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Holy EN, Li E, Bhattarai A, Fletcher E, Alfaro ER, Harvey DJ, Spencer BA, Cherry SR, DeCarli CS, Fan AP. Non-invasive quantification of 18F-florbetaben with total-body EXPLORER PET. EJNMMI Res 2024; 14:39. [PMID: 38625413 PMCID: PMC11021392 DOI: 10.1186/s13550-024-01104-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/02/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Kinetic modeling of 18F-florbetaben provides important quantification of brain amyloid deposition in research and clinical settings but its use is limited by the requirement of arterial blood data for quantitative PET. The total-body EXPLORER PET scanner supports the dynamic acquisition of a full human body simultaneously and permits noninvasive image-derived input functions (IDIFs) as an alternative to arterial blood sampling. This study quantified brain amyloid burden with kinetic modeling, leveraging dynamic 18F-florbetaben PET in aorta IDIFs and the brain in an elderly cohort. METHODS 18F-florbetaben dynamic PET imaging was performed on the EXPLORER system with tracer injection (300 MBq) in 3 individuals with Alzheimer's disease (AD), 3 with mild cognitive impairment, and 9 healthy controls. Image-derived input functions were extracted from the descending aorta with manual regions of interest based on the first 30 s after injection. Dynamic time-activity curves (TACs) for 110 min were fitted to the two-tissue compartment model (2TCM) using population-based metabolite corrected IDIFs to calculate total and specific distribution volumes (VT, Vs) in key brain regions with early amyloid accumulation. Non-displaceable binding potential ([Formula: see text] was also calculated from the multi-reference tissue model (MRTM). RESULTS Amyloid-positive (AD) patients showed the highest VT and VS in anterior cingulate, posterior cingulate, and precuneus, consistent with [Formula: see text] analysis. [Formula: see text]and VT from kinetic models were correlated (r² = 0.46, P < 2[Formula: see text] with a stronger positive correlation observed in amyloid-positive participants, indicating reliable model fits with the IDIFs. VT from 2TCM was highly correlated ([Formula: see text]= 0.65, P < 2[Formula: see text]) with Logan graphical VT estimation. CONCLUSION Non-invasive quantification of amyloid binding from total-body 18F-florbetaben PET data is feasible using aorta IDIFs with high agreement between kinetic distribution volume parameters compared to [Formula: see text]in amyloid-positive and amyloid-negative older individuals.
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Affiliation(s)
- Emily Nicole Holy
- Department of Neurology, University of California (UC) Davis Health, 1590 Drew Avenue, Davis, CA, 95618, USA.
- Department of Biomedical Engineering, UC Davis, Davis, USA.
| | - Elizabeth Li
- Department of Biomedical Engineering, UC Davis, Davis, USA
| | - Anjan Bhattarai
- Department of Neurology, University of California (UC) Davis Health, 1590 Drew Avenue, Davis, CA, 95618, USA
- Department of Biomedical Engineering, UC Davis, Davis, USA
| | - Evan Fletcher
- Department of Neurology, University of California (UC) Davis Health, 1590 Drew Avenue, Davis, CA, 95618, USA
| | - Evelyn R Alfaro
- Department of Neurology, University of California (UC) Davis Health, 1590 Drew Avenue, Davis, CA, 95618, USA
| | | | - Benjamin A Spencer
- Department of Biomedical Engineering, UC Davis, Davis, USA
- Department of Radiology, UC Davis Health, Davis, USA
| | - Simon R Cherry
- Department of Biomedical Engineering, UC Davis, Davis, USA
- Department of Radiology, UC Davis Health, Davis, USA
| | - Charles S DeCarli
- Department of Neurology, University of California (UC) Davis Health, 1590 Drew Avenue, Davis, CA, 95618, USA
| | - Audrey P Fan
- Department of Neurology, University of California (UC) Davis Health, 1590 Drew Avenue, Davis, CA, 95618, USA
- Department of Biomedical Engineering, UC Davis, Davis, USA
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Shirzadi Z, Boyle R, Yau WYW, Coughlan G, Fu JF, Properzi MJ, Buckley RF, Yang HS, Scanlon CE, Hsieh S, Amariglio RE, Papp K, Rentz D, Price JC, Johnson KA, Sperling RA, Chhatwal JP, Schultz AP. Vascular contributions to cognitive decline: Beyond amyloid and tau in the Harvard aging brain study. J Cereb Blood Flow Metab 2024:271678X241237624. [PMID: 38452039 DOI: 10.1177/0271678x241237624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
In addition to amyloid and tau pathology, elevated systemic vascular risk, white matter injury, and reduced cerebral blood flow contribute to late-life cognitive decline. Given the strong collinearity among these parameters, we proposed a framework to extract the independent latent features underlying cognitive decline using the Harvard Aging Brain Study (N = 166 cognitively unimpaired older adults at baseline). We used the following measures from the baseline visit: cortical amyloid, inferior temporal cortex tau, relative cerebral blood flow, white matter hyperintensities, peak width of skeletonized mean diffusivity, and Framingham Heart Study cardiovascular disease risk. We used exploratory factor analysis to extract orthogonal factors from these variables and their interactions. These factors were used in a regression model to explain longitudinal Preclinical Alzheimer Cognitive Composite-5 (PACC) decline (follow-up = 8.5 ±2.7 years). We next examined whether gray matter volume atrophy acts as a mediator of factors and PACC decline. Latent factors of systemic vascular risk, white matter injury, and relative cerebral blood flow independently explain cognitive decline beyond amyloid and tau. Gray matter volume atrophy mediates these associations with the strongest effect on white matter injury. These results suggest that systemic vascular risk contributes to cognitive decline beyond current markers of cerebrovascular injury, amyloid, and tau.
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Affiliation(s)
- Zahra Shirzadi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Rory Boyle
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Wai-Ying W Yau
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Gillian Coughlan
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jessie Fanglu Fu
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael J Properzi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Rachel F Buckley
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Hyun-Sik Yang
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Catherine E Scanlon
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Stephanie Hsieh
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Rebecca E Amariglio
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kathryn Papp
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Dorene Rentz
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Julie C Price
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Keith A Johnson
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Reisa A Sperling
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jasmeer P Chhatwal
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Aaron P Schultz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Jiang C, Li S, Wang Y, Lai Y, Bai Y, Zhao M, He L, Kong Y, Guo X, Li S, Liu N, Jiang C, Tang R, Sang C, Long D, Du X, Dong J, Anderson CS, Ma C. Diastolic Blood Pressure and Intensive Blood Pressure Control on Cognitive Outcomes: Insights From the SPRINT MIND Trial. Hypertension 2023; 80:580-589. [PMID: 36688305 DOI: 10.1161/hypertensionaha.122.20112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND The potential benefits or harms of intensive systolic blood pressure (BP) control on cognitive function and cerebral blood flow in individuals with low diastolic blood pressure (DBP) remain unclear. METHODS We conducted a post hoc analysis of the SPRINT MIND (Systolic Blood Pressure Intervention Trial Memory and Cognition in Decreased Hypertension) that randomly assigned hypertensive participants to an intensive (<120 mm Hg; n=4278) or standard (<140 mm Hg; n=4385) systolic blood pressure target. We evaluated the effects of BP intervention on cognitive outcomes and cerebral blood flow across baseline DBP quartiles. RESULTS Participants in the intensive group had a lower incidence rate of probable dementia or mild cognitive impairment than those in the standard group, regardless of DBP quartiles. The hazard ratio of intensive versus standard target for probable dementia or mild cognitive impairment was 0.91 (95% CI, 0.73-1.12) in the lowest DBP quartile and 0.70 (95% CI, 0.48-1.02) in the highest DBP quartile, respectively, with an interaction P value of 0.24. Similar results were found for probable dementia (interaction P=0.06) and mild cognitive impairment (interaction P=0.80). The effect of intensive treatment on cerebral blood flow was not modified by baseline DBP either (interaction P=0.25). Even among participants within the lowest DBP quartile, intensive versus standard BP treatment resulted in an increasing trend of annualized change in cerebral blood flow (+0.26 [95% CI, -0.72 to 1.24] mL/[100 g·min]). CONCLUSIONS Intensive BP control did not appear to have a detrimental effect on cognitive outcomes and cerebral perfusion in patients with low baseline DBP. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT01206062.
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Affiliation(s)
- Chao Jiang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China (C.J., S.L., Y.W., Y.L., M.Z., L.H., Y.K., X.G., S.L., N.L., C.J., R.T., C.S., D.L., X.D., J.D., C.M.)
| | - Sitong Li
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China (C.J., S.L., Y.W., Y.L., M.Z., L.H., Y.K., X.G., S.L., N.L., C.J., R.T., C.S., D.L., X.D., J.D., C.M.)
| | - Yufeng Wang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China (C.J., S.L., Y.W., Y.L., M.Z., L.H., Y.K., X.G., S.L., N.L., C.J., R.T., C.S., D.L., X.D., J.D., C.M.)
| | - Yiwei Lai
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China (C.J., S.L., Y.W., Y.L., M.Z., L.H., Y.K., X.G., S.L., N.L., C.J., R.T., C.S., D.L., X.D., J.D., C.M.)
| | - Yu Bai
- DSchool of Clinical Medicine, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China (Y.B.)
| | - Manlin Zhao
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China (C.J., S.L., Y.W., Y.L., M.Z., L.H., Y.K., X.G., S.L., N.L., C.J., R.T., C.S., D.L., X.D., J.D., C.M.)
| | - Liu He
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China (C.J., S.L., Y.W., Y.L., M.Z., L.H., Y.K., X.G., S.L., N.L., C.J., R.T., C.S., D.L., X.D., J.D., C.M.)
| | - Yu Kong
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China (C.J., S.L., Y.W., Y.L., M.Z., L.H., Y.K., X.G., S.L., N.L., C.J., R.T., C.S., D.L., X.D., J.D., C.M.)
| | - Xueyuan Guo
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China (C.J., S.L., Y.W., Y.L., M.Z., L.H., Y.K., X.G., S.L., N.L., C.J., R.T., C.S., D.L., X.D., J.D., C.M.)
| | - Songnan Li
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China (C.J., S.L., Y.W., Y.L., M.Z., L.H., Y.K., X.G., S.L., N.L., C.J., R.T., C.S., D.L., X.D., J.D., C.M.)
| | - Nian Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China (C.J., S.L., Y.W., Y.L., M.Z., L.H., Y.K., X.G., S.L., N.L., C.J., R.T., C.S., D.L., X.D., J.D., C.M.)
| | - Chenxi Jiang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China (C.J., S.L., Y.W., Y.L., M.Z., L.H., Y.K., X.G., S.L., N.L., C.J., R.T., C.S., D.L., X.D., J.D., C.M.)
| | - Ribo Tang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China (C.J., S.L., Y.W., Y.L., M.Z., L.H., Y.K., X.G., S.L., N.L., C.J., R.T., C.S., D.L., X.D., J.D., C.M.)
| | - Caihua Sang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China (C.J., S.L., Y.W., Y.L., M.Z., L.H., Y.K., X.G., S.L., N.L., C.J., R.T., C.S., D.L., X.D., J.D., C.M.)
| | - Deyong Long
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China (C.J., S.L., Y.W., Y.L., M.Z., L.H., Y.K., X.G., S.L., N.L., C.J., R.T., C.S., D.L., X.D., J.D., C.M.)
| | - Xin Du
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China (C.J., S.L., Y.W., Y.L., M.Z., L.H., Y.K., X.G., S.L., N.L., C.J., R.T., C.S., D.L., X.D., J.D., C.M.).,DHeart Health Research Center, Beijing, China (X.D., C.S.A.)
| | - Jianzeng Dong
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China (C.J., S.L., Y.W., Y.L., M.Z., L.H., Y.K., X.G., S.L., N.L., C.J., R.T., C.S., D.L., X.D., J.D., C.M.).,DDepartment of Cardiology, The First Affiliated Hospital of Zhengzhou University, Henan Province, China (J.D.)
| | - Craig S Anderson
- DHeart Health Research Center, Beijing, China (X.D., C.S.A.).,DDepartment of Neurology, Royal Prince Alfred Hospital, University of Sydney, Australia (C.S.A.).,DFaculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, Australia (C.S.A.)
| | - Changsheng Ma
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China (C.J., S.L., Y.W., Y.L., M.Z., L.H., Y.K., X.G., S.L., N.L., C.J., R.T., C.S., D.L., X.D., J.D., C.M.)
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