern was minimal. Finally, despite the overlap between bFDRP and FDG-PET-derived DMN, we demonstrated a predominant role of the specific bFDRP. Taken together, we validated the bFDRP network as a diagnostic/prognostic biomarker specific for bvFTD, provided a unique insight into its highly reproducible internal structure, and proved that bFDRP is unaffected by structural atrophy and independent of normal resting state networks loss.
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Affiliation(s)
- Tomaž Rus
- Department of NeurologyUMC LjubljanaLjubljanaSlovenia,Medical FacultyUniversity of LjubljanaLjubljanaSlovenia
| | | | - An Vo
- Center for NeurosciencesFeinstein Institutes for Medical ResearchManhassetNew YorkUSA
| | - Nha Nguyen
- Department of GeneticsAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Chris Tang
- Center for NeurosciencesFeinstein Institutes for Medical ResearchManhassetNew YorkUSA
| | - Jan Jamšek
- Department of Nuclear MedicineUMC LjubljanaLjubljanaSlovenia
| | | | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum rechts der IsarTechnical University of Munich, School of MedicineMunichGermany
| | - Igor Yakushev
- Department of Nuclear Medicine, Klinikum rechts der IsarTechnical University of MunichMunichGermany,TUM Neuroimaging Center, Klinikum rechts der IsarTechnical University of MunichMunichGermany
| | - Janine Diehl‐Schmid
- Department of Psychiatry and Psychotherapy, Klinikum rechts der IsarTechnical University of Munich, School of MedicineMunichGermany
| | - David Eidelberg
- Center for NeurosciencesFeinstein Institutes for Medical ResearchManhassetNew YorkUSA
| | - Maja Trošt
- Department of NeurologyUMC LjubljanaLjubljanaSlovenia,Medical FacultyUniversity of LjubljanaLjubljanaSlovenia,Department of Nuclear MedicineUMC LjubljanaLjubljanaSlovenia
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14
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Deery HA, Di Paolo R, Moran C, Egan GF, Jamadar SD. Lower brain glucose metabolism in normal ageing is predominantly frontal and temporal: A systematic review and pooled effect size and activation likelihood estimates meta-analyses. Hum Brain Mapp 2022; 44:1251-1277. [PMID: 36269148 PMCID: PMC9875940 DOI: 10.1002/hbm.26119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/29/2022] [Accepted: 10/05/2022] [Indexed: 01/31/2023] Open
Abstract
This review provides a qualitative and quantitative analysis of cerebral glucose metabolism in ageing. We undertook a systematic literature review followed by pooled effect size and activation likelihood estimates (ALE) meta-analyses. Studies were retrieved from PubMed following the PRISMA guidelines. After reviewing 635 records, 21 studies with 22 independent samples (n = 911 participants) were included in the pooled effect size analyses. Eight studies with eleven separate samples (n = 713 participants) were included in the ALE analyses. Pooled effect sizes showed significantly lower cerebral metabolic rates of glucose for older versus younger adults for the whole brain, as well as for the frontal, temporal, parietal, and occipital lobes. Among the sub-cortical structures, the caudate showed a lower metabolic rate among older adults. In sub-group analyses controlling for changes in brain volume or partial volume effects, the lower glucose metabolism among older adults in the frontal lobe remained significant, whereas confidence intervals crossed zero for the other lobes and structures. The ALE identified nine clusters of lower glucose metabolism among older adults, ranging from 200 to 2640 mm3 . The two largest clusters were in the left and right inferior frontal and superior temporal gyri and the insula. Clusters were also found in the inferior temporal junction, the anterior cingulate and caudate. Taken together, the results are consistent with research showing less efficient glucose metabolism in the ageing brain. The findings are discussed in the context of theories of cognitive ageing and are compared to those found in neurodegenerative disease.
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Affiliation(s)
- Hamish A. Deery
- Turner Institute for Brain and Mental HealthMonash UniversityMelbourneAustralia,Monash Biomedical ImagingMonash UniversityMelbourneAustralia
| | - Robert Di Paolo
- Turner Institute for Brain and Mental HealthMonash UniversityMelbourneAustralia,Monash Biomedical ImagingMonash UniversityMelbourneAustralia
| | - Chris Moran
- Peninsula Clinical School, Central Clinical SchoolMonash UniversityFrankstonVictoriaAustralia,Department of Geriatric MedicinePeninsula HealthFrankstonVictoriaAustralia
| | - Gary F. Egan
- Turner Institute for Brain and Mental HealthMonash UniversityMelbourneAustralia,Monash Biomedical ImagingMonash UniversityMelbourneAustralia,Australian Research Council Centre of Excellence for Integrative Brain FunctionMelbourneAustralia
| | - Sharna D. Jamadar
- Turner Institute for Brain and Mental HealthMonash UniversityMelbourneAustralia,Monash Biomedical ImagingMonash UniversityMelbourneAustralia,Australian Research Council Centre of Excellence for Integrative Brain FunctionMelbourneAustralia
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15
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Schroyen G, Schramm G, Van Weehaeghe D, Leenaerts N, Vande Casteele T, Blommaert J, Koole M, Smeets A, Van Laere K, Sunaert S, Deprez S. Cerebral glucose changes after chemotherapy and their relation to long-term cognitive complaints and fatigue. Front Oncol 2022; 12:1021615. [PMID: 36313711 PMCID: PMC9612406 DOI: 10.3389/fonc.2022.1021615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 09/21/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose To investigate the short-term cerebral metabolic effects of intravenous chemotherapy and their association with long-term fatigue/cognitive complaints. Experimental design Using [18F]-FDG-PET/CT whole-body scans, we retrospectively quantified relative cerebral glucose metabolism before and after neoadjuvant chemotherapy in a cohort of patients treated for non-metastatic breast cancer (2009-2019). Self-report of cognitive complaints and fatigue were prospectively assessed 7 ± 3 years after therapy. Metabolic changes were estimated with i) robust mixed-effects modelling in regions-of-interest (frontal, parietal, temporal, occipital, and insular cortex) and ii) general-linear modelling of whole-brain voxel-wise outcomes. iii) The association between metabolic changes and self-reported outcomes was evaluated using linear regression-analysis. Results Of the 667 screened patients, 263 underwent PET/CT before and after chemotherapy and 183 (48 ± 9 years) met the inclusion criteria. After chemotherapy, decreased frontal and increased parietal and insular metabolism were observed (|ß|>0.273, pFDR<0.008). Separately, additional increased occipital metabolism after epiribucin+ cyclophosphamide (EC) and temporal metabolism after EC+ fluorouracil chemotherapy were observed (ß>0.244, pFDR≤0.048). Voxel-based analysis (pcluster-FWE<0.001) showed decreased metabolism in the paracingulate gyrus (-3.2 ± 3.9%) and putamen (3.1 ± 4.1%) and increased metabolism in the lateral cortex (L=2.9 ± 3.1%) and pericentral gyri (3.0 ± 4.4%). Except for the central sulcus, the same regions showed changes in EC, but not in FEC patients. Of the 97 self-reported responders, 23% and 27% experienced extreme fatigue and long-term cognitive complaints, respectively, which were not associated with metabolic changes. Conclusion Both hyper- and hypometabolism were observed after chemotherapy for breast cancer. Combined with earlier findings, this study could support inflammatory mechanisms resulting in relative hypermetabolism, mainly in the parietal/occipital cortices. As early metabolic changes did not precede long-term complaints, further research is necessary to identify vulnerable patients.
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Affiliation(s)
- Gwen Schroyen
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Leuven Cancer Institute, KU Leuven, Leuven, Belgium
- Department of Imaging and Pathology, Translational MRI, KU Leuven, Leuven, Belgium
- *Correspondence: Gwen Schroyen,
| | - Georg Schramm
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Department of Imaging and Pathology, Nuclear Medicine and Molecular Imaging, KU Leuven, Leuven, Belgium
| | - Donatienne Van Weehaeghe
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Department of Imaging and Pathology, Nuclear Medicine and Molecular Imaging, KU Leuven, Leuven, Belgium
- Division of Nuclear Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Nicolas Leenaerts
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Department of Neurosciences, Mind-Body Research, KU Leuven, Leuven, Belgium
- University Psychiatric Centre, KU Leuven, Leuven, Belgium
- Department of Psychiatry, University Hospitals Leuven, Leuven, Belgium
| | - Thomas Vande Casteele
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
- University Psychiatric Centre, KU Leuven, Leuven, Belgium
- Department of Psychiatry, University Hospitals Leuven, Leuven, Belgium
- Department of Neurosciences, Neuropsychiatry, KU Leuven, Leuven, Belgium
| | - Jeroen Blommaert
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Leuven Cancer Institute, KU Leuven, Leuven, Belgium
- Department of Oncology, Gynaecological Oncology, KU Leuven, Leuven, Belgium
| | - Michel Koole
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Leuven Cancer Institute, KU Leuven, Leuven, Belgium
- Department of Imaging and Pathology, Nuclear Medicine and Molecular Imaging, KU Leuven, Leuven, Belgium
| | - Ann Smeets
- Leuven Cancer Institute, KU Leuven, Leuven, Belgium
- Department of Oncology, Surgical Oncology, KU Leuven, Leuven, Belgium
- Surgical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Koen Van Laere
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Leuven Cancer Institute, KU Leuven, Leuven, Belgium
- Department of Imaging and Pathology, Nuclear Medicine and Molecular Imaging, KU Leuven, Leuven, Belgium
- Division of Nuclear Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Stefan Sunaert
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Department of Imaging and Pathology, Translational MRI, KU Leuven, Leuven, Belgium
- Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Sabine Deprez
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Leuven Cancer Institute, KU Leuven, Leuven, Belgium
- Department of Imaging and Pathology, Translational MRI, KU Leuven, Leuven, Belgium
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16
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Spelta LEW, Real CC, Buchpiguel CA, de Paula Faria D, Marcourakis T. [ 18 F]FDG brain uptake of C57Bl/6 male mice is affected by locomotor activity after cocaine use: A small animal positron emission tomography study. J Neurosci Res 2022; 100:1876-1889. [PMID: 35779255 DOI: 10.1002/jnr.25102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/09/2022] [Accepted: 06/20/2022] [Indexed: 11/12/2022]
Abstract
We verified if cocaine-induced peripheral activation might disrupt [18 F]FDG brain uptake after a cocaine challenge and suggested an optimal protocol to measure cocaine-induced brain metabolic alterations in mice. C57Bl/6 male mice were injected with [18 F]FDG and randomly separated into three groups. Groups 1 and 2 were kept conscious after [18 F]FDG administration and after 5 min received saline or cocaine (20 mg/kg). The animals in group 1 (n = 5) were then evaluated in the open field for 30 min and those from group 2 (n = 6) were kept alone in a home cage for the same period. Forty-five minutes after [18 F]FDG administration, images were acquired for 30 min. Group 3 (n = 6) was kept anesthetized and image acquisition started immediately after tracer injection, for 75 min. Saline (Day 1) or cocaine (Day 2) was injected 5 min after starting acquisition. Another set of animals (n = 5) were treated with cocaine every other day for 10 days or saline (n = 6) and were scanned with the dynamic protocol to verify its efficacy. [18 F]FDG uptake increased after cocaine administration when compared to baseline only in animals kept under anesthesia. No brain effect of cocaine was observed in animals submitted to the open field or kept in the home cage. The use of anesthesia is essential to visualize cocaine-induced changes in brain metabolism by [18 F]FDG PET, providing an interesting preclinical approach to investigate naïve subjects and enabling a bidirectional translational science approach for better understanding of cocaine use disorder.
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Affiliation(s)
- Lidia Emmanuela Wiazowski Spelta
- Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Caroline Cristiano Real
- Laboratory of Nuclear Medicine, Department of Radiology and Oncology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Carlos Alberto Buchpiguel
- Laboratory of Nuclear Medicine, Department of Radiology and Oncology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Daniele de Paula Faria
- Laboratory of Nuclear Medicine, Department of Radiology and Oncology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Tania Marcourakis
- Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
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17
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Leaffer EB, De Vivo DC, Engelstad K, Fryer RH, Gu Y, Shungu DC, Hirano M, DiMauro S, Hinton VJ. Visual memory failure presages conversion to MELAS phenotype. Ann Clin Transl Neurol 2022; 9:841-852. [PMID: 35522125 PMCID: PMC9186137 DOI: 10.1002/acn3.51564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 04/02/2022] [Accepted: 04/07/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To examine the correlation between verbal and visual memory function and correlation with brain metabolites (lactate and N-Acetylaspartate, NAA) in individuals with mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS). METHODS Memory performance and brain metabolites (ventricular lactate, occipital lactate, and occipital NAA) were examined in 18 MELAS, 58 m.3243A > G carriers, and 20 familial controls. Measures included the Selective Reminding Test (verbal memory), Benton Visuospatial Retention Test (visual memory), and MR Spectroscopy (NAA, Lactate). ANOVA, chi-squared/Fisher's exact tests, paired t-tests, Pearson correlations, and Spearman correlations were used. RESULTS When compared to carriers and controls, MELAS patients had the: (1) most impaired memory functions (Visual: p = 0.0003; Verbal: p = 0.02), (2) greatest visual than verbal memory impairment, (3) highest brain lactate levels (p < 0.0001), and (4) lowest brain NAA levels (p = 0.0003). Occipital and ventricular lactate to NAA ratios correlated significantly with visual memory performance (p ≤ 0.001). Higher lactate levels (p ≤ 0.01) and lower NAA levels (p = 0.0009) correlated specifically with greater visual memory dysfunction in MELAS. There was little or no correlation with verbal memory. INTERPRETATION Individuals with MELAS are at increased risk for impaired memory. Although verbal and visual memory are both affected, visual memory is preferentially affected and more clearly associated with brain metabolite levels. Preferential involvement of posterior brain regions is a distinctive clinical signature of MELAS. We now report a distinctive cognitive phenotype that targets visual memory more prominently and earlier than verbal memory. We speculate that this finding in carriers presages a conversion to the MELAS phenotype.
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Affiliation(s)
- Emily B Leaffer
- Sergievsky Center & Department of Neurology, Columbia University, New York City, New York, USA.,Department of Psychology, Queens College & The Graduate Center, City University of New York, New York City, New York, USA.,Northeast Cognitive Assessment, Rye Brook, New York, USA
| | - Darryl C De Vivo
- Department of Neurology, Columbia University, New York City, New York, USA
| | - Kristin Engelstad
- Department of Neurology, Columbia University, New York City, New York, USA
| | - Robert H Fryer
- Department of Neurology, Columbia University, New York City, New York, USA
| | - Yian Gu
- Taub Institute, Department of Neurology, Department of Epidemiology, Columbia University, New York City, New York, USA
| | - Dikoma C Shungu
- Department of Radiology, Weill Cornell Medical College, New York City, New York, USA
| | - Michio Hirano
- Department of Neurology, Columbia University, New York City, New York, USA
| | - Salvatore DiMauro
- Department of Neurology, Columbia University, New York City, New York, USA
| | - Veronica J Hinton
- Sergievsky Center & Department of Neurology, Columbia University, New York City, New York, USA.,Department of Psychology, Queens College & The Graduate Center, City University of New York, New York City, New York, USA
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18
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Positron emission tomography and magnetic resonance imaging of the brain in experimental human malaria, a prospective cohort study. Sci Rep 2022; 12:5696. [PMID: 35383257 PMCID: PMC8983718 DOI: 10.1038/s41598-022-09748-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 02/01/2022] [Indexed: 12/25/2022] Open
Abstract
Cerebral malaria is the most serious manifestation of severe falciparum malaria. Sequestration of infected red blood cells and microvascular dysfunction are key contributing processes. Whether these processes occur in early stage disease prior to clinical manifestations is unknown. To help localize and understand these processes during the early stages of infection, we performed 18-F fluorodeoxyglucose positron emission tomography/magnetic resonance imaging in volunteers with Plasmodium falciparum induced blood stage malaria (IBSM) infection, and compared results to individuals with P. vivax infection, in whom coma is rare. Seven healthy, malaria-naïve participants underwent imaging at baseline, and at early symptom onset a median 9 days following inoculation (n = 4 P. falciparum, n = 3 P. vivax). Participants with P. falciparum infection demonstrated marked lability in radiotracer uptake across all regions of the brain, exceeding expected normal variation (within subject coefficient of variation (wCV): 14.4%) compared to the relatively stable uptake in participants with P. vivax infection (wCV: 3.5%). No consistent imaging changes suggestive of microvascular dysfunction were observed in either group. Neuroimaging in early IBSM studies is safe and technically feasible, with preliminary results suggesting that differences in brain tropism between P. falciparum and P. vivax may occur very early in infection.
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Kase AM, Bullock C, Parrondo R, Alhaj Moustafa M, Iqbal M, Li KD, Parent EE, Tun H. Neuropsychiatric Manifestations of Lymphoma-Associated Cerebral Glucose Hypometabolism Can Be Reversed by Intensive Glucose Supplementation. Blood Lymphat Cancer 2022; 12:17-21. [PMID: 35356784 PMCID: PMC8959016 DOI: 10.2147/blctt.s353430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/07/2022] [Indexed: 11/23/2022] Open
Abstract
Cerebral glucose hypometabolism (CGHM) is characterized by diffuse or focal reduction in uptake of glucose by the brain as determined on a FDG PET-CT. We report a case of lymphoma-associated cerebral glucose hypometabolism (LA-CGHM) in a patient with hepatosplenic T-cell lymphoma (HSTCL) whose neuropsychiatric symptoms were resolved with glucose supplementation. PET-CT scan showed diffuse cerebral hypometabolism in addition to focal hypermetabolism in the liver related to lymphomatous involvement. He responded rapidly to infusion of 10% dextrose with complete resolution of neurological symptoms on two separate occasions and was later maintained on oral glucose without relapse. While his neuropsychiatric symptoms improved, his aggressive lymphoma and chemo-refractory disease ultimately led to his demise. We suggest that LA-CGHM can cause neuropsychiatric manifestations which can be reversed by intensive glucose supplementation.
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Affiliation(s)
- Adam M Kase
- Division of Hematology and Medical Oncology, Mayo Clinic Hospital, Jacksonville, FL, 32224, USA
- Correspondence: Adam M Kase, Division of Hematology and Medical Oncology, Mayo Clinic, 4500 San Pablo Road South, Jacksonville, FL, USA, Tel +1 904-953-2000, Fax +1 904-953-2315, Email
| | - Catherine Bullock
- Department of Internal Medicine, Mayo Clinic Hospital, Jacksonville, FL, 32224, USA
| | - Ricardo Parrondo
- Division of Hematology and Medical Oncology, Mayo Clinic Hospital, Jacksonville, FL, 32224, USA
| | - Muhamad Alhaj Moustafa
- Division of Hematology and Medical Oncology, Mayo Clinic Hospital, Jacksonville, FL, 32224, USA
| | - Madiha Iqbal
- Division of Hematology and Medical Oncology, Mayo Clinic Hospital, Jacksonville, FL, 32224, USA
| | - K David Li
- Department of Pathology, Mayo Clinic Hospital, Jacksonville, FL, 32224, USA
| | - Ephraim E Parent
- Nuclear Medicine Division of Radiology Department, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Han Tun
- Division of Hematology and Medical Oncology, Mayo Clinic Hospital, Jacksonville, FL, 32224, USA
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Rissanen E, Carter K, Cicero S, Ficke J, Kijewski M, Park MA, Kijewski J, Stern E, Chitnis T, Silbersweig D, Weiner HL, Kim CK, Lyons J, Klein JP, Bhattacharyya S, Singhal T. Cortical and Subcortical Dysmetabolism Are Dynamic Markers of Clinical Disability and Course in Anti-LGI1 Encephalitis. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2022; 9:9/2/e1136. [PMID: 35091466 PMCID: PMC8802686 DOI: 10.1212/nxi.0000000000001136] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 12/14/2021] [Indexed: 12/19/2022]
Abstract
Background and Objectives This [18F]fluorodeoxyglucose (FDG) PET study evaluates the accuracy of semiquantitative measurement of putaminal hypermetabolism in identifying anti–leucine-rich, glioma–inactivated-1 (LGI1) protein autoimmune encephalitis (AE). In addition, the extent of brain dysmetabolism, their association with clinical outcomes, and longitudinal metabolic changes after immunotherapy in LGI1-AE are examined. Methods FDG-PET scans from 49 age-matched and sex-matched subjects (13 in LGI1-AE group, 15 in non–LGI1-AE group, 11 with Alzheimer disease [AD], and 10 negative controls [NCs]) and follow-up scans from 8 patients with LGI1 AE on a median 6 months after immunotherapy were analyzed. Putaminal standardized uptake value ratios (SUVRs) normalized to global brain (P-SUVRg), thalamus (P/Th), and midbrain (P/Mi) were evaluated for diagnostic accuracy. SUVRg was applied for all other analyses. Results P-SUVRg, P/Th, and P/Mi were higher in LGI1-AE group than in non–LGI1-AE group, AD group, and NCs (all p < 0.05). P/Mi and P-SUVRg differentiated LGI1-AE group robustly from other groups (areas under the curve 0.84–0.99). Mediotemporal lobe (MTL) SUVRg was increased in both LGI1-AE and non–LGI1-AE groups when compared with NCs (both p < 0.05). SUVRg was decreased in several frontoparietal regions and increased in pallidum, caudate, pons, olfactory, and inferior occipital gyrus in LGI1-AE group when compared with that in NCs (all p < 0.05). In LGI1-AE group, both MTL and putaminal hypermetabolism were reduced after immunotherapy. Normalization of regional cortical dysmetabolism associated with clinical improvement at the 6- and 20-month follow-up. Discussion Semiquantitative measurement of putaminal hypermetabolism with FDG-PET may be used to distinguish LGI1-AE from other pathologies. Metabolic abnormalities in LGI1-AE extend beyond putamen and MTL into other subcortical and cortical regions. FDG-PET may be used in evaluating disease evolution in LGI1-AE. Classification of Evidence This study provides Class II evidence that semiquantitative measures of putaminal metabolism on PET can differentiate patients with LGI1-AE from patients without LGI1-AE, patients with AD, or NCs.
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Affiliation(s)
- Eero Rissanen
- From the PET Imaging Program in Neurologic Diseases (E.R., K.C., S.C., J.F., T.S.) and Brigham Multiple Sclerosis Center (E.R., T.C., H.L.W., S.B., T.S.), Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School; Division of Nuclear Medicine and Molecular Imaging (M.K.), Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Medical Physics Section (M.-A.P.), Radiology Department, University of Texas Southwestern Medical Center, Dallas, TX; Department of Neurology (J.K.), Brigham and Women's Hospital, Boston, MA; Ceretype Neuromedicine (E.S.), Cambridge, MA; Functional Neuroimaging Laboratory (D.S.), Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Nuclear Medicine (C.K.K.), Department of Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea; Biogen Inc. (J.L.), Cambridge, MA; and Department of Neurology (J.P.K.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Kelsey Carter
- From the PET Imaging Program in Neurologic Diseases (E.R., K.C., S.C., J.F., T.S.) and Brigham Multiple Sclerosis Center (E.R., T.C., H.L.W., S.B., T.S.), Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School; Division of Nuclear Medicine and Molecular Imaging (M.K.), Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Medical Physics Section (M.-A.P.), Radiology Department, University of Texas Southwestern Medical Center, Dallas, TX; Department of Neurology (J.K.), Brigham and Women's Hospital, Boston, MA; Ceretype Neuromedicine (E.S.), Cambridge, MA; Functional Neuroimaging Laboratory (D.S.), Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Nuclear Medicine (C.K.K.), Department of Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea; Biogen Inc. (J.L.), Cambridge, MA; and Department of Neurology (J.P.K.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Steven Cicero
- From the PET Imaging Program in Neurologic Diseases (E.R., K.C., S.C., J.F., T.S.) and Brigham Multiple Sclerosis Center (E.R., T.C., H.L.W., S.B., T.S.), Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School; Division of Nuclear Medicine and Molecular Imaging (M.K.), Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Medical Physics Section (M.-A.P.), Radiology Department, University of Texas Southwestern Medical Center, Dallas, TX; Department of Neurology (J.K.), Brigham and Women's Hospital, Boston, MA; Ceretype Neuromedicine (E.S.), Cambridge, MA; Functional Neuroimaging Laboratory (D.S.), Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Nuclear Medicine (C.K.K.), Department of Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea; Biogen Inc. (J.L.), Cambridge, MA; and Department of Neurology (J.P.K.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - John Ficke
- From the PET Imaging Program in Neurologic Diseases (E.R., K.C., S.C., J.F., T.S.) and Brigham Multiple Sclerosis Center (E.R., T.C., H.L.W., S.B., T.S.), Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School; Division of Nuclear Medicine and Molecular Imaging (M.K.), Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Medical Physics Section (M.-A.P.), Radiology Department, University of Texas Southwestern Medical Center, Dallas, TX; Department of Neurology (J.K.), Brigham and Women's Hospital, Boston, MA; Ceretype Neuromedicine (E.S.), Cambridge, MA; Functional Neuroimaging Laboratory (D.S.), Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Nuclear Medicine (C.K.K.), Department of Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea; Biogen Inc. (J.L.), Cambridge, MA; and Department of Neurology (J.P.K.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Marie Kijewski
- From the PET Imaging Program in Neurologic Diseases (E.R., K.C., S.C., J.F., T.S.) and Brigham Multiple Sclerosis Center (E.R., T.C., H.L.W., S.B., T.S.), Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School; Division of Nuclear Medicine and Molecular Imaging (M.K.), Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Medical Physics Section (M.-A.P.), Radiology Department, University of Texas Southwestern Medical Center, Dallas, TX; Department of Neurology (J.K.), Brigham and Women's Hospital, Boston, MA; Ceretype Neuromedicine (E.S.), Cambridge, MA; Functional Neuroimaging Laboratory (D.S.), Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Nuclear Medicine (C.K.K.), Department of Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea; Biogen Inc. (J.L.), Cambridge, MA; and Department of Neurology (J.P.K.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Mi-Ae Park
- From the PET Imaging Program in Neurologic Diseases (E.R., K.C., S.C., J.F., T.S.) and Brigham Multiple Sclerosis Center (E.R., T.C., H.L.W., S.B., T.S.), Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School; Division of Nuclear Medicine and Molecular Imaging (M.K.), Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Medical Physics Section (M.-A.P.), Radiology Department, University of Texas Southwestern Medical Center, Dallas, TX; Department of Neurology (J.K.), Brigham and Women's Hospital, Boston, MA; Ceretype Neuromedicine (E.S.), Cambridge, MA; Functional Neuroimaging Laboratory (D.S.), Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Nuclear Medicine (C.K.K.), Department of Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea; Biogen Inc. (J.L.), Cambridge, MA; and Department of Neurology (J.P.K.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Joseph Kijewski
- From the PET Imaging Program in Neurologic Diseases (E.R., K.C., S.C., J.F., T.S.) and Brigham Multiple Sclerosis Center (E.R., T.C., H.L.W., S.B., T.S.), Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School; Division of Nuclear Medicine and Molecular Imaging (M.K.), Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Medical Physics Section (M.-A.P.), Radiology Department, University of Texas Southwestern Medical Center, Dallas, TX; Department of Neurology (J.K.), Brigham and Women's Hospital, Boston, MA; Ceretype Neuromedicine (E.S.), Cambridge, MA; Functional Neuroimaging Laboratory (D.S.), Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Nuclear Medicine (C.K.K.), Department of Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea; Biogen Inc. (J.L.), Cambridge, MA; and Department of Neurology (J.P.K.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Emily Stern
- From the PET Imaging Program in Neurologic Diseases (E.R., K.C., S.C., J.F., T.S.) and Brigham Multiple Sclerosis Center (E.R., T.C., H.L.W., S.B., T.S.), Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School; Division of Nuclear Medicine and Molecular Imaging (M.K.), Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Medical Physics Section (M.-A.P.), Radiology Department, University of Texas Southwestern Medical Center, Dallas, TX; Department of Neurology (J.K.), Brigham and Women's Hospital, Boston, MA; Ceretype Neuromedicine (E.S.), Cambridge, MA; Functional Neuroimaging Laboratory (D.S.), Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Nuclear Medicine (C.K.K.), Department of Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea; Biogen Inc. (J.L.), Cambridge, MA; and Department of Neurology (J.P.K.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Tanuja Chitnis
- From the PET Imaging Program in Neurologic Diseases (E.R., K.C., S.C., J.F., T.S.) and Brigham Multiple Sclerosis Center (E.R., T.C., H.L.W., S.B., T.S.), Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School; Division of Nuclear Medicine and Molecular Imaging (M.K.), Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Medical Physics Section (M.-A.P.), Radiology Department, University of Texas Southwestern Medical Center, Dallas, TX; Department of Neurology (J.K.), Brigham and Women's Hospital, Boston, MA; Ceretype Neuromedicine (E.S.), Cambridge, MA; Functional Neuroimaging Laboratory (D.S.), Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Nuclear Medicine (C.K.K.), Department of Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea; Biogen Inc. (J.L.), Cambridge, MA; and Department of Neurology (J.P.K.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - David Silbersweig
- From the PET Imaging Program in Neurologic Diseases (E.R., K.C., S.C., J.F., T.S.) and Brigham Multiple Sclerosis Center (E.R., T.C., H.L.W., S.B., T.S.), Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School; Division of Nuclear Medicine and Molecular Imaging (M.K.), Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Medical Physics Section (M.-A.P.), Radiology Department, University of Texas Southwestern Medical Center, Dallas, TX; Department of Neurology (J.K.), Brigham and Women's Hospital, Boston, MA; Ceretype Neuromedicine (E.S.), Cambridge, MA; Functional Neuroimaging Laboratory (D.S.), Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Nuclear Medicine (C.K.K.), Department of Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea; Biogen Inc. (J.L.), Cambridge, MA; and Department of Neurology (J.P.K.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Howard L Weiner
- From the PET Imaging Program in Neurologic Diseases (E.R., K.C., S.C., J.F., T.S.) and Brigham Multiple Sclerosis Center (E.R., T.C., H.L.W., S.B., T.S.), Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School; Division of Nuclear Medicine and Molecular Imaging (M.K.), Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Medical Physics Section (M.-A.P.), Radiology Department, University of Texas Southwestern Medical Center, Dallas, TX; Department of Neurology (J.K.), Brigham and Women's Hospital, Boston, MA; Ceretype Neuromedicine (E.S.), Cambridge, MA; Functional Neuroimaging Laboratory (D.S.), Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Nuclear Medicine (C.K.K.), Department of Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea; Biogen Inc. (J.L.), Cambridge, MA; and Department of Neurology (J.P.K.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Chun K Kim
- From the PET Imaging Program in Neurologic Diseases (E.R., K.C., S.C., J.F., T.S.) and Brigham Multiple Sclerosis Center (E.R., T.C., H.L.W., S.B., T.S.), Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School; Division of Nuclear Medicine and Molecular Imaging (M.K.), Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Medical Physics Section (M.-A.P.), Radiology Department, University of Texas Southwestern Medical Center, Dallas, TX; Department of Neurology (J.K.), Brigham and Women's Hospital, Boston, MA; Ceretype Neuromedicine (E.S.), Cambridge, MA; Functional Neuroimaging Laboratory (D.S.), Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Nuclear Medicine (C.K.K.), Department of Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea; Biogen Inc. (J.L.), Cambridge, MA; and Department of Neurology (J.P.K.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Jennifer Lyons
- From the PET Imaging Program in Neurologic Diseases (E.R., K.C., S.C., J.F., T.S.) and Brigham Multiple Sclerosis Center (E.R., T.C., H.L.W., S.B., T.S.), Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School; Division of Nuclear Medicine and Molecular Imaging (M.K.), Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Medical Physics Section (M.-A.P.), Radiology Department, University of Texas Southwestern Medical Center, Dallas, TX; Department of Neurology (J.K.), Brigham and Women's Hospital, Boston, MA; Ceretype Neuromedicine (E.S.), Cambridge, MA; Functional Neuroimaging Laboratory (D.S.), Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Nuclear Medicine (C.K.K.), Department of Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea; Biogen Inc. (J.L.), Cambridge, MA; and Department of Neurology (J.P.K.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Joshua P Klein
- From the PET Imaging Program in Neurologic Diseases (E.R., K.C., S.C., J.F., T.S.) and Brigham Multiple Sclerosis Center (E.R., T.C., H.L.W., S.B., T.S.), Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School; Division of Nuclear Medicine and Molecular Imaging (M.K.), Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Medical Physics Section (M.-A.P.), Radiology Department, University of Texas Southwestern Medical Center, Dallas, TX; Department of Neurology (J.K.), Brigham and Women's Hospital, Boston, MA; Ceretype Neuromedicine (E.S.), Cambridge, MA; Functional Neuroimaging Laboratory (D.S.), Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Nuclear Medicine (C.K.K.), Department of Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea; Biogen Inc. (J.L.), Cambridge, MA; and Department of Neurology (J.P.K.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Shamik Bhattacharyya
- From the PET Imaging Program in Neurologic Diseases (E.R., K.C., S.C., J.F., T.S.) and Brigham Multiple Sclerosis Center (E.R., T.C., H.L.W., S.B., T.S.), Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School; Division of Nuclear Medicine and Molecular Imaging (M.K.), Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Medical Physics Section (M.-A.P.), Radiology Department, University of Texas Southwestern Medical Center, Dallas, TX; Department of Neurology (J.K.), Brigham and Women's Hospital, Boston, MA; Ceretype Neuromedicine (E.S.), Cambridge, MA; Functional Neuroimaging Laboratory (D.S.), Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Nuclear Medicine (C.K.K.), Department of Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea; Biogen Inc. (J.L.), Cambridge, MA; and Department of Neurology (J.P.K.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Tarun Singhal
- From the PET Imaging Program in Neurologic Diseases (E.R., K.C., S.C., J.F., T.S.) and Brigham Multiple Sclerosis Center (E.R., T.C., H.L.W., S.B., T.S.), Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School; Division of Nuclear Medicine and Molecular Imaging (M.K.), Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Medical Physics Section (M.-A.P.), Radiology Department, University of Texas Southwestern Medical Center, Dallas, TX; Department of Neurology (J.K.), Brigham and Women's Hospital, Boston, MA; Ceretype Neuromedicine (E.S.), Cambridge, MA; Functional Neuroimaging Laboratory (D.S.), Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Nuclear Medicine (C.K.K.), Department of Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea; Biogen Inc. (J.L.), Cambridge, MA; and Department of Neurology (J.P.K.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
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Clozapine induces astrocyte-dependent FDG-PET hypometabolism. Eur J Nucl Med Mol Imaging 2022; 49:2251-2264. [PMID: 35122511 DOI: 10.1007/s00259-022-05682-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 01/09/2022] [Indexed: 01/30/2023]
Abstract
PURPOSE Advances in functional imaging allowed us to visualize brain glucose metabolism in vivo and non-invasively with [18F]fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) imaging. In the past decades, FDG-PET has been instrumental in the understanding of brain function in health and disease. The source of the FDG-PET signal has been attributed to neuronal uptake, with hypometabolism being considered as a direct index of neuronal dysfunction or death. However, other brain cells are also metabolically active, including astrocytes. Based on the astrocyte-neuron lactate shuttle hypothesis, the activation of the glutamate transporter 1 (GLT-1) acts as a trigger for glucose uptake by astrocytes. With this in mind, we investigated glucose utilization changes after pharmacologically downregulating GLT-1 with clozapine (CLO), an anti-psychotic drug. METHODS Adult male Wistar rats (control, n = 14; CLO, n = 12) received CLO (25/35 mg kg-1) for 6 weeks. CLO effects were evaluated in vivo with FDG-PET and cortical tissue was used to evaluate glutamate uptake and GLT-1 and GLAST levels. CLO treatment effects were also assessed in cortical astrocyte cultures (glucose and glutamate uptake, GLT-1 and GLAST levels) and in cortical neuronal cultures (glucose uptake). RESULTS CLO markedly reduced in vivo brain glucose metabolism in several brain areas, especially in the cortex. Ex vivo analyses demonstrated decreased cortical glutamate transport along with GLT-1 mRNA and protein downregulation. In astrocyte cultures, CLO decreased GLT-1 density as well as glutamate and glucose uptake. By contrast, in cortical neuronal cultures, CLO did not affect glucose uptake. CONCLUSION This work provides in vivo demonstration that GLT-1 downregulation induces astrocyte-dependent cortical FDG-PET hypometabolism-mimicking the hypometabolic signature seen in people developing dementia-and adds further evidence that astrocytes are key contributors of the FDG-PET signal.
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Godard F, Durot E, Durot C, Hoeffel C, Delmer A, Morland D. Cerebellum/liver index in pretherapeutic 18F-FDG PET/CT as a predictive marker of progression-free survival in follicular lymphoma treated by immunochemotherapy and rituximab maintenance. Medicine (Baltimore) 2022; 101:e28791. [PMID: 35119047 PMCID: PMC8812670 DOI: 10.1097/md.0000000000028791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 01/21/2022] [Indexed: 01/04/2023] Open
Abstract
The purpose of this study was to investigate the value of the "cerebellum/ liver index for prognosis" (CLIP) as a new prognostic marker in pretherapeutic 18F-Fluorodeoxyglucose positron emission tomography (18F-FDG PET) in patients with follicular lymphoma treated by immunochemotherapy and rituximab maintenance, focusing on progression-free survival (PFS).Clinicobiological and imaging data from patients with follicular lymphoma between March 2010 and September 2015 were retrospectively collected and 5-year PFS was determined. The conventional PET parameters (maximum standardized uptake value and total metabolic tumor volume) and the CLIP, corresponding to the ratio of the cerebellum maximum standardized uptake value over the liver SUVmean, were extracted from the pretherapeutic 18F-FDG PET.Forty-six patients were included. Eighteen patients (39%) progressed within the 5 years after treatment initiation. Five-year PFS was 78.6% when CLIP was >4.0 and 42.0% when CLIP was <4.0 (P = .04). CLIP was a significant predictor of PFS on univariate analysis (hazard ratio 3.1, P = .049) and was near-significant on multivariate analysis (hazard ratio 2.8, P = .07) with ECOG PS as a cofactor.The CLIP derived from pretherapeutic 18F-FDG PET seems to be an interesting predictive marker of PFS in follicular lymphoma treated by immunochemotherapy and rituximab maintenance. These results should be evaluated prospectively in a larger cohort.
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Affiliation(s)
| | - Eric Durot
- Hématologie Clinique, CHU de Reims, Reims, France
| | | | - Christine Hoeffel
- Radiologie, CHU de Reims, Reims, France
- CReSTIC (Centre de Recherche en Sciences et Technologies de l’Information et de la Communication), Université de Reims Champagne-Ardenne, Reims, France
| | - Alain Delmer
- Hématologie Clinique, CHU de Reims, Reims, France
| | - David Morland
- Médecine Nucléaire, Institut Godinot, Reims, France
- Laboratoire de Biophysique, UFR de médecine, Université de Reims Champagne-Ardenne, Reims, France
- CReSTIC (Centre de Recherche en Sciences et Technologies de l’Information et de la Communication), Université de Reims Champagne-Ardenne, Reims, France
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Beinat C, Patel CB, Haywood T, Murty S, Naya L, Castillo JB, Reyes ST, Phillips M, Buccino P, Shen B, Park JH, Koran MEI, Alam IS, James ML, Holley D, Halbert K, Gandhi H, He JQ, Granucci M, Johnson E, Liu DD, Uchida N, Sinha R, Chu P, Born DE, Warnock GI, Weissman I, Hayden-Gephart M, Khalighi M, Massoud TF, Iagaru A, Davidzon G, Thomas R, Nagpal S, Recht LD, Gambhir SS. A Clinical PET Imaging Tracer ([ 18F]DASA-23) to Monitor Pyruvate Kinase M2-Induced Glycolytic Reprogramming in Glioblastoma. Clin Cancer Res 2021; 27:6467-6478. [PMID: 34475101 PMCID: PMC8639752 DOI: 10.1158/1078-0432.ccr-21-0544] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 07/15/2021] [Accepted: 08/30/2021] [Indexed: 01/10/2023]
Abstract
PURPOSE Pyruvate kinase M2 (PKM2) catalyzes the final step in glycolysis, a key process of cancer metabolism. PKM2 is preferentially expressed by glioblastoma (GBM) cells with minimal expression in healthy brain. We describe the development, validation, and translation of a novel PET tracer to study PKM2 in GBM. We evaluated 1-((2-fluoro-6-[18F]fluorophenyl)sulfonyl)-4-((4-methoxyphenyl)sulfonyl)piperazine ([18F]DASA-23) in cell culture, mouse models of GBM, healthy human volunteers, and patients with GBM. EXPERIMENTAL DESIGN [18F]DASA-23 was synthesized with a molar activity of 100.47 ± 29.58 GBq/μmol and radiochemical purity >95%. We performed initial testing of [18F]DASA-23 in GBM cell culture and human GBM xenografts implanted orthotopically into mice. Next, we produced [18F]DASA-23 under FDA oversight, and evaluated it in healthy volunteers and a pilot cohort of patients with glioma. RESULTS In mouse imaging studies, [18F]DASA-23 clearly delineated the U87 GBM from surrounding healthy brain tissue and had a tumor-to-brain ratio of 3.6 ± 0.5. In human volunteers, [18F]DASA-23 crossed the intact blood-brain barrier and was rapidly cleared. In patients with GBM, [18F]DASA-23 successfully outlined tumors visible on contrast-enhanced MRI. The uptake of [18F]DASA-23 was markedly elevated in GBMs compared with normal brain, and it identified a metabolic nonresponder within 1 week of treatment initiation. CONCLUSIONS We developed and translated [18F]DASA-23 as a new tracer that demonstrated the visualization of aberrantly expressed PKM2 for the first time in human subjects. These results warrant further clinical evaluation of [18F]DASA-23 to assess its utility for imaging therapy-induced normalization of aberrant cancer metabolism.
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Affiliation(s)
- Corinne Beinat
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford, California.
| | - Chirag B Patel
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford, California
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California
| | - Tom Haywood
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford, California
| | - Surya Murty
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford, California
| | - Lewis Naya
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California
| | - Jessa B Castillo
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford, California
| | - Samantha T Reyes
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford, California
| | - Megan Phillips
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California
| | - Pablo Buccino
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford, California
| | - Bin Shen
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford, California
| | - Jun Hyung Park
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford, California
| | - Mary Ellen I Koran
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, Stanford, California
| | - Israt S Alam
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford, California
| | - Michelle L James
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford, California
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California
| | - Dawn Holley
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford, California
| | - Kim Halbert
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford, California
| | - Harsh Gandhi
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford, California
| | - Joy Q He
- Stanford Institute for Stem Cell Biology and Regenerative Medicine, Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Monica Granucci
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, California
| | - Eli Johnson
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, California
| | - Daniel Dan Liu
- Stanford Institute for Stem Cell Biology and Regenerative Medicine, Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Nobuko Uchida
- Stanford Institute for Stem Cell Biology and Regenerative Medicine, Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Rahul Sinha
- Stanford Institute for Stem Cell Biology and Regenerative Medicine, Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Pauline Chu
- Stanford Human Research Histology Core, Stanford University School of Medicine, Stanford, California
| | - Donald E Born
- Department of Pathology, Neuropathology, Stanford University School of Medicine, Stanford, California
| | | | - Irving Weissman
- Stanford Institute for Stem Cell Biology and Regenerative Medicine, Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Melanie Hayden-Gephart
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, California
| | - Mehdi Khalighi
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford, California
| | - Tarik F Massoud
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford, California
- Division of Neuroimaging and Neurointervention, Department of Radiology, Stanford University School of Medicine, Stanford, California
| | - Andrei Iagaru
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, Stanford, California
| | - Guido Davidzon
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, Stanford, California
| | - Reena Thomas
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California
| | - Seema Nagpal
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California
| | - Lawrence D Recht
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California.
| | - Sanjiv Sam Gambhir
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford, California
- Departments of Bioengineering and Materials Science & Engineering, Stanford University, Stanford, California
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18F-FDG-PET Imaging for Post-COVID-19 Brain and Skeletal Muscle Alterations. Viruses 2021; 13:v13112283. [PMID: 34835088 PMCID: PMC8625263 DOI: 10.3390/v13112283] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 11/07/2021] [Accepted: 11/13/2021] [Indexed: 12/25/2022] Open
Abstract
Scientific evidence concerning the subacute and long-term effects of coronavirus disease 2019 (COVID-19) is on the rise. It has been established that infection by serious acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a systemic process that involves multiple organs. The complications and long-term consequences of COVID-19 are diverse and patients need a multidisciplinary treatment approach in the acute and post-acute stages of the disease. A significant proportion of COVID-19 patients experience neurological manifestations, some enduring for several months post-recovery. However, brain and skeletal muscle changes resultant from SARS CoV-2 infection remain largely unknown. Here, we provide a brief overview of the current knowledge, and usefulness, of [18F]fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) to investigate brain and skeletal muscles changes in Post-COVID-19 patients with persistent symptoms. Furthermore, a brief discussion of future 18F-FDG-PET/CT applications that might advance the current knowledge of the pathogenesis of post-COVID-19 is also provided.
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Proesmans S, Raedt R, Germonpré C, Christiaen E, Descamps B, Boon P, De Herdt V, Vanhove C. Voxel-Based Analysis of [18F]-FDG Brain PET in Rats Using Data-Driven Normalization. Front Med (Lausanne) 2021; 8:744157. [PMID: 34746179 PMCID: PMC8565796 DOI: 10.3389/fmed.2021.744157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/24/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: [18F]-FDG PET is a widely used imaging modality that visualizes cellular glucose uptake and provides functional information on the metabolic state of different tissues in vivo. Various quantification methods can be used to evaluate glucose metabolism in the brain, including the cerebral metabolic rate of glucose (CMRglc) and standard uptake values (SUVs). Especially in the brain, these (semi-)quantitative measures can be affected by several physiological factors, such as blood glucose level, age, gender, and stress. Next to this inter- and intra-subject variability, the use of different PET acquisition protocols across studies has created a need for the standardization and harmonization of brain PET evaluation. In this study we present a framework for statistical voxel-based analysis of glucose uptake in the rat brain using histogram-based intensity normalization. Methods: [18F]-FDG PET images of 28 normal rat brains were coregistered and voxel-wisely averaged. Ratio images were generated by voxel-wisely dividing each of these images with the group average. The most prevalent value in the ratio image was used as normalization factor. The normalized PET images were voxel-wisely averaged to generate a normal rat brain atlas. The variability of voxel intensities across the normalized PET images was compared to images that were either normalized by whole brain normalization, or not normalized. To illustrate the added value of this normal rat brain atlas, 9 animals with a striatal hemorrhagic lesion and 9 control animals were intravenously injected with [18F]-FDG and the PET images of these animals were voxel-wisely compared to the normal atlas by group- and individual analyses. Results: The average coefficient of variation of the voxel intensities in the brain across normal [18F]-FDG PET images was 6.7% for the histogram-based normalized images, 11.6% for whole brain normalized images, and 31.2% when no normalization was applied. Statistical voxel-based analysis, using the normal template, indicated regions of significantly decreased glucose uptake at the site of the ICH lesion in the ICH animals, but not in control animals. Conclusion: In summary, histogram-based intensity normalization of [18F]-FDG uptake in the brain is a suitable data-driven approach for standardized voxel-based comparison of brain PET images.
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Affiliation(s)
- Silke Proesmans
- 4Brain Lab, Department of Head and Skin, Ghent University, Ghent, Belgium
| | - Robrecht Raedt
- 4Brain Lab, Department of Head and Skin, Ghent University, Ghent, Belgium
| | | | - Emma Christiaen
- IbiTech-MEDISIP-Infinity Lab, Department of Electronics and Information Systems, Ghent University, Ghent, Belgium
| | - Benedicte Descamps
- IbiTech-MEDISIP-Infinity Lab, Department of Electronics and Information Systems, Ghent University, Ghent, Belgium
| | - Paul Boon
- 4Brain Lab, Department of Head and Skin, Ghent University, Ghent, Belgium
| | - Veerle De Herdt
- 4Brain Lab, Department of Head and Skin, Ghent University, Ghent, Belgium
| | - Christian Vanhove
- IbiTech-MEDISIP-Infinity Lab, Department of Electronics and Information Systems, Ghent University, Ghent, Belgium
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Evaluation of Age and Sex-Related Metabolic Changes in Healthy Subjects: An Italian Brain 18F-FDG PET Study. J Clin Med 2021; 10:jcm10214932. [PMID: 34768454 PMCID: PMC8584846 DOI: 10.3390/jcm10214932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 11/26/2022] Open
Abstract
Background: 18F-fluorodeoxyglucose (18F-FDG) positron-emission-tomography (PET) allows detection of cerebral metabolic alterations in neurological diseases vs. normal aging. We assess age- and sex-related brain metabolic changes in healthy subjects, exploring impact of activity normalization methods. Methods: brain scans of Italian Association of Nuclear Medicine normative database (151 subjects, 67 Males, 84 Females, aged 20–84) were selected. Global mean, white matter, and pons activity were explored as normalization reference. We performed voxel-based and ROI analyses using SPM12 and IBM-SPSS software. Results: SPM proved a negative correlation between age and brain glucose metabolism involving frontal lobes, anterior-cingulate and insular cortices bilaterally. Narrower clusters were detected in lateral parietal lobes, precuneus, temporal pole and medial areas bilaterally. Normalizing on pons activity, we found a more significant negative correlation and no positive one. ROIs analysis confirmed SPM results. Moreover, a significant age × sex interaction effect was revealed, with worse metabolic reduction in posterior-cingulate cortices in females than males, especially in post-menopausal age. Conclusions: this study demonstrated an age-related metabolic reduction in frontal lobes and in some parieto-temporal areas more evident in females. Results suggested pons as the most appropriate normalization reference. Knowledge of age- and sex-related cerebral metabolic changes is critical to correctly interpreting brain 18F-FDG PET imaging.
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27
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Yassine HN, Solomon V, Thakral A, Sheikh-Bahaei N, Chui HC, Braskie MN, Schneider LS, Talbot K. Brain energy failure in dementia syndromes: Opportunities and challenges for glucagon-like peptide-1 receptor agonists. Alzheimers Dement 2021; 18:478-497. [PMID: 34647685 PMCID: PMC8940606 DOI: 10.1002/alz.12474] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 06/11/2021] [Accepted: 08/11/2021] [Indexed: 12/12/2022]
Abstract
Medications for type 2 diabetes (T2DM) offer a promising path for discovery and development of effective interventions for dementia syndromes. A common feature of dementia syndromes is an energy failure due to reduced energy supply to neurons and is associated with synaptic loss and results in cognitive decline and behavioral changes. Among diabetes medications, glucagon‐like peptide‐1 (GLP‐1) receptor agonists (RAs) promote protective effects on vascular, microglial, and neuronal functions. In this review, we present evidence from animal models, imaging studies, and clinical trials that support developing GLP‐1 RAs for dementia syndromes. The review examines how changes in brain energy metabolism differ in conditions of insulin resistance and T2DM from dementia and underscores the challenges that arise from the heterogeneity of dementia syndromes. The development of GLP‐1 RAs as dementia therapies requires a deeper understanding of the regional changes in brain energy homeostasis guided by novel imaging biomarkers.
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Affiliation(s)
- Hussein N Yassine
- Department of Medicine, University of Southern California, Keck School of Medicine USC, Los Angeles, California, USA.,Department of Neurology, University of Southern California, Keck School of Medicine USC, Los Angeles, California, USA
| | - Victoria Solomon
- Department of Medicine, University of Southern California, Keck School of Medicine USC, Los Angeles, California, USA
| | - Angad Thakral
- Department of Medicine, University of Southern California, Keck School of Medicine USC, Los Angeles, California, USA
| | - Nasim Sheikh-Bahaei
- Department of Radiology, Keck School of Medicine USC, Los Angeles, California, USA
| | - Helena C Chui
- Department of Neurology, University of Southern California, Keck School of Medicine USC, Los Angeles, California, USA
| | - Meredith N Braskie
- Imaging Genetics Center, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, USC, Los Angeles, California, USA
| | - Lon S Schneider
- Department of Neurology, University of Southern California, Keck School of Medicine USC, Los Angeles, California, USA.,Department of Psychiatry and Behavioral Sciences, Keck School of Medicine USC, Los Angeles, California, USA
| | - Konrad Talbot
- Departments of Neurosurgery, Pathology and Human Anatomy, and Basic Sciences, Loma Linda University School of Medicine, Loma Linda, California, USA
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28
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Krämer SD, Schuhmann MK, Schadt F, Israel I, Samnick S, Volkmann J, Fluri F. Changes of cerebral network activity after invasive stimulation of the mesencephalic locomotor region in a rat stroke model. Exp Neurol 2021; 347:113884. [PMID: 34624326 DOI: 10.1016/j.expneurol.2021.113884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 09/02/2021] [Accepted: 10/02/2021] [Indexed: 11/29/2022]
Abstract
Motor deficits after stroke reflect both, focal lesion and network alterations in brain regions distant from infarction. This remote network dysfunction may be caused by aberrant signals from cortical motor regions travelling via mesencephalic locomotor region (MLR) to other locomotor circuits. A method for modulating disturbed network activity is deep brain stimulation. Recently, we have shown that high frequency stimulation (HFS) of the MLR in rats has restored gait impairment after photothrombotic stroke (PTS). However, it remains elusive which cerebral regions are involved by MLR-stimulation and contribute to the improvement of locomotion. Seventeen male Wistar rats underwent photothrombotic stroke of the right sensorimotor cortex and implantation of a microelectrode into the right MLR. 2-[18F]Fluoro-2-deoxyglucose ([18F]FDG)-positron emission tomography (PET) was conducted before stroke and thereafter, on day 2 and 3 after stroke, without and with MLR-HFS, respectively. [18F]FDG-PET imaging analyses yielded a reduced glucose metabolism in the right cortico-striatal thalamic loop after PTS compared to the state before intervention. When MLR-HFS was applied after PTS, animals exhibited a significantly higher uptake of [18F]FDG in the right but not in the left cortico-striatal thalamic loop. Furthermore, MLR-HFS resulted in an elevated glucose metabolism of right-sided association cortices related to the ipsilateral sensorimotor cortex. These data support the concept of diaschisis i.e., of dysfunctional brain areas distant to a focal lesion and suggests that MLR-HFS can reverse remote network effects following PTS in rats which otherwise may result in chronic motor symptoms.
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Affiliation(s)
- Stefanie D Krämer
- Radiopharmaceutical Sciences/Biopharmacy, Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, Zurich, Switzerland
| | | | - Fabian Schadt
- Department of Nuclear Medicine, Interdisciplinary PET center, University Hospital Würzburg, Würzburg, Germany
| | - Ina Israel
- Department of Nuclear Medicine, Interdisciplinary PET center, University Hospital Würzburg, Würzburg, Germany
| | - Samuel Samnick
- Department of Nuclear Medicine, Interdisciplinary PET center, University Hospital Würzburg, Würzburg, Germany
| | - Jens Volkmann
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - Felix Fluri
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany.
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Peter J. Musiré: multimodal simulation and reconstruction framework for the radiological imaging sciences. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2021; 379:20200190. [PMID: 34218676 DOI: 10.1098/rsta.2020.0190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/11/2021] [Indexed: 06/13/2023]
Abstract
A software-based workflow is proposed for managing the execution of simulation and image reconstruction for SPECT, PET, CBCT, MRI, BLI and FMI packages in single and multimodal biomedical imaging applications. The workflow is composed of a Bash script, the purpose of which is to provide an interface to the user, and to organize data flow between dedicated programs for simulation and reconstruction. The currently incorporated simulation programs comprise GATE for Monte Carlo simulation of SPECT, PET and CBCT, SpinScenario for simulating MRI, and Lipros for Monte Carlo simulation of BLI and FMI. Currently incorporated image reconstruction programs include CASToR for SPECT and PET as well as RTK for CBCT. MetaImage (mhd) standard is used for voxelized phantom and image data format. Meshlab project (mlp) containers incorporating polygon meshes and point clouds defined by the Stanford triangle format (ply) are employed to represent anatomical structures for optical simulation, and to represent tumour cell inserts. A number of auxiliary programs have been developed for data transformation and adaptive parameter assignment. The software workflow uses fully automatic distribution to, and consolidation from, any number of Linux workstations and CPU cores. Example data are presented for clinical SPECT, PET and MRI systems using the Mida head phantom and for preclinical X-ray, PET and BLI systems employing the Digimouse phantom. The presented method unifies and simplifies multimodal simulation setup and image reconstruction management and might be of value for synergistic image research. This article is part of the theme issue 'Synergistic tomographic image reconstruction: part 2'.
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Affiliation(s)
- Jörg Peter
- German Cancer Research Center (DKFZ), Division of Medical Physics in Radiology, Im Neuenheimer Feld, 280, 69120 Heidelberg, Germany
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30
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An YS, Kim SH, Roh TH, Park SH, Kim TG, Kim JH. Correlation Between 18F-FDG Uptake and Immune Cell Infiltration in Metastatic Brain Lesions. Front Oncol 2021; 11:618705. [PMID: 34249674 PMCID: PMC8266210 DOI: 10.3389/fonc.2021.618705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 06/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background The purpose of this study was to investigate the correlation between 18F-fluorodeoxyglucose (FDG) uptake and infiltrating immune cells in metastatic brain lesions. Methods This retrospective study included 34 patients with metastatic brain lesions who underwent brain 18F-FDG positron emission tomography (PET)/computed tomography (CT) followed by surgery. 18F-FDG uptake ratio was calculated by dividing the standardized uptake value (SUV) of the metastatic brain lesion by the contralateral normal white matter uptake value. We investigated the clinicopathological characteristics of the patients and analyzed the correlation between 18F-FDG uptake and infiltration of various immune cells. In addition, we evaluated immune-expression levels of glucose transporter 1 (GLUT1), hexokinase 2 (HK2), and Ki-67 in metastatic brain lesions. Results The degree of 18F-FDG uptake of metastatic brain lesions was not significantly correlated with clinical parameters. There was no significant relationship between the 18F-FDG uptake and degree of immune cell infiltration in brain metastasis. Furthermore, other markers, such as GLUT1, HK2, and Ki-67, were not correlated with degree of 18F-FDG uptake. In metastatic brain lesions that originated from breast cancer, a higher degree of 18F-FDG uptake was observed in those with high expression of CD68. Conclusions In metastatic brain lesions, the degree of 18F-FDG uptake was not significantly associated with infiltration of immune cells. The 18F-FDG uptake of metastatic brain lesions from breast cancer, however, might be associated with macrophage activity.
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Affiliation(s)
- Young-Sil An
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, South Korea
| | - Se-Hyuk Kim
- Department of Neurosurgery, Ajou University School of Medicine, Suwon, South Korea
| | - Tae Hoon Roh
- Department of Neurosurgery, Ajou University School of Medicine, Suwon, South Korea
| | - So Hyun Park
- Department of Pathology, Ajou University School of Medicine, Suwon, South Korea
| | - Tae-Gyu Kim
- Department of Pathology, Ajou University School of Medicine, Suwon, South Korea
| | - Jang-Hee Kim
- Department of Pathology, Ajou University School of Medicine, Suwon, South Korea
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Schadt F, Israel I, Samnick S. Development and Validation of a Semi-Automated, Preclinical, MRI-Template Based PET Image Data Analysis Tool for Rodents. Front Neuroinform 2021; 15:639643. [PMID: 34168548 PMCID: PMC8217772 DOI: 10.3389/fninf.2021.639643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 05/06/2021] [Indexed: 11/16/2022] Open
Abstract
Aim In PET imaging, the different types of radiotracers and accumulations, as well as the diversity of disease patterns, make the analysis of molecular imaging data acquired in vivo challenging. Here, we evaluate and validate a semi-automated MRI template-based data analysis tool that allows preclinical PET images to be aligned to a self-created PET template. Based on the user-defined volume-of-interest (VOI), image data can then be evaluated using three different semi-quantitative parameters: normalized activity, standardized uptake value, and uptake ratio. Materials and Methods The nuclear medicine Data Processing Analysis tool (NU_DPA) was implemented in Matlab. Testing and validation of the tool was performed using two types of radiotracers in different kinds of stroke-related brain diseases in rat models. The radiotracers used are 2-[18F]fluoro-2-deoxyglucose ([18F]FDG), a metabolic tracer with symmetrical distribution in brain, and [68Ga]Ga-Fucoidan, a target-selective radioligand specifically binding to p-selectin. After manual image import, the NU_DPA tool automatically creates an averaged PET template out of the acquired PET images, to which all PET images are then aligned onto. The added MRI template-based information, resized to the lower PET resolution, defines the VOI and also allows a precise subdivision of the VOI into individual sub-regions. The aligned PET images can then be evaluated semi-quantitatively for all regions defined in the MRI atlas. In addition, a statistical analysis and evaluation of the semi-quantitative parameters can then be performed in the NU_DPA tool. Results Using ischemic stroke data in Wistar rats as an example, the statistical analysis of the tool should be demonstrated. In this [18F]FDG-PET experiment, three different experimental states were compared: healthy control state, ischemic stroke without electrical stimulation, ischemic stroke with electrical stimulation. Thereby, statistical data evaluation using the NU_DPA tool showed that the glucose metabolism in a photothrombotic lesion can be influenced by electrical stimulation. Conclusion Our NU_DPA tool allows a very flexible data evaluation of small animal PET data in vivo including statistical data evaluation. Using the radiotracers [18F]FDG and [68Ga]Ga-Fucoidan, it was shown that the semi-automatic MRI-template based data analysis of the NU_DPA tool is potentially suitable for both metabolic radiotracers as well as target-selective radiotracers.
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Affiliation(s)
- Fabian Schadt
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Ina Israel
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Samuel Samnick
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
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18F-FDG cerebellum/liver index as a prognostic factor for progression-free survival in diffuse large B-cell lymphoma. Ann Nucl Med 2021; 35:785-793. [PMID: 34031852 DOI: 10.1007/s12149-021-01609-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 03/14/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVE 18F-FDG PET/CT provides valuable informations regarding the prognosis of DLBCL. The aim of this study is to test a novel index based on cerebellar uptake to predict progression free survival in DLBCL patients. METHODS Data from patients with de novo DLBCL between January 2011 and December 2018 were retrospectively collected and PFS was determined. The conventional PET parameters (SUVmax and total metabolic tumor volume) and the CLIP, corresponding to the ratio of the cerebellum SUVmax over the liver SUVmean, were extracted from baseline 18F-FDG PET. RESULTS Ninety-five patients were included. When using a threshold of 3.24, CLIP was a significant predictor of PFS on univariate analysis (HR 3.4, p < 0.001) with different 5-year survival rates: 68% (CLIP ≥ 3.24) versus 32% (CLIP < 3.24). Multivariate analysis confirmed the prognostic value of CLIP, as it is one of the two factors remaining significant with β2-microglobulin (HR 2.1 and 2.5 respectively, p = 0.04 and p = 0.03). A score associating β2-microglobulin and CLIP allowed to separate the population into three groups of different outcome in terms of 5-year PFS: low risk (80%), intermediate risk (42%) and high risk (17%). CONCLUSIONS The CLIP derived from pre-therapeutic 18F-FDG PET seems to be an interesting predictive marker of PFS in DLBCL treated by immunochemotherapy.
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Sager G, Akgun E, Abuqbeitah M, Uslu L, Asa S, Akgun MY, Beytur F, Baydili KN, Sager S. Comparison of brain F-18 FDG PET/MRI with PET/CT imaging in pediatric patients. Clin Neurol Neurosurg 2021; 206:106669. [PMID: 33984753 DOI: 10.1016/j.clineuro.2021.106669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/05/2021] [Accepted: 04/17/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Standardized uptake values (SUVs) are important indexes for evaluating the accuracy of disease diagnoses achieved via fluoro-18 deoxyglucose (F-18 FDG) positron emission tomography/computed tomography (PET/CT) and positron emission tomography/magnetic resonance imaging (PET/MRI). The purpose of this study is to describe normal cerebral FDG uptake in the pediatric population and compare SUVmax/mean results for brain images obtained from PET/CT and PET/MRI in neurologically healthy pediatric examinees. METHODS This study included 20 patients who were < 18 years of age and were without intracranial malignancy and/or brain disorders. Patients underwent either PET/CT imaging (n = 10) or PET/MRI imaging (n = 10) after 70-80 min of F-18 FDG injection. The SUVmax and SUVmean for various brain regions were calculated and compared between sides and imaging modalities using with appropriate statistical tests. RESULTS The median SUVmax/SUVmean values of the right-sided frontal, parietal, temporal, and occipital lobes were 8.63/ 6.18, 8.85 / 6.97, 6.88 / 4.99, and 11.06 / 7.02 in PET/CT, respectively, and 11.45 / 8.59, 10.16 / 8.47, 8.82 / 6.6, and 11.71 / 8.25 in PET/MRI, respectively. The median SUVmax/SUVmean values of the left-sided frontal, parietal, temporal, and occipital lobes were 9.05 / 6.86, 8.03 / 6.62, 6.49 / 4.77, and 10.6 / 7.73 in PET/CT, respectively, and 10.7 / 8.16, 11.06 / 7.88, 8.13 / 6.09, and 10.96 / 9.22 in PET/MRI, respectively. CONCLUSIONS These results showed that there was no statistically significant difference in SUVs values between the two brain imaging modalities except from SUVmax value of left-sided parietal lobe and no asymmetric radiopharmaceutical uptake between the left and right brain regions or cerebellums in each modality, suggested that in brain imaging, PET/MRI can be used reliably instead of PET/CT.
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Affiliation(s)
- Gunes Sager
- Kartal Lutfi Kirdar Training and Research Hospital, Department of Pediatric Neurology, Istanbul, Turkey
| | - Elife Akgun
- Kirikkale Yuksek Ihtisas Hospital, Department of Nuclear Medicine, Kirikkale, Turkey.
| | - Muhammed Abuqbeitah
- Istanbul University-Cerrahpasa, School of Medicine, Department of Nuclear Medicine, Istanbul, Turkey
| | - Lebriz Uslu
- Istanbul University-Cerrahpasa, School of Medicine, Department of Nuclear Medicine, Istanbul, Turkey
| | - Sertac Asa
- Istanbul University-Cerrahpasa, School of Medicine, Department of Nuclear Medicine, Istanbul, Turkey
| | - Mehmet Yigit Akgun
- Kirikkale Yuksek Ihtisas Hospital, Department of Neurosurgery, Kirikkale, Turkey
| | - Fatih Beytur
- Istanbul University-Cerrahpasa, School of Medicine, Department of Nuclear Medicine, Istanbul, Turkey
| | | | - Sait Sager
- Istanbul University-Cerrahpasa, School of Medicine, Department of Nuclear Medicine, Istanbul, Turkey
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Lau TY, Kao YH, Toh HB, Sivaratnam D, Lichtenstein M, Velakoulis D, Walterfang M. Brain hypometabolic changes in 14 adolescent-adult patients with Niemann-Pick disease type C assessed by 18F-fluorodeoxyglucose positron emission tomography. J Neurol 2021; 268:3878-3885. [PMID: 33830335 DOI: 10.1007/s00415-021-10535-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/23/2021] [Accepted: 03/25/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Niemann Pick disease type C (NPC) is a rare progressive neurovisceral lysosomal disorder caused by autosomal recessive mutations in the NPC1 or NPC2 genes. 18F-fluorodeoxyglucose (FDG) is a positron-emitting glucose analogue for non-invasive imaging of brain metabolism. FDG PET is commonly used for dementia imaging but its specific application to NPC is rarely described. METHODS This is a retrospective study of all baseline brain FDG PET performed for NPC patients. Images were assessed using a normal database statistical comparison of metabolic changes expressed in standard deviations and three-dimensional Stereotactic Surface Projection maps. Typical hypometabolic patterns in NPC were identified. We further investigated any correlation between the degree of regional brain hypometabolism and the Iturriaga clinical severity scale. RESULTS Brain FDG PET images of 14 adolescent-adult NPC patients were analysed, with mean age of 35 years. We found significant frontal lobe hypometabolism in 12 patients (86%), thalamic hypometabolism in eight patients (57%) and variable parietal lobe hypometabolism in 13 patients (93%). Hypometabolic changes were usually bilateral and symmetric. Ten out of 13 ataxic patients showed cerebellar or thalamic hypometabolism (sensitivity 77%, specificity 100%). Linear regression analysis showed frontal lobe hypometabolism to have the best correlation with the Iturriaga clinical scale (R2 = 0.439; p = 0.01). CONCLUSIONS We found bilateral symmetric hypometabolism of the frontal lobes, thalami and parietal lobes (especially posterior cingulate gyrus) to be typical of adolescent-adult NPC. Ataxia was commonly associated with cerebellar or thalamic hypometabolism. Frontal lobe hypometabolism showed the best inverse correlation with clinical severity.
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Affiliation(s)
- Theodore Y Lau
- Department of Nuclear Medicine, The Royal Melbourne Hospital, Melbourne, Australia
| | - Yung Hsiang Kao
- Department of Nuclear Medicine, The Royal Melbourne Hospital, Melbourne, Australia
| | - H B Toh
- Department of Nuclear Medicine, The Royal Melbourne Hospital, Melbourne, Australia
| | - Dinesh Sivaratnam
- Department of Nuclear Medicine, The Royal Melbourne Hospital, Melbourne, Australia
| | - Meir Lichtenstein
- Department of Nuclear Medicine, The Royal Melbourne Hospital, Melbourne, Australia
| | - Dennis Velakoulis
- Neuropsychiatry Unit, The Royal Melbourne Hospital, Level 2, John Cade Building, Melbourne, 3050, Australia.,Melbourne Neuropsychiatry Centre, University of Melbourne and North Western Mental Health, Melbourne, Australia
| | - Mark Walterfang
- Neuropsychiatry Unit, The Royal Melbourne Hospital, Level 2, John Cade Building, Melbourne, 3050, Australia. .,Melbourne Neuropsychiatry Centre, University of Melbourne and North Western Mental Health, Melbourne, Australia. .,Florey Institute of Neuroscience and Mental Health, Melbourne, Australia.
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Mehta V, Bouchareb Y, Ramaswamy S, Ahmad A, Wodehouse T, Haroon A. Metabolic Imaging of Pain Matrix Using 18 F Fluoro-deoxyglucose Positron Emission Tomography/Computed Tomography for Patients Undergoing L2 Dorsal Root Ganglion Stimulation for Low Back Pain. Neuromodulation 2020; 23:222-233. [PMID: 32103593 DOI: 10.1111/ner.13095] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 10/18/2019] [Accepted: 10/30/2019] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Nociceptive signals from lumbar intervertebral discs ascend in the sympathetic chain via the L2 dorsal root ganglion (L2 DRG), a potential target for discogenic low back pain in neuromodulation. Positron Emission Tomography/Computed Tomography (PET-CT) measures functional changes in the brain metabolic activity, identified by the changes in the regional cerebral blood flow (rCBF) as determined by the changes of F-18 Fluoro-deoxyglucose (18 F FDG) tracer within brain tissues. METHODS AND MATERIALS Nine patients were recruited to explore the changes in PET-CT imaging at baseline and four-weeks post implantation of bilateral L2 DRG neurostimulation leads and implantable pulse generator (IPG). PET-CT scans were performed 30 min following an IV injection of 250±10% MBq of 18 F FDG tracer. Fifteen frames were acquired in 15 min. PET list-mode raw data were reconstructed and normalized appropriately to a brain anatomical atlas. RESULTS Nine patients were recruited to the study, where PET-CT imaging data for five patients were analyzed. The right and left insular cortex, primary and secondary somato-sensory cortices, prefrontal cortex, anterior cingulate cortex, thalamus, amygdala, hippocampus and the midline periaqueductal areas, were assessed for any changes in the metabolic activity. A total of 85 pain matrix regions were delineated SUV (standardized uptake value)MAX , SUV MEAN ± SD, and SUVPEAK were calculated for each of these regions of the brain and were compared pre- and post-L2 DRG stimulation. Sixty-one of the 85 matrices showed an increase in metabolic activity whereas 24 matrices showed a reduction in metabolic activity. CONCLUSION This is the first ever study reporting the changes in cerebral metabolic activity and multi-frame static brain 18 F FDG PET imaging after L2 DRG stimulation for discogenic low back pain. Predominantly an increased metabolic activity in nociceptive brain matrices are seen with an increased in F18 F FDG uptake following L2 DRG stimulation.
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Affiliation(s)
- Vivek Mehta
- Pain and Anaesthesia Research Centre, Barts Health NHS Trust, London, UK
| | - Yassine Bouchareb
- Department of Clinical Physics, Barts Health NHS Trust, London, UK.,Radiology and Molecular Imaging Department, Sultan Qaboos University, Muscat, Oman
| | - Shankar Ramaswamy
- Pain and Anaesthesia Research Centre, Barts Health NHS Trust, London, UK
| | - Alia Ahmad
- Pain and Anaesthesia Research Centre, Barts Health NHS Trust, London, UK
| | - Theresa Wodehouse
- Pain and Anaesthesia Research Centre, Barts Health NHS Trust, London, UK
| | - Athar Haroon
- Department of Nuclear Medicine, St Bartholomew's Hospital, London, UK
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Delorme C, Paccoud O, Kas A, Hesters A, Bombois S, Shambrook P, Boullet A, Doukhi D, Le Guennec L, Godefroy N, Maatoug R, Fossati P, Millet B, Navarro V, Bruneteau G, Demeret S, Pourcher V. COVID-19-related encephalopathy: a case series with brain FDG-positron-emission tomography/computed tomography findings. Eur J Neurol 2020; 27:2651-2657. [PMID: 32881133 PMCID: PMC7461074 DOI: 10.1111/ene.14478] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/11/2020] [Indexed: 12/27/2022]
Abstract
Aim The aim of this paper is to describe the clinical features of COVID‐19‐related encephalopathy and their metabolic correlates using brain 2‐desoxy‐2‐fluoro‐D‐glucose (FDG)‐positron‐emission tomography (PET)/computed tomography (CT) imaging. Background and purpose A variety of neurological manifestations have been reported in association with COVID‐19. COVID‐19‐related encephalopathy has seldom been reported and studied. Methods We report four cases of COVID‐19‐related encephalopathy. The diagnosis was made in patients with confirmed COVID‐19 who presented with new‐onset cognitive disturbances, central focal neurological signs, or seizures. All patients underwent cognitive screening, brain magnetic resonance imaging (MRI), lumbar puncture, and brain 2‐desoxy‐2‐fluoro‐D‐glucose (FDG)‐positron‐emission tomography (PET)/computed tomography (CT) (FDG‐PET/CT). Results The four patients were aged 60 years or older, and presented with various degrees of cognitive impairment, with predominant frontal lobe impairment. Two patients presented with cerebellar syndrome, one patient had myoclonus, one had psychiatric manifestations, and one had status epilepticus. The delay between first COVID‐19 symptoms and onset of neurological symptoms was between 0 and 12 days. None of the patients had MRI features of encephalitis nor significant cerebrospinal fluid (CSF) abnormalities. SARS‐CoV‐2 RT‐PCR in the CSF was negative for all patients. All patients presented with a consistent brain FDG‐PET/CT pattern of abnormalities, namely frontal hypometabolism and cerebellar hypermetabolism. All patients improved after immunotherapy. Conclusions Despite varied clinical presentations, all patients presented with a consistent FDG‐PET pattern, which may reflect an immune mechanism.
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Affiliation(s)
- C Delorme
- Department of Neurology, Sorbonne University, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospitals - Pitié-Salpêtrière Charles Foix, Paris, France
| | - O Paccoud
- Department of Infectious and Tropical diseases, Sorbonne University, AP-HP, University Hospitals Pitié-Salpêtrière Charles Foix, Paris, France
| | - A Kas
- Nuclear Medicine and LIB Department, Sorbonne University, AP-HP, University Hospitals Pitié-Salpêtrière Charles Foix, INSERM U1146, Paris, France
| | - A Hesters
- Department of Neurology, Sorbonne University, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospitals - Pitié-Salpêtrière Charles Foix, Paris, France
| | - S Bombois
- Department of Neurology, Sorbonne University, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospitals - Pitié-Salpêtrière Charles Foix, Paris, France
| | - P Shambrook
- Department of Neurology, Sorbonne University, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospitals - Pitié-Salpêtrière Charles Foix, Paris, France
| | - A Boullet
- Department of Neurology, Sorbonne University, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospitals - Pitié-Salpêtrière Charles Foix, Paris, France
| | - D Doukhi
- Department of Neurology, Sorbonne University, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospitals - Pitié-Salpêtrière Charles Foix, Paris, France
| | - L Le Guennec
- Department of Neurology, Sorbonne University, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospitals - Pitié-Salpêtrière Charles Foix, Paris, France
| | - N Godefroy
- Department of Infectious and Tropical diseases, Sorbonne University, AP-HP, University Hospitals Pitié-Salpêtrière Charles Foix, Paris, France
| | - R Maatoug
- Department of adult Psychiatry, Sorbonne University, AP-HP, University Hospitals Pitié-Salpêtrière Charles Foix, Paris, France
| | - P Fossati
- Department of adult Psychiatry, Sorbonne University, AP-HP, University Hospitals Pitié-Salpêtrière Charles Foix, Paris, France
| | - B Millet
- Department of adult Psychiatry, Sorbonne University, AP-HP, University Hospitals Pitié-Salpêtrière Charles Foix, Paris, France
| | - V Navarro
- Department of Neurophysiology, Sorbonne University, AP-HP, University Hospitals Pitié-Salpêtrière Charles Foix, Paris, France
| | - G Bruneteau
- Department of Neurology, Sorbonne University, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospitals - Pitié-Salpêtrière Charles Foix, Paris, France
| | - S Demeret
- Department of Neurology, Sorbonne University, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospitals - Pitié-Salpêtrière Charles Foix, Paris, France
| | - V Pourcher
- Department of Infectious and Tropical diseases, Sorbonne University, AP-HP, University Hospitals Pitié-Salpêtrière Charles Foix, Paris, France.,Pierre Louis Institute of Epidemiology and Public Health, Sorbonne University, INSERM 1136, Paris, France
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Metabolic activity in subcallosal cingulate predicts response to deep brain stimulation for depression. Neuropsychopharmacology 2020; 45:1681-1688. [PMID: 32580207 PMCID: PMC7419290 DOI: 10.1038/s41386-020-0745-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 05/06/2020] [Accepted: 06/12/2020] [Indexed: 01/03/2023]
Abstract
Subcallosal cingulate (SCC) deep brain stimulation (DBS) is a promising therapy for treatment-resistant depression (TRD), but response rates in open-label studies were not replicated in a large multicenter trial. Identifying biomarkers of response could improve patient selection and outcomes. We examined SCC metabolic activity as both a predictor and marker of SCC DBS treatment response. Brain glucose metabolism (CMRGlu) was measured with [18F] FDG-PET at baseline and 6 months post DBS in 20 TRD patients in a double-blind randomized controlled trial where two stimulation types (long pulse width (LPW) n = 9 and short pulse width (SPW) n = 11) were used. Responders (n = 10) were defined by a ≥48% reduction in Hamilton Depression Rating Scale scores after 6 months. The response rates were similar with five responders in each stimulation group: LPW (55.6%) and SPW (44.5%). First, differences in SCC CMRGlu in responders and non-responders were compared at baseline. Then machine learning analysis was performed with a leave-one-out cross-validation using a Gaussian naive Bayes classifier to test whether baseline CMRGlu in SCC could categorize responders. Finally, we compared 6-month change in metabolic activity with change in depression severity. All analyses were controlled for age. Baseline SCC CMRGlu was significantly higher in responders than non-responders. The machine learning analysis predicted response with 80% accuracy. Furthermore, reduction in SCC CMRGlu 6 months post DBS correlated with symptom improvement (r(17) = 0.509; p = 0.031). This is the first evidence of an image-based treatment selection biomarker that predicts SCC DBS response. Future studies could utilize SCC metabolic activity for prospective patient selection.
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Sachinvala ND, Teramoto N, Stergiou A. Proposed Neuroimmune Roles of Dimethyl Fumarate, Bupropion, S-Adenosylmethionine, and Vitamin D 3 in Affording a Chronically Ill Patient Sustained Relief from Inflammation and Major Depression. Brain Sci 2020; 10:E600. [PMID: 32878267 PMCID: PMC7563300 DOI: 10.3390/brainsci10090600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/23/2020] [Accepted: 08/25/2020] [Indexed: 12/14/2022] Open
Abstract
We had discussed earlier that, after most of the primary author's multiple sclerosis (MS) symptoms were lessened by prior neuroimmune therapies, use of dimethyl fumarate (DMF) gradually subdued his asthma and urticaria symptoms, as well as his MS-related intercostal cramping; and bupropion supplemented with S-adenosylmethionine (SAMe) and vitamin D3 (vit-D3) helped remit major depression (MD). Furthermore, the same cocktail (bupropion plus supplements), along with previously discussed routines (yoga, meditation, physical exercises, and timely use of medications for other illnesses), continued to subdue MD during new difficulties with craniopharyngioma, which caused bitemporal vision loss; sphenoid sinus infections, which caused cranial nerve-VI (CN6) palsy and diplopia; and through their treatments. Impressed by the benefit the four compounds provided, in this manuscript, we focus on explaining current neuroimmune literature proposals on how: (1) DMF impedes inflammation, oxidative stress, and cell death in CNS and peripheral tissues; (2) Bupropion curbs anxiety, MD, and enhances alertness, libido, and moods; (3) SAMe silences oxidative stress and depression by multiple mechanisms; and (4) Vit-D3 helps brain development and functioning and subdues inflammation. we realize that herein we have reviewed proposed mechanisms of remedies we discovered by literature searches and physician assisted auto-experimentation; and our methods might not work with other patients. We present our experiences so readers are heartened to reflect upon their own observations in peer-reviewed forums and make available a wide body of information for the chronically ill and their physicians to benefit from.
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Affiliation(s)
| | - Naozumi Teramoto
- Department of Applied Chemistry, Faculty of Engineering, Chiba Institute of Technology, 2-17-1, Tsudanuma, Narashino, Chiba 275-0016, Japan;
| | - Angeline Stergiou
- Department of Medicine, Fairfield Medical Center, 401 North Ewing, Lancaster, OH 43130, USA;
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López-González FJ, Silva-Rodríguez J, Paredes-Pacheco J, Niñerola-Baizán A, Efthimiou N, Martín-Martín C, Moscoso A, Ruibal Á, Roé-Vellvé N, Aguiar P. Intensity normalization methods in brain FDG-PET quantification. Neuroimage 2020; 222:117229. [PMID: 32771619 DOI: 10.1016/j.neuroimage.2020.117229] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/28/2020] [Accepted: 07/31/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The lack of standardization of intensity normalization methods and its unknown effect on the quantification output is recognized as a major drawback for the harmonization of brain FDG-PET quantification protocols. The aim of this work is the ground truth-based evaluation of different intensity normalization methods on brain FDG-PET quantification output. METHODS Realistic FDG-PET images were generated using Monte Carlo simulation from activity and attenuation maps directly derived from 25 healthy subjects (adding theoretical relative hypometabolisms on 6 regions of interest and for 5 hypometabolism levels). Single-subject statistical parametric mapping (SPM) was applied to compare each simulated FDG-PET image with a healthy database after intensity normalization based on reference regions methods such as the brain stem (RRBS), cerebellum (RRC) and the temporal lobe contralateral to the lesion (RRTL), and data-driven methods, such as proportional scaling (PS), histogram-based method (HN) and iterative versions of both methods (iPS and iHN). The performance of these methods was evaluated in terms of the recovery of the introduced theoretical hypometabolic pattern and the appearance of unspecific hypometabolic and hypermetabolic findings. RESULTS Detected hypometabolic patterns had significantly lower volumes than the introduced hypometabolisms for all intensity normalization methods particularly for slighter reductions in metabolism . Among the intensity normalization methods, RRC and HN provided the largest recovered hypometabolic volumes, while the RRBS showed the smallest recovery. In general, data-driven methods overcame reference regions and among them, the iterative methods overcame the non-iterative ones. Unspecific hypermetabolic volumes were similar for all methods, with the exception of PS, where it became a major limitation (up to 250 cm3) for extended and intense hypometabolism. On the other hand, unspecific hypometabolism was similar far all methods, and usually solved with appropriate clustering. CONCLUSIONS Our findings showed that the inappropriate use of intensity normalization methods can provide remarkable bias in the detected hypometabolism and it represents a serious concern in terms of false positives. Based on our findings, we recommend the use of histogram-based intensity normalization methods. Reference region methods performance was equivalent to data-driven methods only when the selected reference region is large and stable.
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Affiliation(s)
- Francisco J López-González
- Molecular Imaging Group, Radiology Department, Faculty of Medicine, Universidade de Santiago de Compostela, Galicia, Spain; Molecular Imaging Unit, Centro de Investigaciones Médico-Sanitarias, General Foundation of the University of Málaga, Málaga, Spain
| | - Jesús Silva-Rodríguez
- R&D Department, Qubiotech Health Intelligence, SL., Rúa Real n° 24, Planta 1, A Coruña, Galicia, Spain; Nuclear Medicine Department & Molecular Imaging Group, University Hospital (SERGAS) & Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana S/N 15706, Santiago de Compostela, Galicia, Spain.
| | - José Paredes-Pacheco
- Molecular Imaging Group, Radiology Department, Faculty of Medicine, Universidade de Santiago de Compostela, Galicia, Spain; Molecular Imaging Unit, Centro de Investigaciones Médico-Sanitarias, General Foundation of the University of Málaga, Málaga, Spain
| | - Aida Niñerola-Baizán
- Nuclear Medicine Department, Hospital Clínic, Barcelona, Spain; Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Barcelona, Spain
| | - Nikos Efthimiou
- Positron Emission Tomography Research Centre, University of Hull, Hull HU6 7RX, United Kingdom
| | | | - Alexis Moscoso
- Molecular Imaging Group, Radiology Department, Faculty of Medicine, Universidade de Santiago de Compostela, Galicia, Spain; Nuclear Medicine Department & Molecular Imaging Group, University Hospital (SERGAS) & Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana S/N 15706, Santiago de Compostela, Galicia, Spain
| | - Álvaro Ruibal
- Molecular Imaging Group, Radiology Department, Faculty of Medicine, Universidade de Santiago de Compostela, Galicia, Spain; Nuclear Medicine Department & Molecular Imaging Group, University Hospital (SERGAS) & Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana S/N 15706, Santiago de Compostela, Galicia, Spain
| | - Núria Roé-Vellvé
- Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Barcelona, Spain
| | - Pablo Aguiar
- Molecular Imaging Group, Radiology Department, Faculty of Medicine, Universidade de Santiago de Compostela, Galicia, Spain; Nuclear Medicine Department & Molecular Imaging Group, University Hospital (SERGAS) & Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana S/N 15706, Santiago de Compostela, Galicia, Spain.
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Cooper ML, Pasini S, Lambert WS, D'Alessandro KB, Yao V, Risner ML, Calkins DJ. Redistribution of metabolic resources through astrocyte networks mitigates neurodegenerative stress. Proc Natl Acad Sci U S A 2020; 117:18810-18821. [PMID: 32690710 PMCID: PMC7414143 DOI: 10.1073/pnas.2009425117] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
In the central nervous system, glycogen-derived bioenergetic resources in astrocytes help promote tissue survival in response to focal neuronal stress. However, our understanding of the extent to which these resources are mobilized and utilized during neurodegeneration, especially in nearby regions that are not actively degenerating, remains incomplete. Here we modeled neurodegeneration in glaucoma, the world's leading cause of irreversible blindness, and measured how metabolites mobilize through astrocyte gap junctions composed of connexin 43 (Cx43). We elevated intraocular pressure in one eye and determined how astrocyte-derived metabolites in the contralateral optic projection responded. Remarkably, astrocyte networks expand and redistribute metabolites along distances even 10 mm in length, donating resources from the unstressed to the stressed projection in response to intraocular pressure elevation. While resource donation improves axon function and visual acuity in the directly stressed region, it renders the donating tissue susceptible to bioenergetic, structural, and physiological degradation. Intriguingly, when both projections are stressed in a WT animal, axon function and visual acuity equilibrate between the two projections even when each projection is stressed for a different length of time. This equilibration does not occur when Cx43 is not present. Thus, Cx43-mediated astrocyte metabolic networks serve as an endogenous mechanism used to mitigate bioenergetic stress and distribute the impact of neurodegenerative disease processes. Redistribution ultimately renders the donating optic nerve vulnerable to further metabolic stress, which could explain why local neurodegeneration does not remain confined, but eventually impacts healthy regions of the brain more broadly.
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Affiliation(s)
- Melissa L Cooper
- Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville TN 37232-0654
| | - Silvia Pasini
- Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville TN 37232-0654
| | - Wendi S Lambert
- Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville TN 37232-0654
| | - Karis B D'Alessandro
- Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville TN 37232-0654
| | - Vincent Yao
- Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville TN 37232-0654
| | - Michael L Risner
- Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville TN 37232-0654
| | - David J Calkins
- Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville TN 37232-0654
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Cistaro A, Quartuccio N, Piccardo A, Fania P, Spunton M, Liava A, Danesino C, Albani G, Guala A. 18F-FDG PET Identifies Altered Brain Metabolism in Patients with Cri du Chat Syndrome. J Nucl Med 2020; 61:1195-1199. [PMID: 31836684 DOI: 10.2967/jnumed.119.236893] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 12/02/2019] [Indexed: 02/07/2023] Open
Abstract
Cri du chat syndrome (CDCS) is a rare genetic disease that is caused by a deletion in the short arm of chromosome 5 (5p) and has a variable clinical spectrum. To our knowledge, no study in the literature has ever applied 18F-FDG PET/CT to investigate alterations in brain glucose metabolism in these subjects. The aims of this study were to detect differences in brain 18F-FDG metabolism in CDCS patients with different clinical presentations and identify possible brain metabolic phenotypes of this syndrome. Methods: Six patients (5 male and 1 female; age range, 10-27 y) with CDCS were assessed for the presence of cognitive and behavioral symptoms using a battery of neuropsychologic tests and then classified as having either a severe or a mild phenotype. The patients then underwent brain 18F-FDG PET/CT. The PET/CT findings were compared with an age- and sex-matched control group using statistical parametric mapping (SPM). Whether there was an association between different clinical phenotypes and 18F-FDG PET/CT findings was investigated. Results: Four patients had the severe phenotype, and 2 patients demonstrated the mild phenotype. SPM single-subject analysis, and a group analysis in comparison with the control cohort, revealed significant hypometabolism in the left temporal lobe (Brodmann areas [BAs] 20, 36, and 38), in the right frontal subcallosal gyrus (BA 34) and caudate body, and in the cerebellar tonsils (P < 0.001). Hypermetabolism (P = 0.001) was revealed in the right superior and precentral frontal gyrus (BA 6) in the patient group, compared with the control cohort. In SPM single-subject analysis, the hypermetabolic areas were detected only in patients with the severe phenotype. Conclusion: This study revealed different patterns of brain glucose metabolism in patients with the severe and mild phenotypes, compared with control subjects. In particular, abnormal hypermetabolism in the brain, as evaluated by18F-FDG PET/CT, seems to correlate with the severe CDCS phenotype.
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Affiliation(s)
- Angelina Cistaro
- Nuclear Medicine Department, Ente Ospedaliero Ospedali Galliera, Genoa, Italy
- AIMN Pediatric Study Group, Milan, Italy
- Scientific Committee of ABC Associazione Nazionale Bambini Cri du Chat, San Casciano in Val di Pesa (Firenze), Italy
| | - Natale Quartuccio
- AIMN Pediatric Study Group, Milan, Italy
- Nuclear Medicine Unit, ARNAS Ospedali Civico, Di Cristina e Benfratelli, Palermo, Italy
| | - Arnoldo Piccardo
- Nuclear Medicine Department, Ente Ospedaliero Ospedali Galliera, Genoa, Italy
- AIMN Pediatric Study Group, Milan, Italy
| | | | - Marianna Spunton
- Scientific Committee of ABC Associazione Nazionale Bambini Cri du Chat, San Casciano in Val di Pesa (Firenze), Italy
- Paediatric Unit, Castelli Hospital, Verbania, Italy
| | - Alexandra Liava
- Scientific Committee of ABC Associazione Nazionale Bambini Cri du Chat, San Casciano in Val di Pesa (Firenze), Italy
- Child Neuropsychiatric Unit, Castelli Hospital, Verbania, Italy
| | - Cesare Danesino
- Scientific Committee of ABC Associazione Nazionale Bambini Cri du Chat, San Casciano in Val di Pesa (Firenze), Italy
- Department of Molecular Medicine, IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy; and
| | - Giovanni Albani
- Scientific Committee of ABC Associazione Nazionale Bambini Cri du Chat, San Casciano in Val di Pesa (Firenze), Italy
- Department of Neurology, Istituto Auxologico Italiano, IRCCS, Piancavallo-Verbania, Italy
| | - Andrea Guala
- Scientific Committee of ABC Associazione Nazionale Bambini Cri du Chat, San Casciano in Val di Pesa (Firenze), Italy
- Paediatric Unit, Castelli Hospital, Verbania, Italy
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Nadkarni NK, Tudorascu D, Campbell E, Snitz BE, Cohen AD, Halligan E, Mathis CA, Aizenstein HJ, Klunk WE. Association Between Amyloid-β, Small-vessel Disease, and Neurodegeneration Biomarker Positivity, and Progression to Mild Cognitive Impairment in Cognitively Normal Individuals. J Gerontol A Biol Sci Med Sci 2020; 74:1753-1760. [PMID: 30957843 DOI: 10.1093/gerona/glz088] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND We estimated the prevalence and incidence of amyloid-β deposition (A), small-vessel disease (V), and neurodegeneration (N) biomarker positivity in community-dwelling cognitively normal individuals (CN). We determined the longitudinal association between the respective biomarker indices with progression to all-cause mild cognitive impairment (MCI) and its amnestic and nonamnestic subtypes. METHODS CN participants, recruited by advertising, underwent brain [C-11]Pittsburgh Compound-B (PiB)-positron emission tomography (PET), magnetic resonance imaging, and [F-18]fluoro-2-deoxy-glucose (FDG)-PET, and were designated as having high or low amyloid-β (A+/A-), greater or lower white matter hyperintensities burden (V+/V-) and diminished or normal cortical glucose metabolism (N+/N-). MCI was adjudicated using clinical assessments. We examined the association between A, V, and N biomarker positivity at study baseline and endpoint, with progression to MCI using linear regression, Cox proportional hazards and Kaplan-Meier analyses adjusted for age and APOE-ε4 carrier status. RESULTS In 98 CN individuals (average age 74 years, 65% female), A+, V+, and N+ prevalence was 26%, 33%, and 8%, respectively. At study endpoint (median: 5.5 years), an A+, but not a V+ or N+ scan, was associated with higher odds of all-cause MCI (Chi-square = 3.9, p = .048, odds ratio, 95% confidence interval = 2.6 [1.01-6.8]). Baseline A+, V+, or N+ were not associated with all-cause MCI, however, baseline A+ (p = .018) and A+N+ (p = .049), and endpoint A+N+ (p = .025) were associated with time to progression to amnestic, not nonamnestic, MCI. CONCLUSION Longitudinal assessments clarify the association between amyloid-β and progression to all-cause MCI in CN individuals. The association between biomarker positivity indices of amyloid-β and neurodegeneration, and amnestic MCI reflects the underlying pathology involved in the progression to prodromal Alzheimer's disease.
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Affiliation(s)
- Neelesh K Nadkarni
- Division of Geriatric Medicine, Department of Medicine, University of Pittsburgh, Pennsylvania.,Department of Neurology, University of Pittsburgh, Pennsylvania
| | - Dana Tudorascu
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pennsylvania.,Department of Biostatistics, University of Pittsburgh, Pennsylvania.,Department of Psychiatry, University of Pittsburgh, Pennsylvania
| | | | - Beth E Snitz
- Department of Neurology, University of Pittsburgh, Pennsylvania
| | - Annie D Cohen
- Department of Psychiatry, University of Pittsburgh, Pennsylvania
| | - Edye Halligan
- Department of Psychiatry, University of Pittsburgh, Pennsylvania
| | | | | | - William E Klunk
- Department of Neurology, University of Pittsburgh, Pennsylvania.,Department of Psychiatry, University of Pittsburgh, Pennsylvania
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Beheshti M, Manafi-Farid R, Rezaee A, Langsteger W. PET/CT and PET/MRI, Normal Variations, and Artifacts. Clin Nucl Med 2020. [DOI: 10.1007/978-3-030-39457-8_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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44
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Matsudaira T, Terada T, Obi T, Yokokura M, Takahashi Y, Ouchi Y. Coexistence of cerebral hypometabolism and neuroinflammation in the thalamo-limbic-brainstem region in young women with functional somatic syndrome. EJNMMI Res 2020; 10:29. [PMID: 32198578 PMCID: PMC7083979 DOI: 10.1186/s13550-020-00617-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 03/12/2020] [Indexed: 12/02/2022] Open
Abstract
Background Functional somatic syndrome (FSS) is a disorder characterized by clusters of medically unexplained symptoms. Some women suffer from persistent FSS after human papillomavirus (HPV) vaccination. However, a causal relationship has not been established, and the pathophysiology of FSS remains elusive. Here, we aimed to identify the brain regions showing altered cerebral metabolism and neuroinflammation in patients with FSS and to correlate the measures of positron emission tomography (PET) with clinical data. Twelve women diagnosed with FSS following HPV vaccination (FSS group) underwent both [18F]FDG-PET to measure glucose metabolism and [11C]DPA713-PET to measure neuroinflammation. [18F]FDG standardized uptake value ratio (SUVR) and [11C]DPA713 binding potential (BPND) values were compared voxel-wise between the FSS and control groups (n = 12 for [18F]FDG, n = 16 for [11C]DPA713). A region-of-interest (ROI)-based analysis was performed to correlate PET parameters with clinical scores. Statistical significance was set at p < 0.05 corrected for multiple comparisons. Results Statistical parametric mapping revealed a concomitant significant decrease of [18F]FDG SUVR and increase of [11C]DPA713 BPND in the regions covering the thalamus, mesial temporal area, and brainstem in the FSS group. Correlation analysis revealed that intelligence and memory scores were significantly positively correlated with [18F]FDG SUVR and negatively so with [11C]DPA713 BPND in these regions. A direct comparison between [18F]FDG SUVR and [11C]DPA713 BPND revealed a significant positive correlation in the right hippocampus and amygdala. Conclusions Cerebral hypometabolism with neuroinflammation occurring in the thalamo-limbic-brainstem region may reflect the pathophysiology of FSS.
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Affiliation(s)
- Takashi Matsudaira
- Department of Biofunctional Imaging, Preeminent Medical Photonics Education & Research Center, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan.,Department of Neurology, Shizuoka Institute of Epilepsy and Neurological Disorders, NHO, National Epilepsy Center, Shizuoka, Japan
| | - Tatsuhiro Terada
- Department of Biofunctional Imaging, Preeminent Medical Photonics Education & Research Center, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan.,Department of Neurology, Shizuoka Institute of Epilepsy and Neurological Disorders, NHO, National Epilepsy Center, Shizuoka, Japan
| | - Tomokazu Obi
- Department of Neurology, Shizuoka Institute of Epilepsy and Neurological Disorders, NHO, National Epilepsy Center, Shizuoka, Japan
| | - Masamichi Yokokura
- Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yukitoshi Takahashi
- Department of Pediatrics, Shizuoka Institute of Epilepsy and Neurological Disorders, NHO, National Epilepsy Center, Shizuoka, Japan
| | - Yasuomi Ouchi
- Department of Biofunctional Imaging, Preeminent Medical Photonics Education & Research Center, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan.
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Clinical Use of Integrated Positron Emission Tomography-Magnetic Resonance Imaging for Dementia Patients. Top Magn Reson Imaging 2020; 28:299-310. [PMID: 31794502 DOI: 10.1097/rmr.0000000000000225] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Combining magnetic resonance imaging (MRI) with 2-deoxy-2-F-fluoro-D-glucose positron emission tomography (FDG-PET) data improve the imaging accuracy for detection of Alzheimer disease and related dementias. Integrated FDG-PET-MRI is a recent technical innovation that allows both imaging modalities to be obtained simultaneously from individual patients with cognitive impairment. This report describes the practical benefits and challenges of using integrated FDG-PET-MRI to support the clinical diagnosis of various dementias. Over the past 7 years, we have performed integrated FDG-PET-MRI on >1500 patients with possible cognitive impairment or dementia. The FDG-PET and MRI protocols are the same as current conventions, but are obtained simultaneously over 25 minutes. An additional Dixon MRI sequence with superimposed bone atlas is used to calculate PET attenuation correction. A single radiologist interprets all imaging data and generates 1 report. The most common positive finding is concordant temporoparietal volume loss and FDG hypometabolism that suggests increased risk for underlying Alzheimer disease. Lobar-specific atrophy and FDG hypometabolism patterns that may be subtle, asymmetric, and focal also are more easily recognized using combined FDG-PET and MRI, thereby improving detection of other neurodegeneration conditions such as primary progressive aphasias and frontotemporal degeneration. Integrated PET-MRI has many practical benefits to individual patients, referrers, and interpreting radiologists. The integrated PET-MRI system requires several modifications to standard imaging center workflows, and requires training individual radiologists to interpret both modalities in conjunction. Reading MRI and FDG-PET together increases imaging diagnostic yield for individual patients; however, both modalities have limitations in specificity.
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Marín-Lahoz J, Sampedro F, Horta-Barba A, Martínez-Horta S, Aracil-Bolaños I, Camacho V, Bejr-kasem H, Pascual-Sedano B, Pérez-Pérez J, Gironell A, Pagonabarraga J, Carrió I, Kulisevsky J. Preservation of brain metabolism in recently diagnosed Parkinson’s impulse control disorders. Eur J Nucl Med Mol Imaging 2020; 47:2165-2174. [DOI: 10.1007/s00259-019-04664-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 12/16/2019] [Indexed: 12/16/2022]
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Abdul Aziz SA, Jia Ling L, Ahmad Saad FF, Nordin AJ, Ibrahim N, Nuruddin A, Tunan E, Rosalina, Saripan MI, Suppiah S. Voxel-wise analysis of 18F-fluorodeoxyglucose metabolism in correlation with variations in the presentation of Alzheimer’s disease: a clinician’s guide. MEDICAL JOURNAL OF INDONESIA 2019. [DOI: 10.13181/mji.v28i3.2770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Diagnostic imaging can be applied in the management of Alzheimer’s disease as it provides structural and functional information to exclude possible secondary causes and offers additional information, especially in atypical cases of Alzheimer’s disease. The utility of positron emission tomography/computed tomography (PET/CT) can help in the noninvasive diagnosis of Alzheimer’s disease by voxel-wise quantification of cerebral 18F-fluorodeoxyglucose (FDG) metabolism.
METHODS This prospective study was conducted among 10 subjects with Alzheimer’s disease and 10 healthy control subjects who underwent neuropsychological testing and 18F-FDG PET/CT scans. Images of the brain were postprocessed using voxel-wise analysis and segmented into 20 regions of interest. The standardized uptake value (SUV)max/SUVmean/standard deviation of SUVmean results were analyzed accordingly and correlated with the subjects’ Montreal cognitive assessment (MoCA) results that were adjusted for age and education level.
RESULTS Hypometabolism at the right parietal lobe significantly correlated with increasing age and lower MoCA scores. Global hypometabolism was observed in subjects who had advanced Alzheimer’s disease but preserved primary somatosensory cortices (S1) region metabolism. Predominance of frontal lobe hypometabolism was a feature of subjects with Alzheimer’s disease having associated depressive symptoms.
CONCLUSIONS 18F-FDG PET/CT voxel-wise analysis can be used for quantitative assessment and can assist clinicians in the diagnosis of Alzheimer’s disease and other variations of the disease spectrum.
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Clergue-Duval V, Questel F, Azuar J, Paquet C, Cognat E, Amami J, Queneau M, Dereux A, Barré T, Bellivier F, Farid K, Vorspan F. Brain 18FDG-PET pattern in patients with alcohol-related cognitive impairment. Eur J Nucl Med Mol Imaging 2019; 47:281-291. [DOI: 10.1007/s00259-019-04487-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 08/14/2019] [Indexed: 10/26/2022]
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Abstract
PURPOSE OF REVIEW The purposes of this review were to examine literature published over the last 5 years and to evaluate the role of nutrition in cognitive function and brain ageing, focussing on the Mediterranean diet (MeDi), Dietary Approaches to Stop Hypertension (DASH), and Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diets. RECENT FINDINGS Results suggest that higher adherence to a healthy dietary pattern is associated with preservation of brain structure and function as well as slower cognitive decline, with the MIND diet substantially slowing cognitive decline, over and above the MeDi and DASH diets. Whilst results to-date suggest adherence to a healthy diet, such as the MeDi, DASH, or MIND, is an important modifiable risk factor in the quest to develop strategies aimed at increasing likelihood of healthy brain ageing, further work is required to develop dietary guidelines with the greatest potential benefit for public health; a research topic of increasing importance as the world's population ages.
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50
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Grist JT, McLean MA, Riemer F, Schulte RF, Deen SS, Zaccagna F, Woitek R, Daniels CJ, Kaggie JD, Matys T, Patterson I, Slough R, Gill AB, Chhabra A, Eichenberger R, Laurent MC, Comment A, Gillard JH, Coles AJ, Tyler DJ, Wilkinson I, Basu B, Lomas DJ, Graves MJ, Brindle KM, Gallagher FA. Quantifying normal human brain metabolism using hyperpolarized [1- 13C]pyruvate and magnetic resonance imaging. Neuroimage 2019; 189:171-179. [PMID: 30639333 PMCID: PMC6435102 DOI: 10.1016/j.neuroimage.2019.01.027] [Citation(s) in RCA: 124] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 01/08/2019] [Accepted: 01/10/2019] [Indexed: 01/14/2023] Open
Abstract
Hyperpolarized 13C Magnetic Resonance Imaging (13C-MRI) provides a highly sensitive tool to probe tissue metabolism in vivo and has recently been translated into clinical studies. We report the cerebral metabolism of intravenously injected hyperpolarized [1-13C]pyruvate in the brain of healthy human volunteers for the first time. Dynamic acquisition of 13C images demonstrated 13C-labeling of both lactate and bicarbonate, catalyzed by cytosolic lactate dehydrogenase and mitochondrial pyruvate dehydrogenase respectively. This demonstrates that both enzymes can be probed in vivo in the presence of an intact blood-brain barrier: the measured apparent exchange rate constant (kPL) for exchange of the hyperpolarized 13C label between [1-13C]pyruvate and the endogenous lactate pool was 0.012 ± 0.006 s-1 and the apparent rate constant (kPB) for the irreversible flux of [1-13C]pyruvate to [13C]bicarbonate was 0.002 ± 0.002 s-1. Imaging also revealed that [1-13C]pyruvate, [1-13C]lactate and [13C]bicarbonate were significantly higher in gray matter compared to white matter. Imaging normal brain metabolism with hyperpolarized [1-13C]pyruvate and subsequent quantification, have important implications for interpreting pathological cerebral metabolism in future studies.
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Affiliation(s)
- James T Grist
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Mary A McLean
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Frank Riemer
- Department of Radiology, University of Cambridge, Cambridge, UK
| | | | - Surrin S Deen
- Department of Radiology, University of Cambridge, Cambridge, UK; Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Fulvio Zaccagna
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Ramona Woitek
- Department of Radiology, University of Cambridge, Cambridge, UK; Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | | | - Joshua D Kaggie
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Tomasz Matys
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Ilse Patterson
- Radiology, Cambridge University Hospitals, Cambridge, UK
| | - Rhys Slough
- Radiology, Cambridge University Hospitals, Cambridge, UK
| | - Andrew B Gill
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Anita Chhabra
- Pharmacy, Cambridge University Hospitals, Cambridge, UK
| | | | | | - Arnaud Comment
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK; GE Healthcare, Chalfont St Giles, UK
| | | | - Alasdair J Coles
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Damian J Tyler
- Department of Physiology, Anatomy, and Genetics, University of Oxford, Oxford, UK
| | - Ian Wilkinson
- Department of Medicine, University of Cambridge and Cambridge Clinical Trials Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Bristi Basu
- Department of Oncology, University of Cambridge, Cambridge, UK
| | - David J Lomas
- Department of Radiology, University of Cambridge, Cambridge, UK
| | | | - Kevin M Brindle
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
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