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Blazhenets G, Soleimani-Meigooni DN, Thomas W, Mundada N, Brendel M, Vento S, VandeVrede L, Heuer HW, Ljubenkov P, Rojas JC, Chen MK, Amuiri AN, Miller Z, Gorno-Tempini ML, Miller BL, Rosen HJ, Litvan I, Grossman M, Boeve B, Pantelyat A, Tartaglia MC, Irwin DJ, Dickerson BC, Baker SL, Boxer AL, Rabinovici GD, La Joie R. [ 18F]PI-2620 Binding Patterns in Patients with Suspected Alzheimer Disease and Frontotemporal Lobar Degeneration. J Nucl Med 2023; 64:1980-1989. [PMID: 37918868 PMCID: PMC10690126 DOI: 10.2967/jnumed.123.265856] [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: 04/13/2023] [Revised: 09/27/2023] [Indexed: 11/04/2023] Open
Abstract
Tau PET has enabled the visualization of paired helical filaments of 3 or 4 C-terminal repeat tau in Alzheimer disease (AD), but its ability to detect aggregated tau in frontotemporal lobar degeneration (FTLD) spectrum disorders is uncertain. We investigated 2-(2-([18F]fluoro)pyridin-4-yl)-9H-pyrrolo[2,3-b:4,5c']dipyridine ([18F]PI-2620), a newer tracer with ex vivo evidence for binding to FTLD tau, in a convenience sample of patients with suspected FTLD and AD using a static acquisition protocol and parametric SUV ratio (SUVr) images. Methods: We analyzed [18F]PI-2620 PET data from 65 patients with clinical diagnoses associated with AD or FTLD neuropathology; most (60/65) also had amyloid-β (Aβ) PET. Scans were acquired 30-60 min after injection; SUVr maps (reference, inferior cerebellar cortex) were created for the full acquisition and for 10-min truncated sliding windows (30-40, 35-45,…50-60 min). Age- and sex-adjusted z score maps were computed for each patient, relative to 23 Aβ-negative cognitively healthy controls (HC). Mean SUVr in the globus pallidus, substantia nigra, subthalamic nuclei, dentate nuclei, white matter, and temporal gray matter was extracted for the full and truncated windows. Results: Patients with suspected AD neuropathology (Aβ-positive patients with mild cognitive impairment or AD dementia) showed high-intensity temporoparietal cortex-predominant [18F]PI-2620 binding. At the group level, patients with clinical diagnoses associated with FTLD (progressive supranuclear palsy with Richardson syndrome [PSP Richardson syndrome], corticobasal syndrome, and nonfluent-variant primary progressive aphasia) exhibited higher globus pallidus SUVr than did HCs; pallidal retention was highest in the PSP Richardson syndrome group, in whom SUVr was correlated with symptom severity (ρ = 0.53, P = 0.05). At the individual level, only half of PSP Richardson syndrome, corticobasal syndrome, and nonfluent-variant primary progressive aphasia patients had a pallidal SUVr above that of HCs. Temporal SUVr discriminated AD patients from HCs with high accuracy (area under the receiver operating characteristic curve, 0.94 [95% CI, 0.83-1.00]) for all time windows, whereas discrimination between patients with PSP Richardson syndrome and HCs using pallidal SUVr was fair regardless of time window (area under the receiver operating characteristic curve, 0.77 [95% CI, 0.61-0.92] at 30-40 min vs. 0.81 [95% CI, 0.66-0.96] at 50-60 min; P = 0.67). Conclusion: [18F]PI-2620 SUVr shows an intense and consistent signal in AD but lower-intensity, heterogeneous, and rapidly decreasing binding in patients with suspected FTLD. Further work is needed to delineate the substrate of [18F]PI-2620 binding and the usefulness of [18F]PI2620 SUVr quantification outside the AD continuum.
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Affiliation(s)
- Ganna Blazhenets
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California
- Department of Nuclear Medicine, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany
| | - David N Soleimani-Meigooni
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California
| | - Wesley Thomas
- Lawrence Berkeley National Laboratory, Berkeley, California
| | - Nidhi Mundada
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Stephanie Vento
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California
| | - Lawren VandeVrede
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California
| | - Hilary W Heuer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California
| | - Peter Ljubenkov
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California
| | - Julio C Rojas
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California
| | - Miranda K Chen
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California
| | - Alinda N Amuiri
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California
| | - Zachary Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California
| | - Maria L Gorno-Tempini
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California
| | - Howie J Rosen
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California
| | - Irene Litvan
- University of California, San Diego, San Diego, California
| | - Murray Grossman
- Penn FTD Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | | | | | - David J Irwin
- Penn FTD Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | | | - Adam L Boxer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California
| | - Gil D Rabinovici
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California
| | - Renaud La Joie
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California;
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2
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Burnham SC, Iaccarino L, Pontecorvo MJ, Fleisher AS, Lu M, Collins EC, Devous MD. A review of the flortaucipir literature for positron emission tomography imaging of tau neurofibrillary tangles. Brain Commun 2023; 6:fcad305. [PMID: 38187878 PMCID: PMC10768888 DOI: 10.1093/braincomms/fcad305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 09/13/2023] [Accepted: 11/14/2023] [Indexed: 01/09/2024] Open
Abstract
Alzheimer's disease is defined by the presence of β-amyloid plaques and neurofibrillary tau tangles potentially preceding clinical symptoms by many years. Previously only detectable post-mortem, these pathological hallmarks are now identifiable using biomarkers, permitting an in vivo definitive diagnosis of Alzheimer's disease. 18F-flortaucipir (previously known as 18F-T807; 18F-AV-1451) was the first tau positron emission tomography tracer to be introduced and is the only Food and Drug Administration-approved tau positron emission tomography tracer (Tauvid™). It has been widely adopted and validated in a number of independent research and clinical settings. In this review, we present an overview of the published literature on flortaucipir for positron emission tomography imaging of neurofibrillary tau tangles. We considered all accessible peer-reviewed literature pertaining to flortaucipir through 30 April 2022. We found 474 relevant peer-reviewed publications, which were organized into the following categories based on their primary focus: typical Alzheimer's disease, mild cognitive impairment and pre-symptomatic populations; atypical Alzheimer's disease; non-Alzheimer's disease neurodegenerative conditions; head-to-head comparisons with other Tau positron emission tomography tracers; and technical considerations. The available flortaucipir literature provides substantial evidence for the use of this positron emission tomography tracer in assessing neurofibrillary tau tangles in Alzheimer's disease and limited support for its use in other neurodegenerative disorders. Visual interpretation and quantitation approaches, although heterogeneous, mostly converge and demonstrate the high diagnostic and prognostic value of flortaucipir in Alzheimer's disease.
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Affiliation(s)
| | | | | | | | - Ming Lu
- Avid, Eli Lilly and Company, Philadelphia, PA 19104, USA
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3
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Wu N, Zhang L, Zhang X, Zhang Q, Liu J, Li Y, Yan XX, Liang Y, Zhang J, Cui M. Synthesis and Bioevaluation of 2-Styrylquinoxaline Derivatives as Tau-PET Tracers. Mol Pharm 2023; 20:5865-5876. [PMID: 37852240 DOI: 10.1021/acs.molpharmaceut.3c00717] [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] [Indexed: 10/20/2023]
Abstract
This study focused on designing and evaluating Tau-PET tracers for noninvasive positron emission computed tomography (PET) imaging of neurofibrillary tangles (NFTs), a hallmark pathology of Alzheimer's disease (AD). The tracers were synthesized with a 2-styrylquinoxaline scaffold and varying lengths of FPEG chains. The compound [18F]15, which had two ethoxy units, showed high affinity for recombinant K18-Tau aggregates (Ki = 41.48 nM) and the highest selectivity versus Aβ1-42 aggregates (8.83-fold). In vitro autoradiography and fluorescent staining profiles further validated the binding of [18F]15 or 15 toward NFTs in brain sections from AD patients and Tau-transgenic mice. In normal ICR mice, [18F]15 exhibited an ideal initial brain uptake (11.21% ID/g at 2 min) and moderate washout ratio (2.29), and micro-PET studies in rats confirmed its ability to penetrate the blood-brain barrier with the peak SUV value of 1.94 in the cortex. These results suggest that [18F]15 has the potential to be developed into a useful Tau-PET tracer for early AD diagnosis and evaluation of anti-Tau therapeutics.
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Affiliation(s)
- Nan Wu
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing 100875, China
| | - Longfei Zhang
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing 100875, China
| | - Xiaojun Zhang
- Department of Nuclear Medicine, Chinese PLA General Hospital, Beijing 100853, China
| | - Qilei Zhang
- Department of Anatomy and Neurobiology, Xiangya School of Medicine, Central South University, Changsha 410013, China
| | - Jiaqi Liu
- Hubei Key Laboratory of Cell Homeostasis, College of Life Sciences, Taikang Center for Life and Medical Science, Hubei Key Laboratory of Cell Homeostasis, Wuhan University, Wuhan 430072, China
| | - Yuying Li
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing 100875, China
| | - Xiao-Xin Yan
- Department of Anatomy and Neurobiology, Xiangya School of Medicine, Central South University, Changsha 410013, China
| | - Yi Liang
- Hubei Key Laboratory of Cell Homeostasis, College of Life Sciences, Taikang Center for Life and Medical Science, Hubei Key Laboratory of Cell Homeostasis, Wuhan University, Wuhan 430072, China
| | - Jinming Zhang
- Department of Nuclear Medicine, Chinese PLA General Hospital, Beijing 100853, China
| | - Mengchao Cui
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing 100875, China
- Center for Advanced Materials Research, Beijing Normal University, Zhuhai 519087, China
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4
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Saito Y, Kamagata K, Andica C, Uchida W, Takabayashi K, Yoshida S, Nakaya M, Tanaka Y, Kamio S, Sato K, Nishizawa M, Akashi T, Shimoji K, Wada A, Aoki S. Glymphatic system impairment in corticobasal syndrome: diffusion tensor image analysis along the perivascular space (DTI-ALPS). Jpn J Radiol 2023; 41:1226-1235. [PMID: 37273112 DOI: 10.1007/s11604-023-01454-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 05/19/2023] [Indexed: 06/06/2023]
Abstract
PURPOSE This study aimed to evaluate the along the perivascular space (ALPS) index based on the diffusion tensor image ALPS (DTI-ALPS) in corticobasal degeneration with corticobasal syndrome (CBD-CBS) and investigate its correlation with motor and cognitive functions. MATERIALS AND METHODS The data of 21 patients with CBD-CBS and 17 healthy controls (HCs) were obtained from the 4-Repeat Tauopathy Neuroimaging Initiative and the Frontotemporal Lobar Degeneration Neuroimaging Initiative databases. Diffusion magnetic resonance imaging was performed using a 3-Tesla MRI scanner. The ALPS index based on DTI-ALPS was automatically calculated after preprocessing. The ALPS index was compared between the CBD-CBS and HC groups via a general linear model analysis, with covariates such as age, sex, years of education, and intracranial volume (ICV). Furthermore, to confirm the relation between the ALPS index and the motor and cognitive score in CBD-CBS, the partial Spearman's rank correlation coefficient was calculated with covariates such as age, sex, years of education, and ICV. A p value of < 0.05 was considered as statistically significant in all statistical analyses. RESULTS The ALPS index of CBD-CBS was significantly lower than that of HC (Cohen's d = - 1.53, p < 0.005). Moreover, the ALPS index had a significant positive correlation with the mini mental state evaluation score (rs = 0.65, p < 0.005) and a significant negative correlation with the unified Parkinson's Disease Rating Scale III score (rs = - 0.75, p < 0.001). CONCLUSION The ALPS index of patients with CBD-CBS, which is significantly lower than that of HCs, is significantly associated with motor and cognitive functions.
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Affiliation(s)
- Yuya Saito
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan
| | - Koji Kamagata
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan.
| | - Christina Andica
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan
- Faculty of Health Data Science, Juntendo University, Chiba, Japan
| | - Wataru Uchida
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan
| | - Kaito Takabayashi
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan
| | - Seina Yoshida
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan
- Department of Radiological Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Moto Nakaya
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan
- Department of Radiology, The University of Tokyo, Tokyo, Japan
| | - Yuya Tanaka
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan
- Department of Radiology, The University of Tokyo, Tokyo, Japan
| | - Satoru Kamio
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan
- Department of Radiology, The University of Tokyo, Tokyo, Japan
| | - Kanako Sato
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan
| | - Mitsuo Nishizawa
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan
- Faculty of Health Data Science, Juntendo University, Chiba, Japan
| | - Toshiaki Akashi
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan
| | - Keigo Shimoji
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan
- Faculty of Health Data Science, Juntendo University, Chiba, Japan
| | - Akihiko Wada
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan
| | - Shigeki Aoki
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan
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5
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Groot C, Villeneuve S, Smith R, Hansson O, Ossenkoppele R. Tau PET Imaging in Neurodegenerative Disorders. J Nucl Med 2022; 63:20S-26S. [PMID: 35649647 DOI: 10.2967/jnumed.121.263196] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/09/2022] [Indexed: 11/16/2022] Open
Abstract
The advent of PET ligands that bind tau pathology has enabled the quantification and visualization of tau pathology in aging and in Alzheimer disease (AD). There is strong evidence from neuropathologic studies that the most widely used tau PET tracers (i.e., 18F-flortaucipir, 18F-MK6240, 18F-RO948, and 18F-PI2620) bind tau aggregates formed in AD in the more advanced (i.e., ≥IV) Braak stages. However, tracer binding in most non-AD tauopathies is weaker and overlaps to a large extent with known off-target binding regions, limiting the quantification and visualization of non-AD tau pathology in vivo. Off-target binding is generally present in the substantia nigra, basal ganglia, pituitary, choroid plexus, longitudinal sinuses, meninges, or skull in a tracer-specific manner. Most cross-sectional studies use the inferior aspect of the cerebellar gray matter as a reference region, whereas for longitudinal analyses, an eroded white matter reference region is sometimes selected. No consensus has yet been reached on whether to use partial-volume correction of tau PET data. Although an increased neocortical tau PET signal is rare in cognitively unimpaired individuals, even in amyloid-β-positive cases, such a signal holds important prognostic information because preliminary data suggest that an elevated tau PET signal predicts cognitive decline over time. Also, in symptomatic stages of AD (i.e., mild cognitive impairment or AD dementia), tau PET shows great potential as a prognostic marker because an elevated baseline tau PET retention forecasts future cognitive decline and brain atrophy. For differential diagnostic use, the primary utility of tau PET is to differentiate AD dementia from other neurodegenerative diseases, as is in line with the conditions for the approval of 18F-flortaucipir by the U.S. Food and Drug Administration for clinical use. The differential diagnostic performance drops substantially at the mild-cognitive-impairment stage of AD, and there is no sufficient evidence for detection of sporadic non-AD primary tauopathies at the individual level for any of the currently available tau PET tracers. In conclusion, while the field is currently addressing outstanding methodologic issues, tau PET is gradually moving toward clinical application as a diagnostic and possibly prognostic marker in dementia expert centers and as a tool for selecting participants, assessing target engagement, and monitoring treatment effects in clinical trials.
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Affiliation(s)
- Colin Groot
- Clinical Memory Research Unit, Lund University, Lund, Sweden.,Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Location VUMC, Amsterdam, The Netherlands
| | - Sylvia Villeneuve
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Canada.,Douglas Mental Health University Institute, Montreal, Canada.,McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Canada; and
| | - Ruben Smith
- Clinical Memory Research Unit, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Lund University, Lund, Sweden; .,Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Location VUMC, Amsterdam, The Netherlands
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Nakano Y, Shimada H, Shinotoh H, Hirano S, Tagai K, Sano Y, Yamamoto Y, Endo H, Matsuoka K, Takahata K, Kubota M, Takado Y, Kimura Y, Ichise M, Ono M, Sahara N, Kawamura K, Zhang MR, Kuwabara S, Suhara T, Higuchi M. PET-based classification of corticobasal syndrome. Parkinsonism Relat Disord 2022; 98:92-98. [PMID: 35533530 DOI: 10.1016/j.parkreldis.2022.04.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 03/16/2022] [Accepted: 04/21/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Corticobasal degeneration (CBD) is the most common neuropathological substrate for clinically diagnosed corticobasal syndrome (CBS), while identifying CBD pathology in living individuals has been challenging. This study aimed to examine the capability of positron emission tomography (PET) to detect CBD-type tau depositions and neuropathological classification of CBS. METHODS Sixteen CBS cases diagnosed by Cambridge's criteria and 12 cognitively healthy controls (HCs) underwent PET scans with 11C-PiB, 11C-PBB3, and 18F-FDG, along with T1-weighted magnetic resonance imaging. Amyloid positivity was assessed by visual inspection of 11C-PiB retentions. Tau positivity was judged by quantitative comparisons of 11C-PBB3 binding to HCs. RESULTS Sixteen CBS cases consisted of two cases (13%) with amyloid and tau positivities indicative of Alzheimer's disease (AD) pathologies, 11 cases (69%) with amyloid negativity and tau positivity, and three cases (19%) with amyloid and tau negativities. Amyloid(-), tau(+) CBS cases showed increased retentions of 11C-PBB3 in the frontoparietal areas, basal ganglia, and midbrain, and reduced metabolism in the precentral gyrus and thalamus relative to HCs. The enhanced tau probe retentions in the frontal gray and white matters partially overlapped with metabolic deficits and atrophy and correlated with Clinical Dementia Rating scores. CONCLUSIONS PET-based classification of CBS was in accordance with previous neuropathological reports on the prevalences of AD, non-AD tauopathies, and others in CBS. The current work suggests that 11C-PBB3-PET may assist the biological classification of CBS and understanding of links between CBD-type tau depositions and neuronal deteriorations leading to cognitive declines.
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Affiliation(s)
- Yoshikazu Nakano
- National Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan; Department of Neurology, Chiba University Graduate School of Medicine, Chiba, Japan; Department of Neurology, Chibaken Saiseikai Narashino Hospital, Narashino, Japan
| | - Hitoshi Shimada
- National Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan; Department of Functional Neurology & Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Hitoshi Shinotoh
- National Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan; Neurology Clinic Chiba, Chiba, Japan
| | - Shigeki Hirano
- National Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan; Department of Neurology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Kenji Tagai
- National Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Yasunori Sano
- National Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Yasuharu Yamamoto
- National Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Hironobu Endo
- National Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Kiwamu Matsuoka
- National Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Keisuke Takahata
- National Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Manabu Kubota
- National Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Yuhei Takado
- National Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Yasuyuki Kimura
- National Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan; National Center for Geriatrics and Gerontology, Obu, Japan
| | - Masanori Ichise
- National Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Maiko Ono
- National Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Naruhiko Sahara
- National Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Kazunori Kawamura
- National Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Ming-Rong Zhang
- National Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Satoshi Kuwabara
- Department of Neurology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Tetsuya Suhara
- National Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Makoto Higuchi
- National Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan.
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7
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Kim JS, Son HJ, Oh M, Lee DY, Kim HW, Oh J. 60 Years of Achievements by KSNM in Neuroimaging Research. Nucl Med Mol Imaging 2022; 56:3-16. [PMID: 35186156 PMCID: PMC8828843 DOI: 10.1007/s13139-021-00727-1] [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: 07/22/2021] [Revised: 11/01/2021] [Accepted: 12/07/2021] [Indexed: 02/03/2023] Open
Abstract
Nuclear medicine neuroimaging is able to show functional and molecular biologic abnormalities in various neuropsychiatric diseases. Therefore, it has played important roles in the clinical diagnosis and in research on the normal and pathological states of the brain. More than 400 outstanding studies have been conducted by Korean researchers over the past 60 years. In the 1990s, when multiheaded single-photon emission computed tomography (SPECT) scanners were first introduced in South Korea, stroke research using brain perfusion SPECT was conducted. With the spread of positron emission tomography (PET) scanners in the 2000s, research on the clinical usefulness of PET and the evaluation of pathophysiology in various diseases such as epilepsy, brain tumors, degenerative brain diseases, and other neuropsychiatric diseases were actively conducted using [18F]FDG and various neuroreceptor tracers. In the 2010s, with the clinical application of new radiopharmaceuticals for amyloid and tau imaging, research demonstrating the clinical usefulness of PET imaging and the pathophysiology of dementia has increased rapidly. It is expected that the role of nuclear medicine will expand with the development of new radiopharmaceuticals and analysis technologies, along with the application of artificial intelligence for early and differential diagnosis, and the development of therapeutic agents for degenerative brain diseases.
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Affiliation(s)
- Jae Seung Kim
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hye Joo Son
- Department of Nuclear Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Minyoung Oh
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Dong Yun Lee
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hae Won Kim
- Department of Nuclear Medicine, Keimyung University Dongsan Hospital, Daegu, Republic of Korea
| | - Jungsu Oh
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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8
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Mena AM, Strafella AP. Imaging pathological tau in atypical parkinsonisms: A review. Clin Park Relat Disord 2022; 7:100155. [PMID: 35880206 PMCID: PMC9307942 DOI: 10.1016/j.prdoa.2022.100155] [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: 04/04/2022] [Revised: 06/06/2022] [Accepted: 07/07/2022] [Indexed: 11/27/2022] Open
Abstract
[18F]AV-1451 displays mixed results for specificity to 4R CBD- and PSP-tau. [18F]PI-2620 and [18F]PM-PBB3 are the most promising second-generation tau PET tracers. Research using second-generation tau PET tracers in CBD and PSP is still limited. Finding an imaging diagnostic biomarker requires further work with larger samples.
Atypical parkinsonisms (APs) are a group of diseases linked to tau pathology. These include progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD). In the initial stages, these APs may have similar clinical manifestations to Parkinson’s disease (PD) and other parkinsonisms: bradykinesia, postural instability, tremor, and cognitive decline. Because of this, one major hurdle is the accurate early diagnosis of APs. Recent advances in positron emission tomography (PET) radiotracer development have allowed for targeting pathological tau in Alzheimer’s disease (AD). Currently, work is still in progress for identifying a first-in-class radiotracer for imaging tau in APs. In this review, we evaluate the literature on in vitro and in vivo testing of current tau PET radiotracers in APs. The tau PET tracers assessed include both first-generation tracers ([18F]AV-1451, [18F]FDDNP, [18F]THK derivatives, and [11C]PBB3) and second-generation tracers ([18F]PM-PBB3, [18F]PI-2620, [18F]RO-948, [18F]JNJ-067, [18F]MK-6240, and [18F]CBD-2115). Concerns regarding off-target binding to cerebral white matter and the basal ganglia are still prominent with first-generation tracers, but this seems to have been mediated in a handful of second-generation tracers, including [18F]PI-2620 and [18F]PM-PBB3. Additionally, these two tracers and [18F]MK-6240 show promising results for imaging PSP- and CBD-tau. Overall, [18F]AV-1451 is the most widely studied tracer but the mixed results regarding its efficacy for use in imaging AP-tau is a cause for concern moving forward. Instead, future work may benefit from focusing on the second-generation radiotracers which seem to have a higher specificity for AP-tau than those originally developed for imaging AD-tau.
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9
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Bauckneht M, Chiola S, Donegani MI, Raffa S, Miceli A, Ferrarazzo G, Morbelli S. Central Nervous System Imaging in Movement Disorders. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00095-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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10
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Stamelou M, Respondek G, Giagkou N, Whitwell JL, Kovacs GG, Höglinger GU. Evolving concepts in progressive supranuclear palsy and other 4-repeat tauopathies. Nat Rev Neurol 2021; 17:601-620. [PMID: 34426686 DOI: 10.1038/s41582-021-00541-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2021] [Indexed: 02/07/2023]
Abstract
Tauopathies are classified according to whether tau deposits predominantly contain tau isoforms with three or four repeats of the microtubule-binding domain. Those in which four-repeat (4R) tau predominates are known as 4R-tauopathies, and include progressive supranuclear palsy, corticobasal degeneration, argyrophilic grain disease, globular glial tauopathies and conditions associated with specific MAPT mutations. In these diseases, 4R-tau deposits are found in various cell types and anatomical regions of the brain and the conditions share pathological, pathophysiological and clinical characteristics. Despite being considered 'prototype' tauopathies and, therefore, ideal for studying neuroprotective agents, 4R-tauopathies are still severe and untreatable diseases for which no validated biomarkers exist. However, advances in research have addressed the issues of phenotypic overlap, early clinical diagnosis, pathophysiology and identification of biomarkers, setting a road map towards development of treatments. New clinical criteria have been developed and large cohorts with early disease are being followed up in prospective studies. New clinical trial readouts are emerging and biomarker research is focused on molecular pathways that have been identified. Lessons learned from failed trials of neuroprotective drugs are being used to design new trials. In this Review, we present an overview of the latest research in 4R-tauopathies, with a focus on progressive supranuclear palsy, and discuss how current evidence dictates ongoing and future research goals.
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Affiliation(s)
- Maria Stamelou
- Parkinson's Disease and Movement Disorders Dept, HYGEIA Hospital, Athens, Greece. .,European University of Cyprus, Nicosia, Cyprus. .,Philipps University, Marburg, Germany.
| | - Gesine Respondek
- Department of Neurology, Hanover Medical School, Hanover, Germany
| | - Nikolaos Giagkou
- Parkinson's Disease and Movement Disorders Dept, HYGEIA Hospital, Athens, Greece
| | | | - Gabor G Kovacs
- Department of Laboratory Medicine and Pathobiology and Tanz Centre for Research in Neurodegenerative Disease (CRND), University of Toronto, Toronto, Ontario, Canada.,Laboratory Medicine Program and Krembil Brain Institute, University Health Network, Toronto, Ontario, Canada
| | - Günter U Höglinger
- Department of Neurology, Hanover Medical School, Hanover, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
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11
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Sexton C, Snyder H, Beher D, Boxer AL, Brannelly P, Brion JP, Buée L, Cacace AM, Chételat G, Citron M, DeVos SL, Diaz K, Feldman HH, Frost B, Goate AM, Gold M, Hyman B, Johnson K, Karch CM, Kerwin DR, Koroshetz WJ, Litvan I, Morris HR, Mummery CJ, Mutamba J, Patterson MC, Quiroz YT, Rabinovici GD, Rommel A, Shulman MB, Toledo-Sherman LM, Weninger S, Wildsmith KR, Worley SL, Carrillo MC. Current directions in tau research: Highlights from Tau 2020. Alzheimers Dement 2021; 18:988-1007. [PMID: 34581500 DOI: 10.1002/alz.12452] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 07/07/2021] [Accepted: 07/22/2021] [Indexed: 11/07/2022]
Abstract
Studies supporting a strong association between tau deposition and neuronal loss, neurodegeneration, and cognitive decline have heightened the allure of tau and tau-related mechanisms as therapeutic targets. In February 2020, leading tau experts from around the world convened for the first-ever Tau2020 Global Conference in Washington, DC, co-organized and cosponsored by the Rainwater Charitable Foundation, the Alzheimer's Association, and CurePSP. Representing academia, industry, government, and the philanthropic sector, presenters and attendees discussed recent advances and current directions in tau research. The meeting provided a unique opportunity to move tau research forward by fostering global partnerships among academia, industry, and other stakeholders and by providing support for new drug discovery programs, groundbreaking research, and emerging tau researchers. The meeting also provided an opportunity for experts to present critical research-advancing tools and insights that are now rapidly accelerating the pace of tau research.
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Affiliation(s)
| | | | | | - Adam L Boxer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - Pat Brannelly
- Alzheimer's Disease Data Initiative, Kirkland, WI, USA
| | - Jean-Pierre Brion
- Laboratory of Histology, Neuroanatomy and Neuropathology, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Luc Buée
- Univ Lille, Inserm, CHU-Lille, Lille Neuroscience and Cognition, Place de Verdun, Lille, France
| | | | - Gaël Chételat
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, Caen, France
| | - Martin Citron
- Neuroscience TA, Braine l'Alleud, UCB Biopharma, Brussels, Belgium
| | - Sarah L DeVos
- Translational Sciences, Denali Therapeutics, San Francisco, California, USA
| | | | - Howard H Feldman
- Alzheimer's Disease Cooperative Study, Department of Neurosciences, University of California, San Diego, La Jolla, California, USA
| | - Bess Frost
- Sam & Ann Barshop Institute for Longevity and Aging Studies, Glenn Biggs Institute for Alzheimer's & Neurodegenerative Disorders, Department of Cell Systems & Anatomy, University of Texas Health San Antonio, San Antonio, Texas, USA
| | - Alison M Goate
- Ronald M. Loeb Center for Alzheimer's Disease, Department of Neuroscience, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Michael Gold
- AbbVie, Neurosciences Development, North Chicago, Illinois, USA
| | - Bradley Hyman
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Keith Johnson
- Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Celeste M Karch
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Diana R Kerwin
- Kerwin Medical Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Walter J Koroshetz
- National Institute of Neurological Disorders and Stroke, Bethesda, Maryland, USA
| | - Irene Litvan
- Parkinson and Other Movement Disorders Center, Department of Neurosciences, University of California San Diego, San Diego, California, USA
| | - Huw R Morris
- Department of Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, London, UK
| | - Catherine J Mummery
- Dementia Research Centre, National Hospital for Neurology and Neurosurgery, University College London, London, UK
| | | | - Marc C Patterson
- Departments of Neurology, Pediatrics and Medical Genetics, Mayo Clinic, Rochester, Minnesota, USA
| | - Yakeel T Quiroz
- Departments of Neurology and Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Gil D Rabinovici
- Memory & Aging Center, Departments of Neurology, Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Amy Rommel
- Tau Consortium, Rainwater Charitable Foundation, Fort Worth, Texas, USA
| | - Melanie B Shulman
- Neurodegeneration Development Unit, Biogen, Boston, Massachusetts, USA
| | | | | | - Kristin R Wildsmith
- Department of Biomarker Development, Genentech, South San Francisco, California, USA
| | - Susan L Worley
- Independent science writer, Bryn Mawr, Pennsylvania, USA
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12
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Murugan NA, Nordberg A, Ågren H. Cryptic Sites in Tau Fibrils Explain the Preferential Binding of the AV-1451 PET Tracer toward Alzheimer's Tauopathy. ACS Chem Neurosci 2021; 12:2437-2447. [PMID: 34152739 PMCID: PMC8291571 DOI: 10.1021/acschemneuro.0c00340] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
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Tauopathies are a subclass of neurodegenerative diseases characterized
by an accumulation of microtubule binding tau fibrils in brain regions.
Diseases such as Alzheimer’s (AD), chronic traumatic encephalopathy
(CTE), Pick’s disease (PiD), and corticobasal degeneration
(CBD) belong to this subclass. Development of tracers which can visualize
and discriminate between different tauopathies is of clinical importance
in the diagnosis of various tauopathies. Currently, several tau tracers
are available for in vivo imaging using a positron emission tomography
(PET) technique. Among these tracers, PBB3 is reported to bind to
various types of tau fibrils with comparable binding affinities.
In contrast, tau tracer AV-1451 is reported to bind to specific types
of tau fibrils (in particular to AD-associated and CTE) with higher
binding affinity and only show nonspecific or weaker binding toward
tau fibrils dominant with 3R isoforms (associated with PiD). The tau
fibrils associated with different tauopathies can adopt different
microstructures with different binding site microenvironments. By
using detailed studies of the binding profiles of tau tracers for
different types of tau fibrils, it may be possible to design tracers
with high selectivity toward a specific tauopathy. The microstructures
for the tau fibrils from patients with AD, PiD, and CTE have recently
been demonstrated by cryogenic electron microscopy (cryo-EM) measurements
allowing structure-based in silico simulations. In the present study,
we have performed a multiscale computational study involving molecular
docking, molecular dynamics, free energy calculations, and QM fragmentation
calculations to understand the binding profiles of tau tracer AV-1451
and its potential use for diagnosis of AD, CTE, and PiD tauopathies.
Our computational study reveals that different affinity binding sites
exist for AV-1451 in the tau fibrils associated with different tauopathies.
The binding affinity of this tracer toward different tau fibrils goes
in this order: PiD > AD > CTE. The interaction energies for different
tau fibril–tracer complexes using the QM fragmentation scheme
also showed the same trend. However, by carrying out molecular dynamics
simulations for the AD-derived tau fibrils in organic solvents, we
found additional high affinity binding sites for AV-1451. The AV-1451
binding profile in these cryptic sites correctly explains the preferential
binding of this tracer toward the AD fibrils when compared with the
PiD fibrils. This study clearly demonstrates having a cryo-EM structure
is still not sufficient for the structure-based tracer discovery for
certain targets, as they may have “potential but hidden”
high affinity binding sites, and we need additional strategies to
identify them.
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Affiliation(s)
- N. Arul Murugan
- School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, S-106 91 Stockholm, Sweden
| | - Agneta Nordberg
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, S-141 86 Stockholm, Sweden
- Theme Aging, The Aging Brain, Karolinska University Hospital, Huddinge, S-141 86 Stockholm, Sweden
| | - Hans Ågren
- Department of Physics and Astronomy, Uppsala University, Uppsala SE-75120, Sweden
- College of Chemistry and Chemical Engineering, Henan University, Kaifeng, Henan 475004, P. R. China
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13
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Goodheart AE, Locascio JJ, Samore WR, Collins JA, Brickhouse M, Schultz A, Touroutoglou A, Johnson KA, Frosch MP, Growdon JH, Dickerson BC, Gomperts SN. 18F-AV-1451 positron emission tomography in neuropathological substrates of corticobasal syndrome. Brain 2021; 144:266-277. [PMID: 33578418 DOI: 10.1093/brain/awaa383] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 08/18/2020] [Accepted: 08/24/2020] [Indexed: 11/12/2022] Open
Abstract
Multiple neuropathological processes can manifest in life as a corticobasal syndrome. We sought to relate retention of the tau-PET tracer 18F-AV-1451 and structural magnetic resonance measures of regional atrophy to clinical features in clinically diagnosed and neuropathologically confirmed cases of corticobasal syndrome and to determine whether these vary with the underlying neuropathological changes. In this observational, cross-sectional study, 11 subjects (eight female and three male, median age 72 years) with corticobasal syndrome underwent structural MRI, tau-PET with 18F-AV-1451, amyloid-PET with 11C-Pittsburgh compound B, detailed clinical examinations and neuropsychological testing. Of the 11, three had evidence of high amyloid burden consistent with Alzheimer's disease while eight did not. Neuropathological evaluations were acquired in six cases. Mixed effects general linear models were used to compare 18F-AV-1451 retention and atrophy in amyloid-negative corticobasal syndrome cases to 32 age-matched healthy control subjects and to relate cortical and subcortical 18F-AV-1451 retention and atrophy to clinical features. Subjects without amyloid, including three with pathologically confirmed corticobasal degeneration, showed greater regional 18F-AV-1451 retention and associated regional atrophy in areas commonly associated with corticobasal degeneration pathology than healthy control subjects [retention was higher compared to healthy controls (P = 0.0011), driven especially by the precentral gyrus (P = 0.011) and pallidum (P < 0.0001), and greater atrophy was seen in subjects compared to control subjects (P = 0.0004)]. Both 18F-AV-1451 retention and atrophy were greater in the clinically more affected hemisphere [on average, retention was 0.173 standardized uptake value ratio units higher on the more affected side (95% confidence interval, CI 0.11-0.24, P < 0.0001), and volume was 0.719 lower on the more affected side (95% CI 0.35-1.08, P = 0.0001)]. 18F-AV-1451 retention was greater in subcortical than in cortical regions, P < 0.0001. In contrast to these findings, subjects with amyloid-positive corticobasal syndrome, including two neuropathologically confirmed cases of Alzheimer's disease, demonstrated greater and more widespread 18F-AV-1451 retention and regional atrophy than observed in the amyloid-negative cases. There was thalamic 18F-AV-1451 retention but minimal cortical and basal ganglia uptake in a single corticobasal syndrome subject without neuropathological evidence of tau pathology, likely representing non-specific signal. Asymmetric cortical and basal ganglia 18F-AV-1451 retention consonant with the clinical manifestations characterize corticobasal syndrome due to corticobasal degeneration, whereas the cortical retention in cases associated with Alzheimer's disease is greater and more diffuse.
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Affiliation(s)
- Anna E Goodheart
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA.,Massachusetts Alzheimer's Disease Research Center, Massachusetts General Hospital, Boston, MA, USA
| | - Joseph J Locascio
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA.,Massachusetts Alzheimer's Disease Research Center, Massachusetts General Hospital, Boston, MA, USA
| | - Wesley R Samore
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
| | - Jessica A Collins
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Michael Brickhouse
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Aaron Schultz
- Massachusetts Alzheimer's Disease Research Center, Massachusetts General Hospital, Boston, MA, USA.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA.,Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Alexandra Touroutoglou
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Keith A Johnson
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA.,Massachusetts Alzheimer's Disease Research Center, Massachusetts General Hospital, Boston, MA, USA.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA.,Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Matthew P Frosch
- Massachusetts Alzheimer's Disease Research Center, Massachusetts General Hospital, Boston, MA, USA.,Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
| | - John H Growdon
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA.,Massachusetts Alzheimer's Disease Research Center, Massachusetts General Hospital, Boston, MA, USA
| | - Bradford C Dickerson
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA.,Massachusetts Alzheimer's Disease Research Center, Massachusetts General Hospital, Boston, MA, USA.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Stephen N Gomperts
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA.,Massachusetts Alzheimer's Disease Research Center, Massachusetts General Hospital, Boston, MA, USA
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14
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Li CH, Chen TF, Chiu MJ, Yen RF, Shih MC, Lin CH. Integrated 18F-T807 Tau PET, Structural MRI, and Plasma Tau in Tauopathy Neurodegenerative Disorders. Front Aging Neurosci 2021; 13:646440. [PMID: 33854426 PMCID: PMC8039308 DOI: 10.3389/fnagi.2021.646440] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 03/04/2021] [Indexed: 12/11/2022] Open
Abstract
Background and Objective: Tau-specific positron emission topography (PET) imaging enables in vivo assessment of Alzheimer's disease (AD). We aimed to investigate its performance in combination with plasma tau levels in patients with non-AD tauopathy. Methods: A total of 47 participants were enrolled, including 10 healthy controls, 16 with tauopathy parkinsonism syndromes (9 with corticobasal syndrome [CBS], 7 with progressive supranuclear palsy [PSP]), 9 with frontotemporal dementia (FTD), 4 with AD, and 8 with Parkinson's disease (PD). All participants underwent clinical assessments, 18F-T807 tau PET, brain MRI, and plasma tau assay. Results: The global cortical standard uptake value ratio (SUVR) of 18F-T807 PET was comparable between PD and control (p = 0.088). The cortical SUVR was significantly higher in AD group (p = 0.002) but was modestly increased in PSP group compared to the PD group (p = 0.044), especially in parietal and pallidal regions. Asymmetric 18F-T807 uptake at the pallidum was noted in patients with CBS and FTD. Cortical tau tracer uptake was associated with increased plasma total tau level (p = 0.016), especially in frontal and parietal regions. Regional tracer uptake was correlated with cortical thinning in patients with CBS and PSP (CBS: r = −0.092, p = 0.025; PSP: r = −0.114, p = 0.015). Conclusions: The 18F-T807 tau tracer uptake was only modestly increased in patients with PSP. Although the cortical tau tracer uptake correlated with regional cortical atrophy and plasma tau levels, a four-repeated tau-specific tracer is needed for future classifying tauopathy parkinsonism syndromes.
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Affiliation(s)
- Cheng-Hsuan Li
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.,Department of Neurology, National Taiwan University Biomedical Park Hospital, Hsinchu, Taiwan
| | - Ta-Fu Chen
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Jang Chiu
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.,Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Biomedical Engineering and Bioinformatics, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Psychology, National Taiwan University, Taipei, Taiwan
| | - Ruoh-Fang Yen
- Department of Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Chieh Shih
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chin-Hsien Lin
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
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15
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Soleimani-Meigooni DN, Iaccarino L, La Joie R, Baker S, Bourakova V, Boxer AL, Edwards L, Eser R, Gorno-Tempini ML, Jagust WJ, Janabi M, Kramer JH, Lesman-Segev OH, Mellinger T, Miller BL, Pham J, Rosen HJ, Spina S, Seeley WW, Strom A, Grinberg LT, Rabinovici GD. 18F-flortaucipir PET to autopsy comparisons in Alzheimer's disease and other neurodegenerative diseases. Brain 2020; 143:3477-3494. [PMID: 33141172 PMCID: PMC7719031 DOI: 10.1093/brain/awaa276] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 07/06/2020] [Accepted: 07/08/2020] [Indexed: 12/21/2022] Open
Abstract
Few studies have evaluated the relationship between in vivo18F-flortaucipir PET and post-mortem pathology. We sought to compare antemortem 18F-flortaucipir PET to neuropathology in a consecutive series of patients with a broad spectrum of neurodegenerative conditions. Twenty patients were included [mean age at PET 61 years (range 34-76); eight female; median PET-to-autopsy interval of 30 months (range 4-59 months)]. Eight patients had primary Alzheimer's disease pathology, nine had non-Alzheimer tauopathies (progressive supranuclear palsy, corticobasal degeneration, argyrophilic grain disease, and frontotemporal lobar degeneration with MAPT mutations), and three had non-tau frontotemporal lobar degeneration. Using an inferior cerebellar grey matter reference, 80-100-min 18F-flortaucipir PET standardized uptake value ratio (SUVR) images were created. Mean SUVRs were calculated for progressive supranuclear palsy, corticobasal degeneration, and neurofibrillary tangle Braak stage regions of interest, and these values were compared to SUVRs derived from young, non-autopsy, cognitively normal controls used as a standard for tau negativity. W-score maps were generated to highlight areas of increased tracer retention compared to cognitively normal controls, adjusting for age as a covariate. Autopsies were performed blinded to PET results. There was excellent correspondence between areas of 18F-flortaucipir retention, on both SUVR images and W-score maps, and neurofibrillary tangle distribution in patients with primary Alzheimer's disease neuropathology. Patients with non-Alzheimer tauopathies and non-tau frontotemporal lobar degeneration showed a range of tracer retention that was less than Alzheimer's disease, though higher than age-matched, cognitively normal controls. Overall, binding across both tau-positive and tau-negative non-Alzheimer disorders did not reliably correspond with post-mortem tau pathology. 18F-flortaucipir SUVRs in subcortical regions were higher in autopsy-confirmed progressive supranuclear palsy and corticobasal degeneration than in controls, but were similar to values measured in Alzheimer's disease and tau-negative neurodegenerative pathologies. Quantification of 18F-flortaucipir SUVR images at Braak stage regions of interest reliably detected advanced Alzheimer's (Braak VI) pathology. However, patients with earlier Braak stages (Braak I-IV) did not show elevated tracer uptake in these regions compared to young, tau-negative controls. In summary, PET-to-autopsy comparisons confirm that 18F-flortaucipir PET is a reliable biomarker of advanced Braak tau pathology in Alzheimer's disease. The tracer cannot reliably differentiate non-Alzheimer tauopathies and may not detect early Braak stages of neurofibrillary tangle pathology.
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Affiliation(s)
- David N Soleimani-Meigooni
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Leonardo Iaccarino
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Renaud La Joie
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Suzanne Baker
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Viktoriya Bourakova
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Adam L Boxer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Lauren Edwards
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Rana Eser
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | | | - William J Jagust
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
- Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA
| | - Mustafa Janabi
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Joel H Kramer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Orit H Lesman-Segev
- Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Taylor Mellinger
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Julie Pham
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Howard J Rosen
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Salvatore Spina
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - William W Seeley
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Amelia Strom
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Lea T Grinberg
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Gil D Rabinovici
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
- Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
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16
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Ghirelli A, Tosakulwong N, Weigand SD, Clark HM, Ali F, Botha H, Duffy JR, Utianski RL, Buciuc M, Murray ME, Labuzan SA, Spychalla AJ, Pham NTT, Schwarz CG, Senjem ML, Machulda MM, Baker M, Rademakers R, Filippi M, Jack CR, Lowe VJ, Parisi JE, Dickson DW, Josephs KA, Whitwell JL. Sensitivity-Specificity of Tau and Amyloid β Positron Emission Tomography in Frontotemporal Lobar Degeneration. Ann Neurol 2020; 88:1009-1022. [PMID: 32869362 PMCID: PMC7861121 DOI: 10.1002/ana.25893] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/27/2020] [Accepted: 08/28/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To examine associations between tau and amyloid β (Aβ) molecular positron emission tomography (PET) and both Alzheimer-related pathology and 4-repeat tau pathology in autopsy-confirmed frontotemporal lobar degeneration (FTLD). METHODS Twenty-four patients had [18 F]-flortaucipir-PET and died with FTLD (progressive supranuclear palsy [PSP], n = 10; corticobasal degeneration [CBD], n = 10; FTLD-TDP, n = 3; and Pick disease, n = 1). All but 1 had Pittsburgh compound B (PiB)-PET. Braak staging, Aβ plaque and neurofibrillary tangle counts, and semiquantitative tau lesion scores were performed. Flortaucipir standard uptake value ratios (SUVRs) were calculated in a temporal meta region of interest (meta-ROI), entorhinal cortex and cortical/subcortical regions selected to match the tau lesion analysis. Global PiB SUVR was calculated. Autoradiography was performed in 1 PSP patient, with digital pathology used to quantify tau burden. RESULTS Nine cases (37.5%) had Aβ plaques. Global PiB SUVR correlated with Aβ plaque count, with 100% specificity and 50% sensitivity for diffuse plaques. Twenty-one (87.5%) had Braak stages I to IV. Flortaucipir correlated with neurofibrillary tangle counts in entorhinal cortex, but entorhinal and meta-ROI SUVRs were not elevated in Braak IV or primary age-related tauopathy. Flortaucipir uptake patterns differed across FTLD pathologies and could separate PSP and CBD. Flortaucipir correlated with tau lesion score in red nucleus and midbrain tegmentum across patients, but not in cortical or basal ganglia regions. Autoradiography demonstrated minimal uptake of flortaucipir, although flortaucipir correlated with quantitative tau burden across regions. INTERPRETATION Molecular PET shows expected correlations with Alzheimer-related pathology but lacks sensitivity to detect mild Alzheimer pathology in FTLD. Regional flortaucipir uptake was able to separate CBD and PSP. ANN NEUROL 2020;88:1009-1022.
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Affiliation(s)
- Alma Ghirelli
- Department of Neurology, Mayo Clinic, Rochester, MN,
USA
- Università Vita-Salute San Raffaele, Milan,
Italy
| | | | | | | | - Farwa Ali
- Department of Neurology, Mayo Clinic, Rochester, MN,
USA
| | - Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, MN,
USA
| | | | | | - Marina Buciuc
- Department of Neurology, Mayo Clinic, Rochester, MN,
USA
| | | | | | | | | | | | - Matthew L. Senjem
- Department of Radiology, Mayo Clinic, Rochester, MN,
USA
- Department of Information Technology, Mayo Clinic,
Rochester, MN, USA
| | - Mary M. Machulda
- Department of Psychiatry and Psychology, Mayo Clinic,
Rochester, MN, USA
| | - Matthew Baker
- Department of Health Sciences Research, Mayo Clinic,
Rochester, MN, USA
| | - Rosa Rademakers
- Department of Health Sciences Research, Mayo Clinic,
Rochester, MN, USA
| | - Massimo Filippi
- Università Vita-Salute San Raffaele, Milan,
Italy
- Neurology and Neurophysiology Units, and Neuroimaging
Research Unit, INSPE, Division of Neuroscience, IRCCS San Raffaele Scientific
Institute, Milan, Italy
| | | | - Val J. Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN,
USA
| | - Joseph E Parisi
- Department of Laboratory Medicine and Pathology, Mayo
Clinic, Rochester, MN, USA
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17
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Saeed U, Lang AE, Masellis M. Neuroimaging Advances in Parkinson's Disease and Atypical Parkinsonian Syndromes. Front Neurol 2020; 11:572976. [PMID: 33178113 PMCID: PMC7593544 DOI: 10.3389/fneur.2020.572976] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/02/2020] [Indexed: 12/11/2022] Open
Abstract
Parkinson's disease (PD) and atypical Parkinsonian syndromes are progressive heterogeneous neurodegenerative diseases that share clinical characteristic of parkinsonism as a common feature, but are considered distinct clinicopathological disorders. Based on the predominant protein aggregates observed within the brain, these disorders are categorized as, (1) α-synucleinopathies, which include PD and other Lewy body spectrum disorders as well as multiple system atrophy, and (2) tauopathies, which comprise progressive supranuclear palsy and corticobasal degeneration. Although, great strides have been made in neurodegenerative disease research since the first medical description of PD in 1817 by James Parkinson, these disorders remain a major diagnostic and treatment challenge. A valid diagnosis at early disease stages is of paramount importance, as it can help accommodate differential prognostic and disease management approaches, enable the elucidation of reliable clinicopathological relationships ideally at prodromal stages, as well as facilitate the evaluation of novel therapeutics in clinical trials. However, the pursuit for early diagnosis in PD and atypical Parkinsonian syndromes is hindered by substantial clinical and pathological heterogeneity, which can influence disease presentation and progression. Therefore, reliable neuroimaging biomarkers are required in order to enhance diagnostic certainty and ensure more informed diagnostic decisions. In this article, an updated presentation of well-established and emerging neuroimaging biomarkers are reviewed from the following modalities: (1) structural magnetic resonance imaging (MRI), (2) diffusion-weighted and diffusion tensor MRI, (3) resting-state and task-based functional MRI, (4) proton magnetic resonance spectroscopy, (5) transcranial B-mode sonography for measuring substantia nigra and lentiform nucleus echogenicity, (6) single photon emission computed tomography for assessing the dopaminergic system and cerebral perfusion, and (7) positron emission tomography for quantifying nigrostriatal functions, glucose metabolism, amyloid, tau and α-synuclein molecular imaging, as well as neuroinflammation. Multiple biomarkers obtained from different neuroimaging modalities can provide distinct yet corroborative information on the underlying neurodegenerative processes. This integrative "multimodal approach" may prove superior to single modality-based methods. Indeed, owing to the international, multi-centered, collaborative research initiatives as well as refinements in neuroimaging technology that are currently underway, the upcoming decades will mark a pivotal and exciting era of further advancements in this field of neuroscience.
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Affiliation(s)
- Usman Saeed
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Anthony E Lang
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada.,Edmond J Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Mario Masellis
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada.,Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada.,L.C. Campbell Cognitive Neurology Research Unit, Sunnybrook Health Sciences Center, Toronto, ON, Canada.,Cognitive and Movement Disorders Clinic, Sunnybrook Health Sciences Center, Toronto, ON, Canada
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18
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Rowley PA, Samsonov AA, Betthauser TJ, Pirasteh A, Johnson SC, Eisenmenger LB. Amyloid and Tau PET Imaging of Alzheimer Disease and Other Neurodegenerative Conditions. Semin Ultrasound CT MR 2020; 41:572-583. [PMID: 33308496 DOI: 10.1053/j.sult.2020.08.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Although diagnosing the syndrome of dementia is largely a clinical endeavor, neuroimaging plays an increasingly important role in accurately determining the underlying etiology, which extends beyond its traditional role in excluding other causes of altered cognition. New neuroimaging methods not only facilitate the diagnosis of the most common neurodegenerative conditions (particularly Alzheimer Disease [AD]) after symptom onset, but also show diagnostic promise even in the very early or presymptomatic phases of disease. Positron emission tomography (PET) is increasingly recognized as a key clinical tool for differentiating normal age-related changes in brain metabolism (using 18F-fluorodeoxyglucose [FDG]) from those seen in the earliest stages of specific forms of dementia. However, FDG PET only demonstrates nonspecific changes in altered parenchymal glucose uptake and not the specific etiologic proteinopathy causing the abnormal glucose uptake. A growing class of radiotracers targeting specific protein aggregates for amyloid-β (Aβ) and tau are changing the way AD is diagnosed, as these radiotracers directly label the underlying disease pathology. As these pathology-specific radiotracers are currently making their way to the clinic, it is important for the clinical neuroradiologist to understand the underlying patterns of Aβ and tau deposition in the context of AD (across its clinical continuum) and in other causes of dementia, as well as understand the implications of current research.
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Affiliation(s)
- Paul A Rowley
- Department of Radiology, University of Wisconsin, Madison, WI
| | | | | | - Ali Pirasteh
- Department of Radiology, University of Wisconsin, Madison, WI
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19
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Matsuda K, Satoh M, Tabei KI, Ueda Y, Taniguchi A, Matsuura K, Asahi M, Ii Y, Niwa A, Tomimoto H. Impairment of intermediate somatosensory function in corticobasal syndrome. Sci Rep 2020; 10:11155. [PMID: 32636419 PMCID: PMC7340789 DOI: 10.1038/s41598-020-67991-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 06/15/2020] [Indexed: 11/09/2022] Open
Abstract
Corticobasal syndrome (CBS) is characterized by unilateral atrophy of the brain. New diagnostic criteria for CBS include intermediate somatosensory dysfunction. Here, we aimed to carefully examine intermediate somatosensory function to identify tests which can assess impairment in CBS patients. Using voxel-based morphometry (VBM), we also aimed to show the anatomical bases of these impairments. Subjects included 14 patients diagnosed with CBS and 14 patients with Parkinson's disease (PD). Patients were evaluated using intermediate somatosensory tests and neuropsychological assessments. VBM was used to analyze differences in gray matter volumes between CBS and PD patients. In the PD group, no tests showed a significant difference between the dominant-side onset and the non-dominant-side onset. In the CBS group, all tests showed worse scores on the affected side. For detecting intermediate somatosensory dysfunction in CBS, two tests are recommended: tactile object naming and 2-point discrimination. VBM analysis showed that the volume of the left post- and pre-central gyrus, and both sides of the supplementary motor area were significantly decreased in the CBS group compared to the PD group. Although CBS remains untreatable, early and correct diagnosis is possible by performing close examination of intermediate somatosensory function.
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Affiliation(s)
- Kana Matsuda
- Department of Neurology, Mie University Graduate School of Medicine, Tsu, Japan.,Department of Rehabilitation, Mie University Graduate School of Medicine, Tsu, Japan
| | - Masayuki Satoh
- Department of Dementia Prevention and Therapeutics, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
| | - Ken-Ichi Tabei
- Department of Neurology, Mie University Graduate School of Medicine, Tsu, Japan.,Department of Dementia Prevention and Therapeutics, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Yukito Ueda
- Department of Rehabilitation, Mie University Graduate School of Medicine, Tsu, Japan
| | - Akira Taniguchi
- Department of Neurology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Keita Matsuura
- Department of Neurology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Masaru Asahi
- Department of Neurology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Yuichiro Ii
- Department of Neurology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Atsushi Niwa
- Department of Neurology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Hidekazu Tomimoto
- Department of Neurology, Mie University Graduate School of Medicine, Tsu, Japan
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20
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Abstract
PURPOSE OF REVIEW Corticobasal degeneration (CBD) is a rapidly progressive neurodegenerative tauopathy diagnosed postmortem by pathological examination. The clinical presentation of corticobasal syndrome (CBS) is an apraxic, dystonic, and rigid limb with asymmetrical cortical signs and myoclonus. However, less than half of the patients with CBS receive a CBD diagnosis. As tau-lowering therapies have entered clinical trials, improved antemortem diagnosis of CBD is needed. Here, clinicopathological, neuroimaging, and biofluid data in CBS and/or CBD patients are briefly summarized and some knowledge gaps identified. RECENT FINDINGS Developments of MRI-based and nuclear medicine imaging modalities have increased pathophysiological insights of CBS and may improve diagnostic accuracy. In particular, several tau-PET ligands have been evaluated in CBS patients. Cerebrospinal fluid and plasma levels of neurofilament light chain can distinguish CBS from Parkinson's disease but not from other atypical forms of Parkinsonism. SUMMARY Structural and functional imaging approaches provide some aid in the diagnosis of CBD but have low-content validity. None of the currently available tau-PET ligands is suitable for detecting straight filament 4repeat tau disease in clinical routine. Biofluid markers reflecting the distinct tau and/or astrocyte disease of CBD are needed. Examining biosamples along with clinical parameters from longitudinally followed patients with autopsy-confirmed CBD diagnosis shall hopefully delineate improved biomarkers.
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21
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Tau Imaging in the 4-Repeat-Tauopathies Progressive Supranuclear Palsy and Corticobasal Syndrome. Clin Nucl Med 2020; 45:283-287. [DOI: 10.1097/rlu.0000000000002949] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Abstract
Frontotemporal degeneration (FTD) is a heterogeneous spectrum of neurodegenerative disorders characterized by diverse clinical presentations, neuropathological characteristics, and underlying genetic causes. In the last few years, several advances in the knowledge of clinical and biological aspects have been accomplished and three major scenarios have emerged that will represent the core issues in the FTD scene over the next few years. Foremost, the development of cerebrospinal fluid and blood biomarkers as well as neuroimaging techniques will aid the pursuit of new diagnostic and prognostic markers able to identify the ongoing proteinopathy and predict disease progression, which is key in identifying and stratifying patients for enrolment in clinical trials as well as evaluating response to treatment. On the other hand, current research has focused on the first attempts to slow down or revert disease progression, with the identification of disease modulators associated with disease onset and the ongoing development of the first pharmacological treatments for both sporadic and genetic FTD. Future research will certainly improve our knowledge of FTD and possibly open up a new era of disease-modifying therapies for this still-orphan disorder.
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Affiliation(s)
- Barbara Borroni
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, 25100, Italy
| | - Alberto Benussi
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, 25100, Italy
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23
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Lesman-Segev OH, La Joie R, Stephens ML, Sonni I, Tsai R, Bourakova V, Visani AV, Edwards L, O'Neil JP, Baker SL, Gardner RC, Janabi M, Chaudhary K, Perry DC, Kramer JH, Miller BL, Jagust WJ, Rabinovici GD. Tau PET and multimodal brain imaging in patients at risk for chronic traumatic encephalopathy. Neuroimage Clin 2019; 24:102025. [PMID: 31670152 PMCID: PMC6831941 DOI: 10.1016/j.nicl.2019.102025] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 09/03/2019] [Accepted: 09/27/2019] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To characterize individual and group-level neuroimaging findings in patients at risk for Chronic Traumatic Encephalopathy (CTE). METHODS Eleven male patients meeting criteria for Traumatic Encephalopathy Syndrome (TES, median age: 64) underwent neurologic evaluation, 3-Tesla MRI, and PET with [18F]-Flortaucipir (FTP, tau-PET) and [11C]-Pittsburgh compound B (PIB, amyloid-PET). Six patients underwent [18F]-Fluorodeoxyglucose-PET (FDG, glucose metabolism). We assessed imaging findings at the individual patient level, and in group-level comparisons with modality-specific groups of cognitively normal older adults (CN). Tau-PET findings in patients with TES were also compared to a matched group of patients with mild cognitive impairment or dementia due to Alzheimer's disease (AD). RESULTS All patients with TES sustained repetitive head injury participating in impact sports, ten in American football. Three patients met criteria for dementia and eight had mild cognitive impairment. Two patients were amyloid-PET positive and harbored the most severe MRI atrophy, FDG hypometabolism, and FTP-tau PET binding. Among the nine amyloid-negative patients, tau-PET showed either mildly elevated frontotemporal binding, a "dot-like" pattern, or no elevated binding. Medial temporal FTP was mildly elevated in a subset of amyloid-negative patients, but values were considerably lower than in AD. Voxelwise analyses revealed a convergence of imaging abnormalities (higher FTP binding, lower FDG, lower gray matter volumes) in frontotemporal areas in TES compared to controls. CONCLUSIONS Mildly elevated tau-PET binding was observed in a subset of amyloid-negative patients at risk for CTE, in a distribution consistent with CTE pathology stages III-IV. FTP-PET may be useful as a biomarker of tau pathology in CTE but is unlikely to be sensitive to early disease stages.
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Affiliation(s)
- Orit H Lesman-Segev
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, 94158, United States.
| | - Renaud La Joie
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, 94158, United States
| | - Melanie L Stephens
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, 94158, United States
| | - Ida Sonni
- Life Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, United States
| | - Richard Tsai
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, 94158, United States
| | - Viktoriya Bourakova
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, 94158, United States
| | - Adrienne V Visani
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, 94158, United States
| | - Lauren Edwards
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, 94158, United States
| | - James P O'Neil
- Life Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, United States
| | - Suzanne L Baker
- Life Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, United States
| | - Raquel C Gardner
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, 94158, United States; San Francisco Veterans Affairs Medical Center, San Francisco, CA 94121, United States
| | - Mustafa Janabi
- Life Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, United States
| | - Kiran Chaudhary
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, 94158, United States
| | - David C Perry
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, 94158, United States
| | - Joel H Kramer
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, 94158, United States
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, 94158, United States
| | - William J Jagust
- Life Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, United States; Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA 94720, United States
| | - Gil D Rabinovici
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, 94158, United States; Departments of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, United States; Life Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, United States; Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA 94720, United States
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24
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Lagarde J, Olivieri P, Caillé F, Gervais P, Baron JC, Bottlaender M, Sarazin M. [18F]-AV-1451 tau PET imaging in Alzheimer’s disease and suspected non-AD tauopathies using a late acquisition time window. J Neurol 2019; 266:3087-3097. [DOI: 10.1007/s00415-019-09530-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 09/04/2019] [Accepted: 09/06/2019] [Indexed: 01/12/2023]
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25
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Perani D, Iaccarino L, Lammertsma AA, Windhorst AD, Edison P, Boellaard R, Hansson O, Nordberg A, Jacobs AH. A new perspective for advanced positron emission tomography-based molecular imaging in neurodegenerative proteinopathies. Alzheimers Dement 2019; 15:1081-1103. [PMID: 31230910 DOI: 10.1016/j.jalz.2019.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 01/21/2019] [Accepted: 02/20/2019] [Indexed: 12/12/2022]
Abstract
Recent studies in neurodegenerative conditions have increasingly highlighted that the same neuropathology can trigger different clinical phenotypes or, vice-versa, that similar phenotypes can be triggered by different neuropathologies. This evidence has called for the adoption of a pathology spectrum-based approach to study neurodegenerative proteinopathies. These conditions share brain deposition of abnormal protein aggregates, leading to aberrant biochemical, metabolic, functional, and structural changes. Positron emission tomography (PET) is a well-recognized and unique tool for the in vivo assessment of brain neuropathology, and novel PET techniques are emerging for the study of specific protein species. Today, key applications of PET range from early research and clinical diagnostic tools to their use in clinical trials for both participants screening and outcome evaluation. This position article critically reviews the role of distinct PET molecular tracers for different neurodegenerative proteinopathies, highlighting their strengths, weaknesses, and opportunities, with special emphasis on methodological challenges and future applications.
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Affiliation(s)
- Daniela Perani
- Vita-Salute San Raffaele University, Nuclear Medicine Unit San Raffaele Hospital, Division of Neuroscience San Raffaele Scientific Institute, Milan, Italy
| | - Leonardo Iaccarino
- Vita-Salute San Raffaele University, Nuclear Medicine Unit San Raffaele Hospital, Division of Neuroscience San Raffaele Scientific Institute, Milan, Italy
| | - Adriaan A Lammertsma
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Albert D Windhorst
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Paul Edison
- Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK; Neurology Imaging Unit, Imperial College London, London, UK
| | - Ronald Boellaard
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Agneta Nordberg
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Center for Alzheimer Research, Stockholm, Sweden
| | - Andreas H Jacobs
- European Institute for Molecular Imaging, University of Münster, Münster, Germany; Evangelische Kliniken Bonn gGmbH, Johanniter Krankenhaus, Bonn, Germany.
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26
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Ezura M, Kikuchi A, Ishiki A, Okamura N, Hasegawa T, Harada R, Watanuki S, Funaki Y, Hiraoka K, Baba T, Sugeno N, Oshima R, Yoshida S, Kobayashi J, Kobayashi M, Tano O, Nakashima I, Mugikura S, Iwata R, Taki Y, Furukawa K, Arai H, Furumoto S, Tashiro M, Yanai K, Kudo Y, Takeda A, Aoki M. Longitudinal changes in 18 F-THK5351 positron emission tomography in corticobasal syndrome. Eur J Neurol 2019; 26:1205-1211. [PMID: 30980575 DOI: 10.1111/ene.13966] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 04/04/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND PURPOSE Corticobasal syndrome (CBS) is pathologically characterized by tau deposits in neuronal and glial cells and by reactive astrogliosis. In several neurodegenerative disorders, 18 F-THK5351 has been observed to bind to reactive astrocytes expressing monoamine oxidase B. In this study, the aim was to investigate the progression of disease-related pathology in the brains of patients with CBS using positron emission tomography with 18 F-THK5351. METHODS Baseline and 1-year follow-up imaging were acquired using magnetic resonance imaging and positron emission tomography with 18 F-THK5351 in 10 subjects: five patients with CBS and five age-matched normal controls (NCs). RESULTS The 1-year follow-up scan images revealed that 18 F-THK5351 retention had significantly increased in the superior parietal gyrus of the patients with CBS compared with the NCs. The median increases in 18 F-THK5351 accumulation in the patients with CBS were 6.53% in the superior parietal gyrus, 4.34% in the precentral gyrus and 4.33% in the postcentral gyrus. In contrast, there was no significant increase in the regional 18 F-THK5351 retention in the NCs. CONCLUSIONS Longitudinal increases in 18 F-THK5351 binding can be detected over a short interval in the cortical sites of patients with CBS. A monoamine oxidase B binding radiotracer could be useful in monitoring the progression of astrogliosis in CBS.
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Affiliation(s)
- M Ezura
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - A Kikuchi
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - A Ishiki
- Department of Geriatrics and Gerontology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - N Okamura
- Division of Pharmacology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.,Department of Pharmacology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - T Hasegawa
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - R Harada
- Department of Pharmacology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - S Watanuki
- Division of Cyclotron Nuclear Medicine, Cyclotron and Radioisotope Center, Tohoku University, Sendai, Japan
| | - Y Funaki
- Division of Radiopharmaceutical Chemistry, Cyclotron and Radioisotope Center, Tohoku University, Sendai, Japan
| | - K Hiraoka
- Division of Cyclotron Nuclear Medicine, Cyclotron and Radioisotope Center, Tohoku University, Sendai, Japan
| | - T Baba
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - N Sugeno
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - R Oshima
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - S Yoshida
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - J Kobayashi
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - M Kobayashi
- Department of Neurology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - O Tano
- Department of Neurology, Sendai Medical Center, Sendai, Japan
| | - I Nakashima
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Neurology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - S Mugikura
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - R Iwata
- Division of Radiopharmaceutical Chemistry, Cyclotron and Radioisotope Center, Tohoku University, Sendai, Japan
| | - Y Taki
- Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - K Furukawa
- Department of Geriatrics and Gerontology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.,Division of Community of Medicine, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - H Arai
- Department of Geriatrics and Gerontology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - S Furumoto
- Division of Radiopharmaceutical Chemistry, Cyclotron and Radioisotope Center, Tohoku University, Sendai, Japan
| | - M Tashiro
- Division of Cyclotron Nuclear Medicine, Cyclotron and Radioisotope Center, Tohoku University, Sendai, Japan
| | - K Yanai
- Department of Pharmacology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Y Kudo
- Division of Neuroimaging, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - A Takeda
- Department of Neurology, National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan
| | - M Aoki
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
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27
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Di Stasio F, Suppa A, Marsili L, Upadhyay N, Asci F, Bologna M, Colosimo C, Fabbrini G, Pantano P, Berardelli A. Corticobasal syndrome: neuroimaging and neurophysiological advances. Eur J Neurol 2019; 26:701-e52. [PMID: 30720235 DOI: 10.1111/ene.13928] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 01/30/2019] [Indexed: 01/14/2023]
Abstract
Corticobasal degeneration (CBD) is a neurodegenerative condition characterized by 4R tau protein deposition in several brain regions that clinically manifests itself as a heterogeneous atypical parkinsonism typically expressed in adulthood. The prototypical clinical phenotype of CBD is corticobasal syndrome (CBS). Important insights into the pathophysiological mechanisms underlying motor and higher cortical symptoms in CBS have been gained by using advanced neuroimaging and neurophysiological techniques. Structural and functional neuroimaging studies often show asymmetric cortical and subcortical abnormalities, mainly involving perirolandic and parietal regions and basal ganglia structures. Neurophysiological investigations including electroencephalography and somatosensory evoked potentials provide useful information on the origin of myoclonus and on cortical sensory loss. Transcranial magnetic stimulation demonstrates heterogeneous and asymmetric changes in the excitability and plasticity of primary motor cortex and abnormal hemispheric connectivity. Neuroimaging and neurophysiological abnormalities in multiple brain areas reflect asymmetric neurodegeneration, leading to asymmetric motor and higher cortical symptoms in CBS.
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Affiliation(s)
- F Di Stasio
- IRCCS Neuromed Institute, 'Sapienza' University of Rome, Pozzilli (Isernia), Italy
| | - A Suppa
- IRCCS Neuromed Institute, 'Sapienza' University of Rome, Pozzilli (Isernia), Italy.,Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
| | - L Marsili
- Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
| | - N Upadhyay
- Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
| | - F Asci
- Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
| | - M Bologna
- IRCCS Neuromed Institute, 'Sapienza' University of Rome, Pozzilli (Isernia), Italy.,Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
| | - C Colosimo
- Department of Neurology, Santa Maria University Hospital, Terni, Italy
| | - G Fabbrini
- IRCCS Neuromed Institute, 'Sapienza' University of Rome, Pozzilli (Isernia), Italy.,Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
| | - P Pantano
- IRCCS Neuromed Institute, 'Sapienza' University of Rome, Pozzilli (Isernia), Italy.,Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
| | - A Berardelli
- IRCCS Neuromed Institute, 'Sapienza' University of Rome, Pozzilli (Isernia), Italy.,Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
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28
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Alster P, Madetko NK, Koziorowski DM, Królicki L, Budrewicz S, Friedman A. Accumulation of Tau Protein, Metabolism and Perfusion-Application and Efficacy of Positron Emission Tomography (PET) and Single Photon Emission Computed Tomography (SPECT) Imaging in the Examination of Progressive Supranuclear Palsy (PSP) and Corticobasal Syndrome (CBS). Front Neurol 2019; 10:101. [PMID: 30837933 PMCID: PMC6383629 DOI: 10.3389/fneur.2019.00101] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 01/25/2019] [Indexed: 11/13/2022] Open
Abstract
Neuroimaging in the context of examining atypical parkinsonian tauopathies is an evolving matter. Positron Emission Tomography (PET) and Single Photon Emission Computed Tomography (SPECT) bring tools, which may be reasonable in supplementary examination, however cannot be interpreted as a gold standard for correct diagnosis. The review presents advantages and limitations of tau radiotracers in PET, metabolic PET and perfusion SPECT. The aim of this paper is to highlight the possibilities and boundaries in the supplementary examination of tauopathic parkinsonian syndromes.
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Affiliation(s)
- Piotr Alster
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland
| | | | | | - Leszek Królicki
- Department of Nuclear Medicine, Medical University of Warsaw, Warsaw, Poland
| | | | - Andrzej Friedman
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland
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29
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Wilson H, Pagano G, Politis M. Dementia spectrum disorders: lessons learnt from decades with PET research. J Neural Transm (Vienna) 2019; 126:233-251. [PMID: 30762136 PMCID: PMC6449308 DOI: 10.1007/s00702-019-01975-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 01/21/2019] [Indexed: 02/07/2023]
Abstract
The dementia spectrum encompasses a range of disorders with complex diagnosis, pathophysiology and limited treatment options. Positron emission tomography (PET) imaging provides insights into specific neurodegenerative processes underlying dementia disorders in vivo. Here we focus on some of the most common dementias: Alzheimer’s disease, Parkinsonism dementias including Parkinson’s disease with dementia, dementia with Lewy bodies, progressive supranuclear palsy and corticobasal syndrome, and frontotemporal lobe degeneration. PET tracers have been developed to target specific proteinopathies (amyloid, tau and α-synuclein), glucose metabolism, cholinergic system and neuroinflammation. Studies have shown distinct imaging abnormalities can be detected early, in some cases prior to symptom onset, allowing disease progression to be monitored and providing the potential to predict symptom onset. Furthermore, advances in PET imaging have identified potential therapeutic targets and novel methods to accurately discriminate between different types of dementias in vivo. There are promising imaging markers with a clinical application on the horizon, however, further studies are required before they can be implantation into clinical practice.
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Affiliation(s)
- Heather Wilson
- Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, 125 Coldharbour Lane, Camberwell, London, SE5 9NU, UK
| | - Gennaro Pagano
- Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, 125 Coldharbour Lane, Camberwell, London, SE5 9NU, UK
| | - Marios Politis
- Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, 125 Coldharbour Lane, Camberwell, London, SE5 9NU, UK.
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30
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Tsai RM, Bejanin A, Lesman-Segev O, LaJoie R, Visani A, Bourakova V, O'Neil JP, Janabi M, Baker S, Lee SE, Perry DC, Bajorek L, Karydas A, Spina S, Grinberg LT, Seeley WW, Ramos EM, Coppola G, Gorno-Tempini ML, Miller BL, Rosen HJ, Jagust W, Boxer AL, Rabinovici GD. 18F-flortaucipir (AV-1451) tau PET in frontotemporal dementia syndromes. Alzheimers Res Ther 2019; 11:13. [PMID: 30704514 PMCID: PMC6357510 DOI: 10.1186/s13195-019-0470-7] [Citation(s) in RCA: 107] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 01/17/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND The tau positron emission tomography (PET) ligand 18F-flortaucipir binds to paired helical filaments of tau in aging and Alzheimer's disease (AD), but its utility in detecting tau aggregates in frontotemporal dementia (FTD) is uncertain. METHODS We performed 18F-flortaucipir imaging in patients with the FTD syndromes (n = 45): nonfluent variant primary progressive aphasia (nfvPPA) (n = 11), corticobasal syndrome (CBS) (n = 10), behavioral variant frontotemporal dementia (bvFTD) (n = 10), semantic variant primary progressive aphasia (svPPA) (n = 2) and FTD associated pathogenic genetic mutations microtubule-associated protein tau (MAPT) (n = 6), chromosome 9 open reading frame 72 (C9ORF72) (n = 5), and progranulin (GRN) (n = 1). All patients underwent MRI and β-amyloid biomarker testing via 11C-PiB or cerebrospinal fluid. 18F-flortaucipir uptake in patients was compared to 53 β-amyloid negative normal controls using voxelwise and pre-specified region of interest approaches. RESULTS On qualitative assessment, patients with nfvPPA showed elevated 18F-flortacupir binding in the left greater than right inferior frontal gyrus. Patients with CBS showed elevated binding in frontal white matter, with higher cortical gray matter uptake in a subset of β-amyloid-positive patients. Five of ten patients with sporadic bvFTD demonstrated increased frontotemporal binding. MAPT mutation carriers had elevated 18F-flortaucipir retention primarily, but not exclusively, in mutations with Alzheimer's-like neurofibrillary tangles. However, tracer retention was also seen in patients with svPPA, and the mutations C9ORF72, GRN predicted to have TDP-43 pathology. Quantitative region-of-interest differences between patients and controls were seen only in inferior frontal gyrus in nfvPPA and left insula and bilateral temporal poles in MAPT carriers. No significant regional differences were found in CBS or sporadic bvFTD. Two patients underwent postmortem neuropathological examination. A patient with C9ORF72, TDP-43-type B pathology, and incidental co-pathology of scattered neurofibrillary tangles in the middle frontal, inferior temporal gyrus showed corresponding mild 18F-flortaucipir retention without additional uptake matching the widespread TDP-43 type B pathology. A patient with sporadic bvFTD demonstrated punctate inferior temporal and hippocampus tracer retention, corresponding to the area of severe argyrophilic grain disease pathology. CONCLUSIONS 18F-flortaucipir in patients with FTD and predicted tauopathy or TDP-43 pathology demonstrated limited sensitivity and specificity. Further postmortem pathological confirmation and development of FTD tau-specific ligands are needed.
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Affiliation(s)
- Richard M Tsai
- Memory and Aging Center, University of California at San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, USA.
| | - Alexandre Bejanin
- Memory and Aging Center, University of California at San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, USA
| | - Orit Lesman-Segev
- Memory and Aging Center, University of California at San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, USA
| | - Renaud LaJoie
- Memory and Aging Center, University of California at San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, USA
| | - Adrienne Visani
- Memory and Aging Center, University of California at San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, USA
| | - Viktoriya Bourakova
- Memory and Aging Center, University of California at San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, USA
| | - James P O'Neil
- Life Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, USA
| | - Mustafa Janabi
- Life Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, USA
| | - Suzanne Baker
- Life Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, USA
| | - Suzee E Lee
- Memory and Aging Center, University of California at San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, USA
| | - David C Perry
- Memory and Aging Center, University of California at San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, USA
| | - Lynn Bajorek
- Memory and Aging Center, University of California at San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, USA
| | - Anna Karydas
- Memory and Aging Center, University of California at San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, USA
| | - Salvatore Spina
- Memory and Aging Center, University of California at San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, USA
| | - Lea T Grinberg
- Memory and Aging Center, University of California at San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, USA
| | - William W Seeley
- Memory and Aging Center, University of California at San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, USA
| | - Eliana M Ramos
- Departments of Psychiatry and Neurology, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Giovanni Coppola
- Departments of Psychiatry and Neurology, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Maria Luisa Gorno-Tempini
- Memory and Aging Center, University of California at San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, USA
| | - Bruce L Miller
- Memory and Aging Center, University of California at San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, USA
| | - Howard J Rosen
- Memory and Aging Center, University of California at San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, USA
| | - William Jagust
- Helen Wills Neuroscience Institute, University of California at Berkeley, Berkeley, USA
- Life Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, USA
| | - Adam L Boxer
- Memory and Aging Center, University of California at San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, USA
| | - Gil D Rabinovici
- Memory and Aging Center, University of California at San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, USA
- Helen Wills Neuroscience Institute, University of California at Berkeley, Berkeley, USA
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31
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Abstract
Though less common than Parkinson's disease (PD), the atypical Parkinson disorders such as such as dementia with Lewy bodies, multiple system atrophy, progressive supranuclear palsy, and corticobasal degeneration are increasingly recognized and important to distinguish from PD. Atypical or "Parkinson-plus" disorders are multisystem disorders and generally progress more rapidly and respond poorly to current therapies compared to PD. Recent advances in our understanding of the pathophysiology of these disorders, however, have generated new interest in the development of novel diagnostics and disease-modifying therapeutics aimed at identifying and treating these disorders. In this review we discuss the clinical approach to the atypical Parkinson disorders and the recent developments in diagnostic and research criteria that take into account the phenotypic heterogeneity and advances in our understanding of the pathophysiology of these disorders.
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32
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Leuzy A, Chiotis K, Lemoine L, Gillberg PG, Almkvist O, Rodriguez-Vieitez E, Nordberg A. Tau PET imaging in neurodegenerative tauopathies-still a challenge. Mol Psychiatry 2019; 24:1112-1134. [PMID: 30635637 PMCID: PMC6756230 DOI: 10.1038/s41380-018-0342-8] [Citation(s) in RCA: 362] [Impact Index Per Article: 72.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 10/19/2018] [Accepted: 11/26/2018] [Indexed: 12/14/2022]
Abstract
The accumulation of pathological misfolded tau is a feature common to a collective of neurodegenerative disorders known as tauopathies, of which Alzheimer's disease (AD) is the most common. Related tauopathies include progressive supranuclear palsy (PSP), corticobasal syndrome (CBS), Down's syndrome (DS), Parkinson's disease (PD), and dementia with Lewy bodies (DLB). Investigation of the role of tau pathology in the onset and progression of these disorders is now possible due the recent advent of tau-specific ligands for use with positron emission tomography (PET), including first- (e.g., [18F]THK5317, [18F]THK5351, [18F]AV1451, and [11C]PBB3) and second-generation compounds [namely [18F]MK-6240, [18F]RO-948 (previously referred to as [18F]RO69558948), [18F]PI-2620, [18F]GTP1, [18F]PM-PBB3, and [18F]JNJ64349311 ([18F]JNJ311) and its derivative [18F]JNJ-067)]. In this review we describe and discuss findings from in vitro and in vivo studies using both initial and new tau ligands, including their relation to biomarkers for amyloid-β and neurodegeneration, and cognitive findings. Lastly, methodological considerations for the quantification of in vivo ligand binding are addressed, along with potential future applications of tau PET, including therapeutic trials.
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Affiliation(s)
- Antoine Leuzy
- 0000 0004 1937 0626grid.4714.6Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Konstantinos Chiotis
- 0000 0004 1937 0626grid.4714.6Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden ,0000 0000 9241 5705grid.24381.3cTheme Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Laetitia Lemoine
- 0000 0004 1937 0626grid.4714.6Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Per-Göran Gillberg
- 0000 0004 1937 0626grid.4714.6Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Ove Almkvist
- 0000 0004 1937 0626grid.4714.6Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden ,0000 0004 1936 9377grid.10548.38Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Elena Rodriguez-Vieitez
- 0000 0004 1937 0626grid.4714.6Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Agneta Nordberg
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden. .,Theme Aging, Karolinska University Hospital, Stockholm, Sweden.
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33
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Niccolini F, Wilson H, Hirschbichler S, Yousaf T, Pagano G, Whittington A, Caminiti SP, Erro R, Holton JL, Jaunmuktane Z, Esposito M, Martino D, Abdul A, Passchier J, Rabiner EA, Gunn RN, Bhatia KP, Politis M. Disease-related patterns of in vivo pathology in Corticobasal syndrome. Eur J Nucl Med Mol Imaging 2018; 45:2413-2425. [PMID: 30090966 PMCID: PMC6208819 DOI: 10.1007/s00259-018-4104-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 07/18/2018] [Indexed: 01/03/2023]
Abstract
PURPOSE To assess disease-related patterns of in vivo pathology in 11 patients with Corticobasal Syndrome (CBS) compared to 20 healthy controls and 33 mild cognitive impairment (MCI) patients due to Alzheimer's disease. METHODS We assessed tau aggregates with [18F]AV1451 PET, amyloid-β depositions with [18F]AV45 PET, and volumetric microstructural changes with MRI. We validated for [18F]AV1451 standardised uptake value ratio (SUVRs) against input functions from arterial metabolites and found that SUVRs and arterial-derived distribution volume ratio (DVRs) provide equally robust measures of [18F]AV1451 binding. RESULTS CBS patients showed increases in [18F]AV1451 SUVRs in parietal (P < 0.05) and frontal (P < 0.05) cortices in the affected hemisphere compared to healthy controls and in precentral (P = 0.008) and postcentral (P = 0.034) gyrus in the affected hemisphere compared to MCI patients. Our data were confirmed at the histopathological level in one CBS patient who underwent brain biopsy and showed sparse tau pathology in the parietal cortex co-localizing with increased [18F]AV1451 signal. Cortical and subcortical [18F]AV45 uptake was within normal levels in CBS patients. In parietal and frontal cortices of the most affected hemisphere we found also grey matter loss (P < 0.05), increased mean diffusivity (P < 0.05) and decreased fractional anisotropy (P < 0.05) in CBS patients compared to healthy controls and MCI patients. Grey matter loss and white matter changes in the precentral gyrus of CBS patients were associated with worse motor symptoms. CONCLUSIONS Our findings demonstrate disease-related patterns of in vivo tau and microstructural pathology in the absence of amyloid-β, which distinguish CBS from non-affected individuals and MCI patients.
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Affiliation(s)
- Flavia Niccolini
- Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, 125 Coldharbour Lane, Camberwell, London, SE5 9NU, UK
| | - Heather Wilson
- Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, 125 Coldharbour Lane, Camberwell, London, SE5 9NU, UK
| | | | - Tayyabah Yousaf
- Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, 125 Coldharbour Lane, Camberwell, London, SE5 9NU, UK
| | - Gennaro Pagano
- Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, 125 Coldharbour Lane, Camberwell, London, SE5 9NU, UK
| | - Alexander Whittington
- Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
| | - Silvia P Caminiti
- Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, 125 Coldharbour Lane, Camberwell, London, SE5 9NU, UK
| | - Roberto Erro
- Center for Neurodegenerative Diseases (CEMAND) Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Janice L Holton
- Division of Neuropathology, UCL Institute of Neurology, London, UK
| | - Zane Jaunmuktane
- Division of Neuropathology, UCL Institute of Neurology, London, UK
| | - Marcello Esposito
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Naples, Italy
| | - Davide Martino
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Ali Abdul
- Imanova Ltd, Centre for Imaging Sciences, Hammersmith Hospital, London, UK
| | - Jan Passchier
- Imanova Ltd, Centre for Imaging Sciences, Hammersmith Hospital, London, UK
| | - Eugenii A Rabiner
- Imanova Ltd, Centre for Imaging Sciences, Hammersmith Hospital, London, UK
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King s College London, London, UK
| | - Roger N Gunn
- Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
- Imanova Ltd, Centre for Imaging Sciences, Hammersmith Hospital, London, UK
| | - Kailash P Bhatia
- Sobell Department of Motor Neuroscience, UCL Institute of Neurology, London, UK
| | - Marios Politis
- Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, 125 Coldharbour Lane, Camberwell, London, SE5 9NU, UK.
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34
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Cho H, Kim HJ, Choi JY, Ryu YH, Lee MS, Na DL, Seo SW, Lyoo CH. 18F-flortaucipir uptake patterns in clinical subtypes of primary progressive aphasia. Neurobiol Aging 2018; 75:187-197. [PMID: 30594046 DOI: 10.1016/j.neurobiolaging.2018.11.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 11/14/2018] [Accepted: 11/15/2018] [Indexed: 11/19/2022]
Abstract
We analyzed 18F-flortaucipir uptake patterns and structural changes in patients with subtypes of primary progressive aphasia (PPA) using 18F-flortaucipir positron emission tomography and volumetric magnetic resonance imaging. We enrolled 34 consecutive patients with PPA (10 nonfluent/agrammatic PPA [nfvPPA], 18 semantic variant PPA [svPPA], and 6 logopenic variant PPA [lvPPA], as well as 20 healthy controls, and 20 patients with Alzheimer's disease. 18F-flortaucipir uptake was increased in the frontal cortex and underlying white matter, and subcortical nuclei in the 10 nfvPPA and 8 nfvPPA-amyloid-β (Aβ)- subgroup patients. In the svPPA patients (both the 13 svPPA-Aβ- and 5 svPPA-Aβ+), uptake generally increased in the widespread neocortex with left anterior temporal predominance. 18F-flortaucipir uptake patterns in the 6 lvPPA and the 5 lvPPA-Aβ+ subgroup patients were similar to those seen in the patients with Alzheimer's disease with mild predominance in the left lateral temporal cortex. Cortical thinning in each PPA subtype corresponded with increased 18F-flortaucipir uptake. 18F-flortaucipir uptake patterns and cortical atrophy were distinct and corresponded to areas related to the specific language functions that are impaired in each subtype of PPA.
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Affiliation(s)
- Hanna Cho
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hee Jin Kim
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Yong Choi
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Division of RI-Convergence Research, Korea Institute Radiological and Medical Sciences, Seoul, South Korea
| | - Young Hoon Ryu
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Myung Sik Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Duk L Na
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang Won Seo
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
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35
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Tau PET imaging evidence in patients with cognitive impairment: preparing for clinical use. Clin Transl Imaging 2018. [DOI: 10.1007/s40336-018-0297-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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36
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Abstract
PURPOSE OF REVIEW Differential diagnosis of atypical Parkinson syndromes (APS) is difficult as clinical presentations may vary and as there is a strong overlap between disease entities. Aggregations of misfolded and hyperphosphorylated tau proteins are the common denominator of many of these diseases. RECENT FINDINGS Several tau targeting positron emission tomography (PET) tracers have been evaluated as possible biomarkers in APS in the recent years. For Parkinson's disease, dementia with Lewy bodies, progressive supranuclear palsy, and corticobasal degeneration, promising results have been reported with regard to the ability to detect the presence of disease and to discriminate patients from controls. However, the discussion about the specificity of the first-generation radiotracers and their value in the clinical context is ongoing. A combined interpretation of signal strength and distribution pattern in PET scans with first- and second-generation tracers may be helpful in clinical diagnosis and follow-up of patients with APS.
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37
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Harada R, Okamura N, Furumoto S, Yanai K. Imaging Protein Misfolding in the Brain Using β-Sheet Ligands. Front Neurosci 2018; 12:585. [PMID: 30186106 PMCID: PMC6110819 DOI: 10.3389/fnins.2018.00585] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 08/06/2018] [Indexed: 12/12/2022] Open
Abstract
Neurodegenerative diseases characterized by pathological protein accumulation in cells are termed “proteinopathies.” Although various protein aggregates share cross-β-sheet structures, actual conformations vary among each type of protein deposit. Recent progress in the development of radiotracers for positron emission tomography (PET) has enabled the visualization of protein aggregates in living brains. Amyloid PET tracers have been developed, and are widely used for the diagnosis of Alzheimer’s disease and non-invasive assessment of amyloid burden in clinical trials of anti-dementia drugs. Furthermore, several tau PET tracers have been successfully developed and used in the clinical studies. However, recent studies have identified the presence of off-target binding of radiotracers in areas of tau deposition, suggesting that concomitant neuroinflammatory changes might affect tracer binding. In contrast to amyloid and tau PET, there are no established tracers for imaging Lewy bodies in the human brain. In this review, we describe lessons learned from the development of PET tracers and discuss the future direction of tracer development for protein misfolding diseases.
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Affiliation(s)
- Ryuichi Harada
- Department of Pharmacology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Nobuyuki Okamura
- Division of Pharmacology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Shozo Furumoto
- Cyclotron and Radioisotope Center, Tohoku University, Sendai, Japan
| | - Kazuhiko Yanai
- Department of Pharmacology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Cyclotron and Radioisotope Center, Tohoku University, Sendai, Japan
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Okamura N, Harada R, Ishiki A, Kikuchi A, Nakamura T, Kudo Y. The development and validation of tau PET tracers: current status and future directions. Clin Transl Imaging 2018; 6:305-316. [PMID: 30148121 PMCID: PMC6096533 DOI: 10.1007/s40336-018-0290-y] [Citation(s) in RCA: 111] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 07/03/2018] [Indexed: 01/02/2023]
Abstract
Purpose To provide an overview on positron emission tomography (PET) imaging of tau pathology in Alzheimer’s disease (AD) and other neurodegenerative disorders. Results Different classes of tau tracers such as flortaucipir, THK5317, and PBB3 have been developed and utilized in previous clinical studies. In AD, the topographical distribution of tracer binding follows the known distribution of neurofibrillary tangles and is closely associated with neurodegeneration as well as the clinical phenotype of dementia. Significant retention of tracers has also been observed in the frequent site of the 4-repeat (4R) tau isoform deposits in non-AD tauopathies, such as in progressive supranuclear palsy. However, in vitro binding studies indicate that most tau tracers are less sensitive to straight tau filaments, in contrast to their high binding affinity to paired helical filaments of tau (PHF-tau). The first-generation of tau tracers shows off-target binding in the basal ganglia, midbrain, thalamus, choroid plexus, and venous sinus. Off-target binding of THK5351 to monoamine oxidase B (MAO-B) has been observed in disease-associated brain regions linked to neurodegeneration and is associated with astrogliosis in areas of misfolded protein accumulation. The second generation of tau tracers, such as [18F]MK-6240, is highly selective to PHF-tau with little off-target binding and have enabled the reliable assessment of PHF-tau burden in aging and AD. Conclusions Tau PET tracers have enabled in vivo quantification of PHF-tau burden in human brains. Tau PET can help in understanding the underlying cause of dementia symptoms, and in patient selection for clinical trials of anti-dementia therapies.
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Affiliation(s)
- Nobuyuki Okamura
- 1Division of Pharmacology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.,3Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Ryuichi Harada
- 2Department of Pharmacology, Tohoku University School of Medicine, Sendai, Japan
| | - Aiko Ishiki
- 3Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Akio Kikuchi
- 4Department of Neurology, Tohoku University School of Medicine, Sendai, Japan
| | - Tadaho Nakamura
- 1Division of Pharmacology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Yukitsuka Kudo
- 3Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
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Molecular imaging in dementia: Past, present, and future. Alzheimers Dement 2018; 14:1522-1552. [DOI: 10.1016/j.jalz.2018.06.2855] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 06/02/2018] [Accepted: 06/03/2018] [Indexed: 12/14/2022]
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40
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Perez-Soriano A, Matarazzo M, Vafai N, Shahinfard E, Miao Q, Higuchi M, Sossi V, Stoessl AJ. PBB3 binding in a patient with corticobasal syndrome. Mov Disord 2018; 33:1359-1360. [PMID: 29932465 DOI: 10.1002/mds.27405] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 03/02/2018] [Accepted: 03/08/2018] [Indexed: 11/07/2022] Open
Affiliation(s)
- Alexandra Perez-Soriano
- Pacific Parkinson's Research Centre & Djavad Mowafaghian Centre for Brain Health, University of British Columbia and Vancouver Coastal Health, Vancouver, British Columbia, Canada
| | - Michele Matarazzo
- Pacific Parkinson's Research Centre & Djavad Mowafaghian Centre for Brain Health, University of British Columbia and Vancouver Coastal Health, Vancouver, British Columbia, Canada
| | - Nasim Vafai
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Elham Shahinfard
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Makoto Higuchi
- National Institute of Radiological Sciences and National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Vesna Sossi
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
| | - A Jon Stoessl
- Pacific Parkinson's Research Centre & Djavad Mowafaghian Centre for Brain Health, University of British Columbia and Vancouver Coastal Health, Vancouver, British Columbia, Canada
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Kasanuki K, Josephs KA, Ferman TJ, Murray ME, Koga S, Konno T, Sakae N, Parks A, Uitti RJ, Van Gerpen JA, Graff-Radford NR, Wszolek ZK, Dickson DW. Diffuse Lewy body disease manifesting as corticobasal syndrome: A rare form of Lewy body disease. Neurology 2018; 91:e268-e279. [PMID: 29898972 DOI: 10.1212/wnl.0000000000005828] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 04/13/2018] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE To describe clinical and pathologic characteristics of diffuse Lewy body disease (DLBD) manifesting as corticobasal syndrome (CBS). METHODS In 523 autopsy-confirmed cases of DLBD, we identified 11 patients diagnosed with CBS. For comparison, we studied 22 DLBD brains with antemortem presentation of dementia with Lewy bodies (DLB). Given previous studies suggesting the importance of pathology in peri-Rolandic cortices in CBS, we used digital pathology to count Lewy bodies and to quantify intracytoplasmic and neuritic α-synuclein and phospho-tau burden in the motor cortex. RESULTS DLBD patients with antemortem features of CBS were significantly younger at disease onset and less likely to have REM sleep behavior disorder than DLBD cases who met clinical criteria for DLB during life. Patients with DLBD manifesting as CBS had more Lewy bodies in the motor cortex than DLBD manifesting as clinically probable DLB. Three cases had concomitant progressive supranuclear palsy and 4 cases had concomitant Alzheimer disease as probable correlates of CBS. CONCLUSION The neuropathology underlying CBS is heterogeneous, including corticobasal degeneration, Alzheimer disease, and progressive supranuclear palsy. This study suggests that atypical variants of Lewy body disease with severe peri-Rolandic Lewy-related pathology can present clinically as CBS. Patients with DLBD who present as CBS tend to have an earlier age at onset and are less likely to have clinical features of DLB, such as dream enactment behavior during sleep, visual hallucinations, and levodopa-responsive parkinsonism. Future studies with biofluid or molecular imaging biomarkers for α-synuclein will permit better recognition of this uncommon pathologic substrate of CBS.
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Affiliation(s)
- Koji Kasanuki
- From the Departments of Neuroscience (K.K., M.E.M., S.K., N.S., J.A.V.G., D.W.D.), Psychiatry and Psychology (T.J.F., A.P.), and Neurology (T.K., R.J.U., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; and Behavioral Neurology (K.A.J.), Department of Neurology, Mayo Clinic, Rochester, MN
| | - Keith A Josephs
- From the Departments of Neuroscience (K.K., M.E.M., S.K., N.S., J.A.V.G., D.W.D.), Psychiatry and Psychology (T.J.F., A.P.), and Neurology (T.K., R.J.U., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; and Behavioral Neurology (K.A.J.), Department of Neurology, Mayo Clinic, Rochester, MN
| | - Tanis J Ferman
- From the Departments of Neuroscience (K.K., M.E.M., S.K., N.S., J.A.V.G., D.W.D.), Psychiatry and Psychology (T.J.F., A.P.), and Neurology (T.K., R.J.U., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; and Behavioral Neurology (K.A.J.), Department of Neurology, Mayo Clinic, Rochester, MN
| | - Melissa E Murray
- From the Departments of Neuroscience (K.K., M.E.M., S.K., N.S., J.A.V.G., D.W.D.), Psychiatry and Psychology (T.J.F., A.P.), and Neurology (T.K., R.J.U., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; and Behavioral Neurology (K.A.J.), Department of Neurology, Mayo Clinic, Rochester, MN
| | - Shunsuke Koga
- From the Departments of Neuroscience (K.K., M.E.M., S.K., N.S., J.A.V.G., D.W.D.), Psychiatry and Psychology (T.J.F., A.P.), and Neurology (T.K., R.J.U., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; and Behavioral Neurology (K.A.J.), Department of Neurology, Mayo Clinic, Rochester, MN
| | - Takuya Konno
- From the Departments of Neuroscience (K.K., M.E.M., S.K., N.S., J.A.V.G., D.W.D.), Psychiatry and Psychology (T.J.F., A.P.), and Neurology (T.K., R.J.U., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; and Behavioral Neurology (K.A.J.), Department of Neurology, Mayo Clinic, Rochester, MN
| | - Nobutaka Sakae
- From the Departments of Neuroscience (K.K., M.E.M., S.K., N.S., J.A.V.G., D.W.D.), Psychiatry and Psychology (T.J.F., A.P.), and Neurology (T.K., R.J.U., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; and Behavioral Neurology (K.A.J.), Department of Neurology, Mayo Clinic, Rochester, MN
| | - Adam Parks
- From the Departments of Neuroscience (K.K., M.E.M., S.K., N.S., J.A.V.G., D.W.D.), Psychiatry and Psychology (T.J.F., A.P.), and Neurology (T.K., R.J.U., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; and Behavioral Neurology (K.A.J.), Department of Neurology, Mayo Clinic, Rochester, MN
| | - Ryan J Uitti
- From the Departments of Neuroscience (K.K., M.E.M., S.K., N.S., J.A.V.G., D.W.D.), Psychiatry and Psychology (T.J.F., A.P.), and Neurology (T.K., R.J.U., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; and Behavioral Neurology (K.A.J.), Department of Neurology, Mayo Clinic, Rochester, MN
| | - Jay A Van Gerpen
- From the Departments of Neuroscience (K.K., M.E.M., S.K., N.S., J.A.V.G., D.W.D.), Psychiatry and Psychology (T.J.F., A.P.), and Neurology (T.K., R.J.U., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; and Behavioral Neurology (K.A.J.), Department of Neurology, Mayo Clinic, Rochester, MN
| | - Neill R Graff-Radford
- From the Departments of Neuroscience (K.K., M.E.M., S.K., N.S., J.A.V.G., D.W.D.), Psychiatry and Psychology (T.J.F., A.P.), and Neurology (T.K., R.J.U., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; and Behavioral Neurology (K.A.J.), Department of Neurology, Mayo Clinic, Rochester, MN
| | - Zbigniew K Wszolek
- From the Departments of Neuroscience (K.K., M.E.M., S.K., N.S., J.A.V.G., D.W.D.), Psychiatry and Psychology (T.J.F., A.P.), and Neurology (T.K., R.J.U., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; and Behavioral Neurology (K.A.J.), Department of Neurology, Mayo Clinic, Rochester, MN
| | - Dennis W Dickson
- From the Departments of Neuroscience (K.K., M.E.M., S.K., N.S., J.A.V.G., D.W.D.), Psychiatry and Psychology (T.J.F., A.P.), and Neurology (T.K., R.J.U., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; and Behavioral Neurology (K.A.J.), Department of Neurology, Mayo Clinic, Rochester, MN.
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Ali F, Whitwell JL, Martin PR, Senjem ML, Knopman DS, Jack CR, Lowe VJ, Petersen RC, Boeve BF, Josephs KA. [ 18F] AV-1451 uptake in corticobasal syndrome: the influence of beta-amyloid and clinical presentation. J Neurol 2018; 265:1079-1088. [PMID: 29497818 PMCID: PMC6095646 DOI: 10.1007/s00415-018-8815-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 02/09/2018] [Accepted: 02/26/2018] [Indexed: 12/12/2022]
Abstract
Corticobasal syndrome (CBS) is a phenotypic manifestation of diverse pathologies, including Alzheimer's disease and 4-repeat tauopathies. Predicting pathology in CBS is unreliable and, hence, molecular neuroimaging may prove to be useful. The aim of this study was to assess regional patterns of uptake on [18F] AV-1451 PET in CBS and determine whether patterns of uptake differ according to beta-amyloid deposition or differing clinical presentations. Fourteen patients meeting criteria for CBS underwent Pittsburgh Compound B (PiB) and [18F] AV-1451 PET. Seven patients presented as CBS and seven presented with apraxia of speech (AOS) and later evolved into CBS. A global PiB summary was calculated and used to classify patients as PiB (-) or PiB (+). AV-1451 uptake was calculated in fourteen regions-of-interest, with values divided by uptake in cerebellar crus grey matter to generate standard uptake value ratios. AV-1451 uptake was considered elevated if it fell above the 95th percentile from a group of 476 cognitively unimpaired normal controls. Six of the 14 CBS patients (43%) were PiB (+), with three of these patients showing strikingly elevated AV-1451 uptake across many cortical regions. Of the eight PiB (-) patients, only those with AOS showed elevated AV-1451 uptake in supplementary motor area and precentral cortex compared to controls. No region of elevated AV-1451 uptake were observed in PiB (-) typical CBS patients without AOS. These results suggest that regional [18F] AV-1451 is variable in CBS and depends on the presence of beta-amyloid as well as clinical presentation such as AOS. PiB (+) CBS does not necessarily reflect underlying Alzheimer's disease; however, the possibility some of these patients will evolve into Alzheimer's disease over time cannot be excluded.
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Affiliation(s)
- F Ali
- Department of Neurology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.
| | - J L Whitwell
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - P R Martin
- Department of Health Sciences Research (Biostatistics), Mayo Clinic, Rochester, MN, USA
| | - M L Senjem
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - D S Knopman
- Department of Neurology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
| | - C R Jack
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - V J Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - R C Petersen
- Department of Neurology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
| | - B F Boeve
- Department of Neurology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
| | - K A Josephs
- Department of Neurology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
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Day GS, Gordon BA, Perrin RJ, Cairns NJ, Beaumont H, Schwetye K, Ferguson C, Sinha N, Bucelli R, Musiek ES, Ghoshal N, Ponisio MR, Vincent B, Mishra S, Jackson K, Morris JC, Benzinger TLS, Ances BM. In vivo [ 18F]-AV-1451 tau-PET imaging in sporadic Creutzfeldt-Jakob disease. Neurology 2018; 90:e896-e906. [PMID: 29438042 DOI: 10.1212/wnl.0000000000005064] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Accepted: 12/05/2017] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine whether specific patterns of [18F]-AV-1451 tau-PET retention are observed in patients with autopsy-proven sporadic Creutzfeldt-Jakob disease (CJD). METHODS In vivo [18F]-AV-1451 PET neuroimaging was performed in 5 patients with sporadic CJD (median age, 66 years [63-74]), and results were compared to cognitively normal (CN) persons (n = 44; median age, 68 years [63-74]) and to participants with very mild Alzheimer disease (AD) dementia (n = 8; median age, 77 years [63-90]). Autopsy was completed in all patients with CJD, confirming the clinical diagnosis and permitting characterization of AD neuropathologic change (ADNC). RESULTS All patients with CJD presented with rapidly progressive dementia, typical magnetic resonance brain imaging changes, and elevated CSF total tau (median = 6,519; range = 1,528-13,240 pg/mL). Death occurred within 9 months of symptom onset, with a median 1 month (0.2-3.3) interval from [18F]-AV-1451 PET to autopsy. No unique pattern of [18F]-AV-1451 retention was observed on visual inspection. Summary standardized uptake value ratios in patients with CJD (1.17, 1.08-1.36) were indistinguishable from CN persons (1.14, 0.84-1.54; p = 0.6), and well below those of participants with AD (2.23, 1.60-3.04; p ≤ 0.01). [18F]-AV-1451 retention in patients with CJD and CN persons was similar in brain areas frequently affected in AD and CJD. Neuropathologic analysis confirmed the clinical diagnosis in all patients with CJD. Four patients with CJD also had low-level ADNC (A1B1C0); one patient had intermediate-level ADNC (A2B2C1/2). CONCLUSION Increased [18F]-AV-1451 retention was not observed in patients with rapidly progressive dementia due to sporadic CJD. The [18F]-AV-1451 PET tracer maintains good specificity for paired helical tau filaments associated with AD dementia.
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Affiliation(s)
- Gregory S Day
- From The Charles F. and Joanne Knight Alzheimer Disease Research Center (G.S.D., B.A.G., R.J.P., N.J.C., H.B., E.S.M., N.G., J.C.M., T.L.S.B., B.M.A.), Department of Neurology (G.S.D., R.B., E.S.M., N.G., J.C.M., B.M.A.), Mallinckrodt Institute of Radiology (B.A.G., H.B., M.R.P., B.V., S.M., K.J., T.L.S.B., B.M.A.), and Department of Pathology (R.J.P., N.J.C., K.S., C.F., N.S., J.C.M.), Washington University School of Medicine (G.S.D., B.A.G., R.J.P., N.J.C., H.B., K.S., C.F., N.S., R.B., E.S.M., N.G., M.R.P., B.V., S.M., K.J., J.C.M., T.L.S.B., B.M.A.), St. Louis, MO.
| | - Brian A Gordon
- From The Charles F. and Joanne Knight Alzheimer Disease Research Center (G.S.D., B.A.G., R.J.P., N.J.C., H.B., E.S.M., N.G., J.C.M., T.L.S.B., B.M.A.), Department of Neurology (G.S.D., R.B., E.S.M., N.G., J.C.M., B.M.A.), Mallinckrodt Institute of Radiology (B.A.G., H.B., M.R.P., B.V., S.M., K.J., T.L.S.B., B.M.A.), and Department of Pathology (R.J.P., N.J.C., K.S., C.F., N.S., J.C.M.), Washington University School of Medicine (G.S.D., B.A.G., R.J.P., N.J.C., H.B., K.S., C.F., N.S., R.B., E.S.M., N.G., M.R.P., B.V., S.M., K.J., J.C.M., T.L.S.B., B.M.A.), St. Louis, MO
| | - Richard J Perrin
- From The Charles F. and Joanne Knight Alzheimer Disease Research Center (G.S.D., B.A.G., R.J.P., N.J.C., H.B., E.S.M., N.G., J.C.M., T.L.S.B., B.M.A.), Department of Neurology (G.S.D., R.B., E.S.M., N.G., J.C.M., B.M.A.), Mallinckrodt Institute of Radiology (B.A.G., H.B., M.R.P., B.V., S.M., K.J., T.L.S.B., B.M.A.), and Department of Pathology (R.J.P., N.J.C., K.S., C.F., N.S., J.C.M.), Washington University School of Medicine (G.S.D., B.A.G., R.J.P., N.J.C., H.B., K.S., C.F., N.S., R.B., E.S.M., N.G., M.R.P., B.V., S.M., K.J., J.C.M., T.L.S.B., B.M.A.), St. Louis, MO
| | - Nigel J Cairns
- From The Charles F. and Joanne Knight Alzheimer Disease Research Center (G.S.D., B.A.G., R.J.P., N.J.C., H.B., E.S.M., N.G., J.C.M., T.L.S.B., B.M.A.), Department of Neurology (G.S.D., R.B., E.S.M., N.G., J.C.M., B.M.A.), Mallinckrodt Institute of Radiology (B.A.G., H.B., M.R.P., B.V., S.M., K.J., T.L.S.B., B.M.A.), and Department of Pathology (R.J.P., N.J.C., K.S., C.F., N.S., J.C.M.), Washington University School of Medicine (G.S.D., B.A.G., R.J.P., N.J.C., H.B., K.S., C.F., N.S., R.B., E.S.M., N.G., M.R.P., B.V., S.M., K.J., J.C.M., T.L.S.B., B.M.A.), St. Louis, MO
| | - Helen Beaumont
- From The Charles F. and Joanne Knight Alzheimer Disease Research Center (G.S.D., B.A.G., R.J.P., N.J.C., H.B., E.S.M., N.G., J.C.M., T.L.S.B., B.M.A.), Department of Neurology (G.S.D., R.B., E.S.M., N.G., J.C.M., B.M.A.), Mallinckrodt Institute of Radiology (B.A.G., H.B., M.R.P., B.V., S.M., K.J., T.L.S.B., B.M.A.), and Department of Pathology (R.J.P., N.J.C., K.S., C.F., N.S., J.C.M.), Washington University School of Medicine (G.S.D., B.A.G., R.J.P., N.J.C., H.B., K.S., C.F., N.S., R.B., E.S.M., N.G., M.R.P., B.V., S.M., K.J., J.C.M., T.L.S.B., B.M.A.), St. Louis, MO
| | - Katherine Schwetye
- From The Charles F. and Joanne Knight Alzheimer Disease Research Center (G.S.D., B.A.G., R.J.P., N.J.C., H.B., E.S.M., N.G., J.C.M., T.L.S.B., B.M.A.), Department of Neurology (G.S.D., R.B., E.S.M., N.G., J.C.M., B.M.A.), Mallinckrodt Institute of Radiology (B.A.G., H.B., M.R.P., B.V., S.M., K.J., T.L.S.B., B.M.A.), and Department of Pathology (R.J.P., N.J.C., K.S., C.F., N.S., J.C.M.), Washington University School of Medicine (G.S.D., B.A.G., R.J.P., N.J.C., H.B., K.S., C.F., N.S., R.B., E.S.M., N.G., M.R.P., B.V., S.M., K.J., J.C.M., T.L.S.B., B.M.A.), St. Louis, MO
| | - Cole Ferguson
- From The Charles F. and Joanne Knight Alzheimer Disease Research Center (G.S.D., B.A.G., R.J.P., N.J.C., H.B., E.S.M., N.G., J.C.M., T.L.S.B., B.M.A.), Department of Neurology (G.S.D., R.B., E.S.M., N.G., J.C.M., B.M.A.), Mallinckrodt Institute of Radiology (B.A.G., H.B., M.R.P., B.V., S.M., K.J., T.L.S.B., B.M.A.), and Department of Pathology (R.J.P., N.J.C., K.S., C.F., N.S., J.C.M.), Washington University School of Medicine (G.S.D., B.A.G., R.J.P., N.J.C., H.B., K.S., C.F., N.S., R.B., E.S.M., N.G., M.R.P., B.V., S.M., K.J., J.C.M., T.L.S.B., B.M.A.), St. Louis, MO
| | - Namita Sinha
- From The Charles F. and Joanne Knight Alzheimer Disease Research Center (G.S.D., B.A.G., R.J.P., N.J.C., H.B., E.S.M., N.G., J.C.M., T.L.S.B., B.M.A.), Department of Neurology (G.S.D., R.B., E.S.M., N.G., J.C.M., B.M.A.), Mallinckrodt Institute of Radiology (B.A.G., H.B., M.R.P., B.V., S.M., K.J., T.L.S.B., B.M.A.), and Department of Pathology (R.J.P., N.J.C., K.S., C.F., N.S., J.C.M.), Washington University School of Medicine (G.S.D., B.A.G., R.J.P., N.J.C., H.B., K.S., C.F., N.S., R.B., E.S.M., N.G., M.R.P., B.V., S.M., K.J., J.C.M., T.L.S.B., B.M.A.), St. Louis, MO
| | - Robert Bucelli
- From The Charles F. and Joanne Knight Alzheimer Disease Research Center (G.S.D., B.A.G., R.J.P., N.J.C., H.B., E.S.M., N.G., J.C.M., T.L.S.B., B.M.A.), Department of Neurology (G.S.D., R.B., E.S.M., N.G., J.C.M., B.M.A.), Mallinckrodt Institute of Radiology (B.A.G., H.B., M.R.P., B.V., S.M., K.J., T.L.S.B., B.M.A.), and Department of Pathology (R.J.P., N.J.C., K.S., C.F., N.S., J.C.M.), Washington University School of Medicine (G.S.D., B.A.G., R.J.P., N.J.C., H.B., K.S., C.F., N.S., R.B., E.S.M., N.G., M.R.P., B.V., S.M., K.J., J.C.M., T.L.S.B., B.M.A.), St. Louis, MO
| | - Erik S Musiek
- From The Charles F. and Joanne Knight Alzheimer Disease Research Center (G.S.D., B.A.G., R.J.P., N.J.C., H.B., E.S.M., N.G., J.C.M., T.L.S.B., B.M.A.), Department of Neurology (G.S.D., R.B., E.S.M., N.G., J.C.M., B.M.A.), Mallinckrodt Institute of Radiology (B.A.G., H.B., M.R.P., B.V., S.M., K.J., T.L.S.B., B.M.A.), and Department of Pathology (R.J.P., N.J.C., K.S., C.F., N.S., J.C.M.), Washington University School of Medicine (G.S.D., B.A.G., R.J.P., N.J.C., H.B., K.S., C.F., N.S., R.B., E.S.M., N.G., M.R.P., B.V., S.M., K.J., J.C.M., T.L.S.B., B.M.A.), St. Louis, MO
| | - Nupur Ghoshal
- From The Charles F. and Joanne Knight Alzheimer Disease Research Center (G.S.D., B.A.G., R.J.P., N.J.C., H.B., E.S.M., N.G., J.C.M., T.L.S.B., B.M.A.), Department of Neurology (G.S.D., R.B., E.S.M., N.G., J.C.M., B.M.A.), Mallinckrodt Institute of Radiology (B.A.G., H.B., M.R.P., B.V., S.M., K.J., T.L.S.B., B.M.A.), and Department of Pathology (R.J.P., N.J.C., K.S., C.F., N.S., J.C.M.), Washington University School of Medicine (G.S.D., B.A.G., R.J.P., N.J.C., H.B., K.S., C.F., N.S., R.B., E.S.M., N.G., M.R.P., B.V., S.M., K.J., J.C.M., T.L.S.B., B.M.A.), St. Louis, MO
| | - Maria R Ponisio
- From The Charles F. and Joanne Knight Alzheimer Disease Research Center (G.S.D., B.A.G., R.J.P., N.J.C., H.B., E.S.M., N.G., J.C.M., T.L.S.B., B.M.A.), Department of Neurology (G.S.D., R.B., E.S.M., N.G., J.C.M., B.M.A.), Mallinckrodt Institute of Radiology (B.A.G., H.B., M.R.P., B.V., S.M., K.J., T.L.S.B., B.M.A.), and Department of Pathology (R.J.P., N.J.C., K.S., C.F., N.S., J.C.M.), Washington University School of Medicine (G.S.D., B.A.G., R.J.P., N.J.C., H.B., K.S., C.F., N.S., R.B., E.S.M., N.G., M.R.P., B.V., S.M., K.J., J.C.M., T.L.S.B., B.M.A.), St. Louis, MO
| | - Benjamin Vincent
- From The Charles F. and Joanne Knight Alzheimer Disease Research Center (G.S.D., B.A.G., R.J.P., N.J.C., H.B., E.S.M., N.G., J.C.M., T.L.S.B., B.M.A.), Department of Neurology (G.S.D., R.B., E.S.M., N.G., J.C.M., B.M.A.), Mallinckrodt Institute of Radiology (B.A.G., H.B., M.R.P., B.V., S.M., K.J., T.L.S.B., B.M.A.), and Department of Pathology (R.J.P., N.J.C., K.S., C.F., N.S., J.C.M.), Washington University School of Medicine (G.S.D., B.A.G., R.J.P., N.J.C., H.B., K.S., C.F., N.S., R.B., E.S.M., N.G., M.R.P., B.V., S.M., K.J., J.C.M., T.L.S.B., B.M.A.), St. Louis, MO
| | - Shruti Mishra
- From The Charles F. and Joanne Knight Alzheimer Disease Research Center (G.S.D., B.A.G., R.J.P., N.J.C., H.B., E.S.M., N.G., J.C.M., T.L.S.B., B.M.A.), Department of Neurology (G.S.D., R.B., E.S.M., N.G., J.C.M., B.M.A.), Mallinckrodt Institute of Radiology (B.A.G., H.B., M.R.P., B.V., S.M., K.J., T.L.S.B., B.M.A.), and Department of Pathology (R.J.P., N.J.C., K.S., C.F., N.S., J.C.M.), Washington University School of Medicine (G.S.D., B.A.G., R.J.P., N.J.C., H.B., K.S., C.F., N.S., R.B., E.S.M., N.G., M.R.P., B.V., S.M., K.J., J.C.M., T.L.S.B., B.M.A.), St. Louis, MO
| | - Kelley Jackson
- From The Charles F. and Joanne Knight Alzheimer Disease Research Center (G.S.D., B.A.G., R.J.P., N.J.C., H.B., E.S.M., N.G., J.C.M., T.L.S.B., B.M.A.), Department of Neurology (G.S.D., R.B., E.S.M., N.G., J.C.M., B.M.A.), Mallinckrodt Institute of Radiology (B.A.G., H.B., M.R.P., B.V., S.M., K.J., T.L.S.B., B.M.A.), and Department of Pathology (R.J.P., N.J.C., K.S., C.F., N.S., J.C.M.), Washington University School of Medicine (G.S.D., B.A.G., R.J.P., N.J.C., H.B., K.S., C.F., N.S., R.B., E.S.M., N.G., M.R.P., B.V., S.M., K.J., J.C.M., T.L.S.B., B.M.A.), St. Louis, MO
| | - John C Morris
- From The Charles F. and Joanne Knight Alzheimer Disease Research Center (G.S.D., B.A.G., R.J.P., N.J.C., H.B., E.S.M., N.G., J.C.M., T.L.S.B., B.M.A.), Department of Neurology (G.S.D., R.B., E.S.M., N.G., J.C.M., B.M.A.), Mallinckrodt Institute of Radiology (B.A.G., H.B., M.R.P., B.V., S.M., K.J., T.L.S.B., B.M.A.), and Department of Pathology (R.J.P., N.J.C., K.S., C.F., N.S., J.C.M.), Washington University School of Medicine (G.S.D., B.A.G., R.J.P., N.J.C., H.B., K.S., C.F., N.S., R.B., E.S.M., N.G., M.R.P., B.V., S.M., K.J., J.C.M., T.L.S.B., B.M.A.), St. Louis, MO
| | - Tammie L S Benzinger
- From The Charles F. and Joanne Knight Alzheimer Disease Research Center (G.S.D., B.A.G., R.J.P., N.J.C., H.B., E.S.M., N.G., J.C.M., T.L.S.B., B.M.A.), Department of Neurology (G.S.D., R.B., E.S.M., N.G., J.C.M., B.M.A.), Mallinckrodt Institute of Radiology (B.A.G., H.B., M.R.P., B.V., S.M., K.J., T.L.S.B., B.M.A.), and Department of Pathology (R.J.P., N.J.C., K.S., C.F., N.S., J.C.M.), Washington University School of Medicine (G.S.D., B.A.G., R.J.P., N.J.C., H.B., K.S., C.F., N.S., R.B., E.S.M., N.G., M.R.P., B.V., S.M., K.J., J.C.M., T.L.S.B., B.M.A.), St. Louis, MO
| | - Beau M Ances
- From The Charles F. and Joanne Knight Alzheimer Disease Research Center (G.S.D., B.A.G., R.J.P., N.J.C., H.B., E.S.M., N.G., J.C.M., T.L.S.B., B.M.A.), Department of Neurology (G.S.D., R.B., E.S.M., N.G., J.C.M., B.M.A.), Mallinckrodt Institute of Radiology (B.A.G., H.B., M.R.P., B.V., S.M., K.J., T.L.S.B., B.M.A.), and Department of Pathology (R.J.P., N.J.C., K.S., C.F., N.S., J.C.M.), Washington University School of Medicine (G.S.D., B.A.G., R.J.P., N.J.C., H.B., K.S., C.F., N.S., R.B., E.S.M., N.G., M.R.P., B.V., S.M., K.J., J.C.M., T.L.S.B., B.M.A.), St. Louis, MO
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Lyoo CH, Cho H, Choi JY, Ryu YH, Lee MS. Tau Positron Emission Tomography Imaging in Degenerative Parkinsonisms. J Mov Disord 2018; 11:1-12. [PMID: 29381890 PMCID: PMC5790630 DOI: 10.14802/jmd.17071] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 11/20/2017] [Indexed: 01/08/2023] Open
Abstract
In recent years, several radiotracers that selectively bind to pathological tau proteins have been developed. Evidence is emerging that binding patterns of in vivo tau positron emission tomography (PET) studies in Alzheimer’s disease (AD) patients closely resemble the distribution patterns of known neurofibrillary tangle pathology, with the extent of tracer binding reflecting the clinical and pathological progression of AD. In Lewy body diseases (LBD), tau PET imaging has clearly revealed cortical tau burden with a distribution pattern distinct from AD and increased cortical binding within the LBD spectrum. In progressive supranuclear palsy, the globus pallidus and midbrain have shown increased binding most prominently. Tau PET patterns in patients with corticobasal syndrome are characterized by asymmetrical uptake in the motor cortex and underlying white matter, as well as in the basal ganglia. Even in the patients with multiple system atrophy, which is basically a synucleinopathy, 18F-flortaucipir, a widely used tau PET tracer, also binds to the atrophic posterior putamen, possibly due to off-target binding. These distinct patterns of tau-selective radiotracer binding in the various degenerative parkinsonisms suggest its utility as a potential imaging biomarker for the differential diagnosis of parkinsonisms.
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Affiliation(s)
- Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hanna Cho
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Yong Choi
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.,Division of RI-Convergence Research, Korea Institute Radiological and Medical Sciences, Seoul, Korea
| | - Young Hoon Ryu
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Myung Sik Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Tau-PET imaging with [18F]AV-1451 in primary progressive apraxia of speech. Cortex 2018; 99:358-374. [PMID: 29353121 DOI: 10.1016/j.cortex.2017.12.021] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 10/24/2017] [Accepted: 12/15/2017] [Indexed: 12/12/2022]
Abstract
Apraxia of speech is a motor speech disorder characterized by combinations of slow speaking rate, abnormal prosody, distorted sound substitutions, and trial-and-error articulatory movements. Apraxia of speech is due to abnormal planning and/or programming of speech production. It is referred to as primary progressive apraxia of speech (PPAOS) when it is the only symptom of a neurodegenerative condition. Past reports suggest an association of PPAOS with primary 4-repeat (4R) tau (e.g., progressive supranuclear palsy, corticobasal degeneration), rather than amyloid, pathology. The goal of the current study was to investigate the distribution of tau tracer uptake using [18F]AV-1451 positron emission tomography (PET) imaging in patients with PPAOS. Fourteen PPAOS patients underwent [18F]AV-1451 PET (tau-PET) imaging, [C11] Pittsburgh Compound B (PiB) PET and structural MRI and were matched 3:1 by age and sex to 42 cognitively normal controls. Tau-PET uptake was assessed at the region-of-interest (ROI) level and at the voxel-level. The PPAOS group (n = 14) showed increased tau-PET uptake in the precentral gyrus, supplementary motor area and Broca's area compared to controls. To examine whether tau deposition in Broca's area was related to the presence of aphasia, we examined a subgroup of the PPAOS patients who had predominant apraxia of speech, with concomitant aphasia (PPAOSa; n = 7). The PPAOSa patients showed tau-PET uptake in the same regions as the whole group. However, the remaining seven patients who did not have aphasia showed uptake only in superior premotor and precentral cortices, with no uptake observed in Broca's area. This cross-sectional study demonstrates that elevated tau tracer uptake is observed using [18F]AV-1451 in PPAOS. Further, it appears that [18F]AV-1451 is sensitive to the regional distribution of tau deposition in different stages of PPAOS, given the relationship between tau signal in Broca's area and the presence of aphasia.
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Xu Z, Arbizu J, Pavese N. PET Molecular Imaging in Atypical Parkinsonism. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 142:3-36. [DOI: 10.1016/bs.irn.2018.09.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Abstract
Background Positron emission tomography ligands are now available that bind to tau proteins in the brain, providing the exciting opportunity to assess the presence and distribution of tau in vivo in living patients. Methods This manuscript performed a systematic review of studies that have performed tau PET imaging in patients with parkinsonian disorders. Pubmed was searched up to November 2017, and the review included case reports and patient-control studies. Results Most tau-PET studies have utilized the [18F]AV-1451 ligand, with a few using the [11C]PBB3 and [18F]THK-5351 ligands. Elevated cortical tau-PET uptake has been observed in Parkinson's disease dementia and dementia with Lewy bodies, presumed to be related to Alzheimer's disease-related pathology. Mild patterns of tau-PET uptake have been observed in subcortical structures in progressive supranuclear palsy and subcortical structures and motor cortex in corticobasal syndrome, although discrepancy with autoradiographic studies that show lack of binding to 4-repeat tau and "off-target" binding observed in subcortical structures limits interpretation of these findings. Findings in frontotemporal dementia with tau mutations are variable, but elevated signal is most pronounced in mutations with deposition of both 3 and 4-repeat tau. Elevated tau-PET uptake has also been observed in multiple system atrophy, a synucleinopathy. Conclusion The value of the current generation of tau-PET ligands varies across Parkinsonian syndromes depending upon underlying variability in tau pathology and "off-target" binding. More work is needed to understand the biological basis of binding and more specific tau PET ligands are needed to study parkinsonian disorders.
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Ali F, Josephs KA. Corticobasal degeneration: key emerging issues. J Neurol 2017; 265:439-445. [PMID: 29063240 DOI: 10.1007/s00415-017-8644-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 10/08/2017] [Accepted: 10/09/2017] [Indexed: 12/26/2022]
Abstract
Corticobasal degeneration (CBD) was first described by Rebeiz et al. in 1967, and was called corticodentatonigral degeneration with neuronal achromasia [1]. Since then, our knowledge of the clinical features and underlying tau pathology has grown tremendously. Clinical antemortem diagnosis of CBD pathology remains challenging and has led to the development of revised diagnostic criteria. As various clinical phenotypes may have CBD pathology, accurate prevalence studies are lacking. Recently, pooled prevalence of fronto-temporal lobar degeneration, PSP and CBS was reported as 10.6 per 100,000 [2]. Although rare, CBD is an important disease to understand because it provides a model of a specific proteinopathy (tauopathy) and, therefore, opportunity to study pathophysiology of tauopathies and efficacy of tau-directed therapies. In the past few years, identification of tau specific ligands has advanced neuroimaging of tauopathies such as CBD and progressive supranuclear palsy. However, clinical prediction of CBD pathology remains challenging and an active are of research. In this review, we highlight key emerging issues in CBD pathophysiology, genetics and novel neuroimaging techniques with tau ligands.
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Affiliation(s)
- F Ali
- Department of Neurology, Mayo Clinic, Rochester, MN, USA.
| | - K A Josephs
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
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Marquié M, Verwer EE, Meltzer AC, Kim SJW, Agüero C, Gonzalez J, Makaretz SJ, Siao Tick Chong M, Ramanan P, Amaral AC, Normandin MD, Vanderburg CR, Gomperts SN, Johnson KA, Frosch MP, Gómez-Isla T. Lessons learned about [F-18]-AV-1451 off-target binding from an autopsy-confirmed Parkinson's case. Acta Neuropathol Commun 2017; 5:75. [PMID: 29047416 PMCID: PMC5648451 DOI: 10.1186/s40478-017-0482-0] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 10/11/2017] [Indexed: 02/07/2023] Open
Abstract
[F-18]-AV-1451 is a novel positron emission tomography (PET) tracer with high affinity to neurofibrillary tau pathology in Alzheimer’s disease (AD). PET studies have shown increased tracer retention in patients clinically diagnosed with dementia of AD type and mild cognitive impairment in regions that are known to contain tau lesions. In vivo uptake has also consistently been observed in midbrain, basal ganglia and choroid plexus in elderly individuals regardless of their clinical diagnosis, including clinically normal whose brains are not expected to harbor tau pathology in those areas. We and others have shown that [F-18]-AV-1451 exhibits off-target binding to neuromelanin, melanin and blood products on postmortem material; and this is important for the correct interpretation of PET images. In the present study, we further investigated [F-18]-AV-1451 off-target binding in the first autopsy-confirmed Parkinson’s disease (PD) subject who underwent antemortem PET imaging. The PET scan showed elevated [F-18]-AV-1451 retention predominantly in inferior temporal cortex, basal ganglia, midbrain and choroid plexus. Neuropathologic examination confirmed the PD diagnosis. Phosphor screen and high resolution autoradiography failed to show detectable [F-18]-AV-1451 binding in multiple brain regions examined with the exception of neuromelanin-containing neurons in the substantia nigra, leptomeningeal melanocytes adjacent to ventricles and midbrain, and microhemorrhages in the occipital cortex (all reflecting off-target binding), in addition to incidental age-related neurofibrillary tangles in the entorhinal cortex. Additional legacy postmortem brain samples containing basal ganglia, choroid plexus, and parenchymal hemorrhages from 20 subjects with various neuropathologic diagnoses were also included in the autoradiography experiments to better understand what [F-18]-AV-1451 in vivo positivity in those regions means. No detectable [F-18]-AV-1451 autoradiographic binding was present in the basal ganglia of the PD case or any of the other subjects. Off-target binding in postmortem choroid plexus samples was only observed in subjects harboring leptomeningeal melanocytes within the choroidal stroma. Off-target binding to parenchymal hemorrhages was noticed in postmortem material from subjects with cerebral amyloid angiopathy. The imaging-postmortem correlation analysis in this PD case reinforces the notion that [F-18]-AV-1451 has strong affinity for neurofibrillary tau pathology but also exhibits off-target binding to neuromelanin, melanin and blood components. The robust off-target in vivo retention in basal ganglia and choroid plexus, in the absence of tau deposits, meningeal melanocytes or any other identifiable binding substrate by autoradiography in the PD case reported here, also suggests that the PET signal in those regions may be influenced, at least in part, by biological or technical factors that occur in vivo and are not captured by autoradiography.
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