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Ferschmann C, Messerschmidt K, Gnörich J, Barthel H, Marek K, Palleis C, Katzdobler S, Stockbauer A, Fietzek U, Finze A, Biechele G, Rumpf JJ, Saur D, Schroeter ML, Rullmann M, Beyer L, Eckenweber F, Wall S, Schildan A, Patt M, Stephens A, Classen J, Bartenstein P, Seibyl J, Franzmeier N, Levin J, Höglinger GU, Sabri O, Brendel M, Scheifele M. Tau accumulation is associated with dopamine deficiency in vivo in four-repeat tauopathies. Eur J Nucl Med Mol Imaging 2024:10.1007/s00259-024-06637-6. [PMID: 38366196 DOI: 10.1007/s00259-024-06637-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 02/04/2024] [Indexed: 02/18/2024]
Abstract
PURPOSE We hypothesized that severe tau burden in brain regions involved in direct or indirect pathways of the basal ganglia correlate with more severe striatal dopamine deficiency in four-repeat (4R) tauopathies. Therefore, we correlated [18F]PI-2620 tau-positron-emission-tomography (PET) imaging with [123I]-Ioflupane single-photon-emission-computed tomography (SPECT) for dopamine transporter (DaT) availability. METHODS Thirty-eight patients with clinically diagnosed 4R-tauopathies (21 male; 69.0 ± 8.5 years) and 15 patients with clinically diagnosed α-synucleinopathies (8 male; 66.1 ± 10.3 years) who underwent [18F]PI-2620 tau-PET and DaT-SPECT imaging with a time gap of 3 ± 5 months were evaluated. Regional Tau-PET signals and DaT availability as well as their principal components were correlated in patients with 4R-tauopathies and α-synucleinopathies. Both biomarkers and the residuals of their association were correlated with clinical severity scores in 4R-tauopathies. RESULTS In patients with 4R-tauopathies, [18F]PI-2620 binding in basal ganglia and midbrain regions was negatively associated with striatal DaT availability (i.e. globus pallidus internus and putamen (β = - 0.464, p = 0.006, Durbin-Watson statistics = 1.824) in a multiple regression model. Contrarily, [18F]PI-2620 binding in the dentate nucleus showed no significant regression factor with DaT availability in the striatum (β = 0.078, p = 0.662, Durbin-Watson statistics = 1.686). Patients with α-synucleinopathies did not indicate any regional associations between [18F]PI-2620-binding and DaT availability. Higher DaT-SPECT binding relative to tau burden was associated with better clinical performance (β = - 0.522, p = 0.011, Durbin-Watson statistics = 2.663) in patients with 4R-tauopathies. CONCLUSION Tau burden in brain regions involved in dopaminergic pathways is associated with aggravated dopaminergic dysfunction in patients with clinically diagnosed primary tauopathies. The ability to sustain dopamine transmission despite tau accumulation may preserve motor function.
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Affiliation(s)
- Christian Ferschmann
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | | | - Johannes Gnörich
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Henryk Barthel
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Ken Marek
- InviCRO, LLC, Boston, MA, USA
- Molecular Neuroimaging, A Division of inviCRO, New Haven, CT, USA
| | - Carla Palleis
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Sabrina Katzdobler
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Anna Stockbauer
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Urban Fietzek
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Anika Finze
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Gloria Biechele
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Jost-Julian Rumpf
- Department of Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Dorothee Saur
- Department of Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Matthias L Schroeter
- Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Michael Rullmann
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Leonie Beyer
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Florian Eckenweber
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Stephan Wall
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Andreas Schildan
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Marianne Patt
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | | | - Joseph Classen
- Department of Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - John Seibyl
- InviCRO, LLC, Boston, MA, USA
- Molecular Neuroimaging, A Division of inviCRO, New Haven, CT, USA
| | - Nicolai Franzmeier
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Institute for Stroke and Dementia Research, LMU University Hospital, LMU Munich, Munich, Germany
| | - Johannes Levin
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Günter U Höglinger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Maximilian Scheifele
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany.
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Schönecker S, Palleis C, Franzmeier N, Katzdobler S, Ferschmann C, Schuster S, Finze A, Scheifele M, Prix C, Fietzek U, Weidinger E, Nübling G, Vöglein J, Patt M, Barthel H, Sabri O, Danek A, Höglinger GU, Brendel M, Levin J. Symptomatology in 4-repeat tauopathies is associated with data-driven topology of [ 18F]-PI-2620 tau-PET signal. Neuroimage Clin 2023; 38:103402. [PMID: 37087820 PMCID: PMC10300609 DOI: 10.1016/j.nicl.2023.103402] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 03/05/2023] [Accepted: 04/08/2023] [Indexed: 04/25/2023]
Abstract
In recent years in vivo visualization of tau deposits has become possible with various PET radiotracers. The tau tracer [18F]PI-2620 proved high affinity both to 3-repeat/4-repeat tau in Alzheimer's disease as well as to 4-repeat tau in progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS). However, to be clinically relevant, biomarkers should not only correlate with pathological changes but also with disease stage and progression. Therefore, we aimed to investigate the correlation between topology of [18F]PI-2620 uptake and symptomatology in 4-repeat tauopathies. 72 patients with possible or probable 4-repeat tauopathy, i.e. 31 patients with PSP-Richardson's syndrome (PSP-RS), 30 with amyloid-negative CBS and 11 with PSP-non-RS/CBS, underwent [18F]PI-2620-PET. Principal component analysis was performed to identify groups of similar brain regions based on 20-40 min p.i. regional standardized uptake value ratio z-scores. Correlations between component scores and the items of the PSP Rating Scale were explored. Motor signs like gait, arising from chair and postural instability showed a positive correlation with tracer uptake in mesial frontoparietal lobes and the medial superior frontal gyrus and adjacent anterior cingulate cortex. While the signs disorientation and bradyphrenia showed a positive correlation with tracer uptake in the parietooccipital junction, the signs disorientation and arising from chair were negatively correlated with tau-PET signal in the caudate nucleus and thalamus. Total PSP Rating Scale Score showed a trend towards a positive correlation with mesial frontoparietal lobes and a negative correlation with caudate nucleus and thalamus. While in CBS patients, the main finding was a negative correlation of tracer binding in the caudate nucleus and thalamus and a positive correlation of tracer binding in medial frontal cortex with gait and motor signs, in PSP-RS patients various correlations of clinical signs with tracer binding in specific cerebral regions could be detected. Our data reveal [18F]PI-2620 tau-PET topology to correlate with symptomatology in 4-repeat tauopathies. Longitudinal studies will be needed to address whether a deterioration of signs and symptoms over time can be monitored by [18F]PI-2620 in 4-repeat tauopathies and whether [18F]PI-2620 may serve as a marker of disease progression in future therapeutic trials. The detected negative correlation of tracer binding in the caudate nucleus and thalamus with the signs disorientation and arising from chair may be due to an increasing atrophy in these regions leading to partial volume effects and a relative decrease of tracer uptake in the disease course. As cerebral regions correlating with symptomatology differ depending on the clinical phenotype, a precise knowledge of clinical signs and symptoms is necessary when interpreting [18F]PI-2620 PET results.
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Affiliation(s)
- Sonja Schönecker
- Department of Neurology, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany
| | - Carla Palleis
- Department of Neurology, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Nicolai Franzmeier
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany; Institute for Stroke and Dementia Research, Ludwig-Maximilians-Universität München, LMU München, Munich, Germany
| | - Sabrina Katzdobler
- Department of Neurology, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Christian Ferschmann
- Department of Nuclear Medicine, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany
| | - Sebastian Schuster
- Department of Nuclear Medicine, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany
| | - Anika Finze
- Department of Nuclear Medicine, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany
| | - Maximilian Scheifele
- Department of Nuclear Medicine, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany
| | - Catharina Prix
- Department of Neurology, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany
| | - Urban Fietzek
- Department of Neurology, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Department of Neurology and Clinical Neurophysiology, Schön Klinik München Schwabing, Munich, Germany
| | - Endy Weidinger
- Department of Neurology, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Georg Nübling
- Department of Neurology, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany
| | - Jonathan Vöglein
- Department of Neurology, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Marianne Patt
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Henryk Barthel
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Adrian Danek
- Department of Neurology, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany
| | - Günter U Höglinger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany; European Reference Network for Rare Neurological Diseases (ERN-RND), Munich, Germany; Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Matthias Brendel
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany; Department of Nuclear Medicine, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany
| | - Johannes Levin
- Department of Neurology, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany; European Reference Network for Rare Neurological Diseases (ERN-RND), Munich, Germany.
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Völter F, Beyer L, Eckenweber F, Scheifele M, Bui N, Patt M, Barthel H, Katzdobler S, Palleis C, Franzmeier N, Levin J, Perneczky R, Rauchmann BS, Sabri O, Hong J, Cumming P, Rominger A, Shi K, Bartenstein P, Brendel M. Assessment of perfusion deficit with early phases of [ 18F]PI-2620 tau-PET versus [ 18F]flutemetamol-amyloid-PET recordings. Eur J Nucl Med Mol Imaging 2023; 50:1384-1394. [PMID: 36572740 PMCID: PMC10027797 DOI: 10.1007/s00259-022-06087-y] [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: 08/24/2022] [Accepted: 12/11/2022] [Indexed: 12/28/2022]
Abstract
PURPOSE Characteristic features of amyloid-PET (A), tau-PET (T), and FDG-PET (N) can serve for the A/T/N classification of neurodegenerative diseases. Recent studies showed that the early, perfusion-weighted phases of amyloid- or tau-PET recordings serve to detect cerebrometabolic deficits equally to FDG-PET, therefore providing a surrogate of neuronal injury. As such, two channels of diagnostic information can be obtained in the setting of a single PET scan. However, there has hitherto been no comparison of early-phase amyloid- and tau-PET as surrogates for deficits in perfusion/metabolism. Therefore, we undertook to compare [18F]flutemetamol-amyloid-PET and [18F]PI-2620 tau-PET as "one-stop shop" dual purpose tracers for the detection of neurodegenerative disease. METHODS We obtained early-phase PET recordings with [18F]PI-2620 (0.5-2.5 min p.i.) and [18F]flutemetamol (0-10 min p.i.) in 64 patients with suspected neurodegenerative disease. We contrasted global mean normalized images (SUVr) in the patients with a normal cohort of 15 volunteers without evidence of increased pathology to β-amyloid- and tau-PET examinations. Regional group differences of tracer uptake (z-scores) of 246 Brainnetome volumes of interest were calculated for both tracers, and the correlations of the z-scores were evaluated using Pearson's correlation coefficient. Lobar compartments, regions with significant neuronal injury (z-scores < - 3), and patients with different neurodegenerative disease entities (e.g., Alzheimer's disease or 4R-tauopathies) served for subgroup analysis. Additionally, we used partial regression to correlate regional perfusion alterations with clinical scores in cognition tests. RESULTS The z-scores of perfusion-weighted images of both tracers showed high correlations across the brain, especially in the frontal and parietal lobes, which were the brain regions with pronounced perfusion deficit in the patient group (R = 0.83 ± 0.08; range, 0.61-0.95). Z-scores of individual patients correlated well by region (R = 0.57 ± 0.15; range, 0.16-0.90), notably when significant perfusion deficits were present (R = 0.66 ± 0.15; range, 0.28-0.90). CONCLUSION The early perfusion phases of [18F]PI-2620 tau- and [18F]flutemetamol-amyloid-PET are roughly equivalent indices of perfusion defect indicative of regional and lobar neuronal injury in patients with various neurodegenerative diseases. As such, either tracer may serve for two diagnostic channels by assessment of amyloid/tau status and neuronal activity.
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Affiliation(s)
- Friederike Völter
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Leonie Beyer
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Florian Eckenweber
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Maximilian Scheifele
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Ngoc Bui
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Marianne Patt
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Henryk Barthel
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Sabrina Katzdobler
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Carla Palleis
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | | | - Johannes Levin
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Robert Perneczky
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, London, UK
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, UK
| | | | - Osama Sabri
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Jimin Hong
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Paul Cumming
- Department of Nuclear Medicine, Bern University Hospital, Bern, Switzerland
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
| | - Axel Rominger
- Department of Nuclear Medicine, Bern University Hospital, Bern, Switzerland
| | - Kuangyu Shi
- Department of Nuclear Medicine, Bern University Hospital, Bern, Switzerland
| | - Peter Bartenstein
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany.
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
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4
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Ballweg A, Klaus C, Vogler L, Katzdobler S, Wind K, Zatcepin A, Ziegler SI, Secgin B, Eckenweber F, Bohr B, Bernhardt A, Fietzek U, Rauchmann BS, Stoecklein S, Quach S, Beyer L, Scheifele M, Simmet M, Joseph E, Lindner S, Berg I, Koglin N, Mueller A, Stephens AW, Bartenstein P, Tonn JC, Albert NL, Kümpfel T, Kerschensteiner M, Perneczky R, Levin J, Paeger L, Herms J, Brendel M. [ 18F]F-DED PET imaging of reactive astrogliosis in neurodegenerative diseases: preclinical proof of concept and first-in-human data. J Neuroinflammation 2023; 20:68. [PMID: 36906584 PMCID: PMC10007845 DOI: 10.1186/s12974-023-02749-2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/23/2023] [Indexed: 03/13/2023] Open
Abstract
OBJECTIVES Reactive gliosis is a common pathological hallmark of CNS pathology resulting from neurodegeneration and neuroinflammation. In this study we investigate the capability of a novel monoamine oxidase B (MAO-B) PET ligand to monitor reactive astrogliosis in a transgenic mouse model of Alzheimer`s disease (AD). Furthermore, we performed a pilot study in patients with a range of neurodegenerative and neuroinflammatory conditions. METHODS A cross-sectional cohort of 24 transgenic (PS2APP) and 25 wild-type mice (age range: 4.3-21.0 months) underwent 60 min dynamic [18F]fluorodeprenyl-D2 ([18F]F-DED), static 18 kDa translocator protein (TSPO, [18F]GE-180) and β-amyloid ([18F]florbetaben) PET imaging. Quantification was performed via image derived input function (IDIF, cardiac input), simplified non-invasive reference tissue modelling (SRTM2, DVR) and late-phase standardized uptake value ratios (SUVr). Immunohistochemical (IHC) analyses of glial fibrillary acidic protein (GFAP) and MAO-B were performed to validate PET imaging by gold standard assessments. Patients belonging to the Alzheimer's disease continuum (AD, n = 2), Parkinson's disease (PD, n = 2), multiple system atrophy (MSA, n = 2), autoimmune encephalitis (n = 1), oligodendroglioma (n = 1) and one healthy control underwent 60 min dynamic [18F]F-DED PET and the data were analyzed using equivalent quantification strategies. RESULTS We selected the cerebellum as a pseudo-reference region based on the immunohistochemical comparison of age-matched PS2APP and WT mice. Subsequent PET imaging revealed that PS2APP mice showed elevated hippocampal and thalamic [18F]F-DED DVR when compared to age-matched WT mice at 5 months (thalamus: + 4.3%; p = 0.048), 13 months (hippocampus: + 7.6%, p = 0.022) and 19 months (hippocampus: + 12.3%, p < 0.0001; thalamus: + 15.2%, p < 0.0001). Specific [18F]F-DED DVR increases of PS2APP mice occurred earlier when compared to signal alterations in TSPO and β-amyloid PET and [18F]F-DED DVR correlated with quantitative immunohistochemistry (hippocampus: R = 0.720, p < 0.001; thalamus: R = 0.727, p = 0.002). Preliminary experience in patients showed [18F]F-DED VT and SUVr patterns, matching the expected topology of reactive astrogliosis in neurodegenerative (MSA) and neuroinflammatory conditions, whereas the patient with oligodendroglioma and the healthy control indicated [18F]F-DED binding following the known physiological MAO-B expression in brain. CONCLUSIONS [18F]F-DED PET imaging is a promising approach to assess reactive astrogliosis in AD mouse models and patients with neurological diseases.
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Affiliation(s)
- Anna Ballweg
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistr.15, 81377, Munich, Germany
| | - Carolin Klaus
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Letizia Vogler
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistr.15, 81377, Munich, Germany
| | - Sabrina Katzdobler
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Karin Wind
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistr.15, 81377, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Artem Zatcepin
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistr.15, 81377, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Sibylle I Ziegler
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistr.15, 81377, Munich, Germany
| | - Birkan Secgin
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistr.15, 81377, Munich, Germany
| | - Florian Eckenweber
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistr.15, 81377, Munich, Germany
| | - Bernd Bohr
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistr.15, 81377, Munich, Germany
| | - Alexander Bernhardt
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Urban Fietzek
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Boris-Stephan Rauchmann
- Department of Radiology, University Hospital of Munich, LMU Munich, Munich, Germany.,Department of Psychiatry and Psychotherapy, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Sophia Stoecklein
- Department of Radiology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Stefanie Quach
- Department of Neurosurgery, University Hospital, LMU Munich, Munich, Germany
| | - Leonie Beyer
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistr.15, 81377, Munich, Germany
| | - Maximilian Scheifele
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistr.15, 81377, Munich, Germany
| | - Marcel Simmet
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistr.15, 81377, Munich, Germany
| | - Emanuel Joseph
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistr.15, 81377, Munich, Germany
| | - Simon Lindner
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistr.15, 81377, Munich, Germany
| | - Isabella Berg
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistr.15, 81377, Munich, Germany
| | | | | | | | - Peter Bartenstein
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistr.15, 81377, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Joerg C Tonn
- Department of Neurosurgery, University Hospital, LMU Munich, Munich, Germany.,German Cancer Consortium (DKTK), Partner Site Munich, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Nathalie L Albert
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistr.15, 81377, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Tania Kümpfel
- Institute of Clinical Neuroimmunology, University Hospital, LMU Munich, Munich, Germany
| | - Martin Kerschensteiner
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.,Institute of Clinical Neuroimmunology, University Hospital, LMU Munich, Munich, Germany.,Biomedical Center, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Robert Perneczky
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Department of Psychiatry and Psychotherapy, University Hospital of Munich, LMU Munich, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.,Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College, London, UK.,Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, UK
| | - Johannes Levin
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Lars Paeger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Jochen Herms
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.,Center for Neuropathology and Prion Research, LMU Munich, Munich, Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistr.15, 81377, Munich, Germany. .,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany. .,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
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5
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Gnörich J, Reifschneider A, Wind K, Zatcepin A, Kunte ST, Beumers P, Bartos LM, Wiedemann T, Grosch M, Xiang X, Fard MK, Ruch F, Werner G, Koehler M, Slemann L, Hummel S, Briel N, Blume T, Shi Y, Biechele G, Beyer L, Eckenweber F, Scheifele M, Bartenstein P, Albert NL, Herms J, Tahirovic S, Haass C, Capell A, Ziegler S, Brendel M. Depletion and activation of microglia impact metabolic connectivity of the mouse brain. J Neuroinflammation 2023; 20:47. [PMID: 36829182 PMCID: PMC9951492 DOI: 10.1186/s12974-023-02735-8] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 02/13/2023] [Indexed: 02/26/2023] Open
Abstract
AIM We aimed to investigate the impact of microglial activity and microglial FDG uptake on metabolic connectivity, since microglial activation states determine FDG-PET alterations. Metabolic connectivity refers to a concept of interacting metabolic brain regions and receives growing interest in approaching complex cerebral metabolic networks in neurodegenerative diseases. However, underlying sources of metabolic connectivity remain to be elucidated. MATERIALS AND METHODS We analyzed metabolic networks measured by interregional correlation coefficients (ICCs) of FDG-PET scans in WT mice and in mice with mutations in progranulin (Grn) or triggering receptor expressed on myeloid cells 2 (Trem2) knockouts (-/-) as well as in double mutant Grn-/-/Trem2-/- mice. We selected those rodent models as they represent opposite microglial signatures with disease associated microglia in Grn-/- mice and microglia locked in a homeostatic state in Trem2-/- mice; however, both resulting in lower glucose uptake of the brain. The direct influence of microglia on metabolic networks was further determined by microglia depletion using a CSF1R inhibitor in WT mice at two different ages. Within maps of global mean scaled regional FDG uptake, 24 pre-established volumes of interest were applied and assigned to either cortical or subcortical networks. ICCs of all region pairs were calculated and z-transformed prior to group comparisons. FDG uptake of neurons, microglia, and astrocytes was determined in Grn-/- and WT mice via assessment of single cell tracer uptake (scRadiotracing). RESULTS Microglia depletion by CSF1R inhibition resulted in a strong decrease of metabolic connectivity defined by decrease of mean cortical ICCs in WT mice at both ages studied (6-7 m; p = 0.0148, 9-10 m; p = 0.0191), when compared to vehicle-treated age-matched WT mice. Grn-/-, Trem2-/- and Grn-/-/Trem2-/- mice all displayed reduced FDG-PET signals when compared to WT mice. However, when analyzing metabolic networks, a distinct increase of ICCs was observed in Grn-/- mice when compared to WT mice in cortical (p < 0.0001) and hippocampal (p < 0.0001) networks. In contrast, Trem2-/- mice did not show significant alterations in metabolic connectivity when compared to WT. Furthermore, the increased metabolic connectivity in Grn-/- mice was completely suppressed in Grn-/-/Trem2-/- mice. Grn-/- mice exhibited a severe loss of neuronal FDG uptake (- 61%, p < 0.0001) which shifted allocation of cellular brain FDG uptake to microglia (42% in Grn-/- vs. 22% in WT). CONCLUSIONS Presence, absence, and activation of microglia have a strong impact on metabolic connectivity of the mouse brain. Enhanced metabolic connectivity is associated with increased microglial FDG allocation.
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Affiliation(s)
- Johannes Gnörich
- grid.5252.00000 0004 1936 973XDepartment of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377 Munich, Germany ,grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Anika Reifschneider
- grid.5252.00000 0004 1936 973XMetabolic Biochemistry, Faculty of Medicine, Biomedical Center (BMC), Ludwig-Maximilians-Universität München, Munich, Germany
| | - Karin Wind
- grid.5252.00000 0004 1936 973XDepartment of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377 Munich, Germany ,grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Artem Zatcepin
- grid.5252.00000 0004 1936 973XDepartment of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377 Munich, Germany ,grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Sebastian T. Kunte
- grid.5252.00000 0004 1936 973XDepartment of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377 Munich, Germany
| | - Philipp Beumers
- grid.5252.00000 0004 1936 973XDepartment of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377 Munich, Germany
| | - Laura M. Bartos
- grid.5252.00000 0004 1936 973XDepartment of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377 Munich, Germany
| | - Thomas Wiedemann
- grid.5252.00000 0004 1936 973XMetabolic Biochemistry, Faculty of Medicine, Biomedical Center (BMC), Ludwig-Maximilians-Universität München, Munich, Germany
| | - Maximilian Grosch
- grid.5252.00000 0004 1936 973XGerman Center for Vertigo and Balance Disorders, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Xianyuan Xiang
- grid.5252.00000 0004 1936 973XMetabolic Biochemistry, Faculty of Medicine, Biomedical Center (BMC), Ludwig-Maximilians-Universität München, Munich, Germany ,grid.9227.e0000000119573309CAS Key Laboratory of Brain Connectome and Manipulation, The Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, 518055 China
| | - Maryam K. Fard
- grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Francois Ruch
- grid.5252.00000 0004 1936 973XDepartment of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377 Munich, Germany
| | - Georg Werner
- grid.5252.00000 0004 1936 973XMetabolic Biochemistry, Faculty of Medicine, Biomedical Center (BMC), Ludwig-Maximilians-Universität München, Munich, Germany
| | - Mara Koehler
- grid.5252.00000 0004 1936 973XDepartment of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377 Munich, Germany
| | - Luna Slemann
- grid.5252.00000 0004 1936 973XDepartment of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377 Munich, Germany
| | - Selina Hummel
- grid.5252.00000 0004 1936 973XDepartment of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377 Munich, Germany
| | - Nils Briel
- grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany ,grid.5252.00000 0004 1936 973XCenter for Neuropathology and Prion Research, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Tanja Blume
- grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany ,grid.5252.00000 0004 1936 973XCenter for Neuropathology and Prion Research, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Yuan Shi
- grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany ,grid.5252.00000 0004 1936 973XCenter for Neuropathology and Prion Research, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Gloria Biechele
- grid.5252.00000 0004 1936 973XDepartment of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377 Munich, Germany
| | - Leonie Beyer
- grid.5252.00000 0004 1936 973XDepartment of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377 Munich, Germany
| | - Florian Eckenweber
- grid.5252.00000 0004 1936 973XDepartment of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377 Munich, Germany
| | - Maximilian Scheifele
- grid.5252.00000 0004 1936 973XDepartment of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377 Munich, Germany
| | - Peter Bartenstein
- grid.5252.00000 0004 1936 973XDepartment of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377 Munich, Germany ,grid.452617.3Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Nathalie L. Albert
- grid.5252.00000 0004 1936 973XDepartment of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377 Munich, Germany
| | - Jochen Herms
- grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany ,grid.5252.00000 0004 1936 973XCenter for Neuropathology and Prion Research, Ludwig-Maximilians-Universität München, Munich, Germany ,grid.452617.3Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Sabina Tahirovic
- grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Christian Haass
- grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany ,grid.5252.00000 0004 1936 973XMetabolic Biochemistry, Faculty of Medicine, Biomedical Center (BMC), Ludwig-Maximilians-Universität München, Munich, Germany ,grid.452617.3Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Anja Capell
- grid.5252.00000 0004 1936 973XMetabolic Biochemistry, Faculty of Medicine, Biomedical Center (BMC), Ludwig-Maximilians-Universität München, Munich, Germany
| | - Sibylle Ziegler
- grid.5252.00000 0004 1936 973XDepartment of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377 Munich, Germany ,grid.452617.3Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377, Munich, Germany. .,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany. .,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
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6
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Katzdobler S, Nitschmann A, Barthel H, Bischof G, Beyer L, Marek K, Song M, Wagemann O, Palleis C, Weidinger E, Nack A, Fietzek U, Kurz C, Häckert J, Stapf T, Ferschmann C, Scheifele M, Eckenweber F, Biechele G, Franzmeier N, Dewenter A, Schönecker S, Saur D, Schroeter ML, Rumpf JJ, Rullmann M, Schildan A, Patt M, Stephens AW, van Eimeren T, Neumaier B, Drzezga A, Danek A, Classen J, Bürger K, Janowitz D, Rauchmann BS, Stöcklein S, Perneczky R, Schöberl F, Zwergal A, Höglinger GU, Bartenstein P, Villemagne V, Seibyl J, Sabri O, Levin J, Brendel M. Additive value of [ 18F]PI-2620 perfusion imaging in progressive supranuclear palsy and corticobasal syndrome. Eur J Nucl Med Mol Imaging 2023; 50:423-434. [PMID: 36102964 PMCID: PMC9816230 DOI: 10.1007/s00259-022-05964-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 09/01/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE Early after [18F]PI-2620 PET tracer administration, perfusion imaging has potential for regional assessment of neuronal injury in neurodegenerative diseases. This is while standard late-phase [18F]PI-2620 tau-PET is able to discriminate the 4-repeat tauopathies progressive supranuclear palsy and corticobasal syndrome (4RTs) from disease controls and healthy controls. Here, we investigated whether early-phase [18F]PI-2620 PET has an additive value for biomarker based evaluation of 4RTs. METHODS Seventy-eight patients with 4RTs (71 ± 7 years, 39 female), 79 patients with other neurodegenerative diseases (67 ± 12 years, 35 female) and twelve age-matched controls (69 ± 8 years, 8 female) underwent dynamic (0-60 min) [18F]PI-2620 PET imaging. Regional perfusion (0.5-2.5 min p.i.) and tau load (20-40 min p.i.) were measured in 246 predefined brain regions [standardized-uptake-value ratios (SUVr), cerebellar reference]. Regional SUVr were compared between 4RTs and controls by an ANOVA including false-discovery-rate (FDR, p < 0.01) correction. Hypoperfusion in resulting 4RT target regions was evaluated at the patient level in all patients (mean value - 2SD threshold). Additionally, perfusion and tau pattern expression levels were explored regarding their potential discriminatory value of 4RTs against other neurodegenerative disorders, including validation in an independent external dataset (n = 37), and correlated with clinical severity in 4RTs (PSP rating scale, MoCA, activities of daily living). RESULTS Patients with 4RTs had significant hypoperfusion in 21/246 brain regions, most dominant in thalamus, caudate nucleus, and anterior cingulate cortex, fitting to the topology of the 4RT disease spectrum. However, single region hypoperfusion was not specific regarding the discrimination of patients with 4RTs against patients with other neurodegenerative diseases. In contrast, perfusion pattern expression showed promise for discrimination of patients with 4RTs from other neurodegenerative diseases (AUC: 0.850). Discrimination by the combined perfusion-tau pattern expression (AUC: 0.903) exceeded that of the sole tau pattern expression (AUC: 0.864) and the discriminatory power of the combined perfusion-tau pattern expression was replicated in the external dataset (AUC: 0.917). Perfusion but not tau pattern expression was associated with PSP rating scale (R = 0.402; p = 0.0012) and activities of daily living (R = - 0.431; p = 0.0005). CONCLUSION [18F]PI-2620 perfusion imaging mirrors known topology of regional hypoperfusion in 4RTs. Single region hypoperfusion is not specific for 4RTs, but perfusion pattern expression may provide an additive value for the discrimination of 4RTs from other neurodegenerative diseases and correlates closer with clinical severity than tau pattern expression.
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Affiliation(s)
- Sabrina Katzdobler
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany ,grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany ,grid.452617.3Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Alexander Nitschmann
- grid.411095.80000 0004 0477 2585Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Henryk Barthel
- grid.411339.d0000 0000 8517 9062Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Gerard Bischof
- grid.411097.a0000 0000 8852 305XDepartment of Nuclear Medicine, University Hospital Cologne, Cologne, Germany ,Molecular Organization of the Brain, Institute for Neuroscience and Medicine, INM-2), Jülich, Germany
| | - Leonie Beyer
- grid.411095.80000 0004 0477 2585Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Ken Marek
- grid.452597.8InviCRO, LLC, Boston, MA USA ,grid.452597.8Molecular Neuroimaging, A Division of inviCRO, New Haven, CT USA
| | - Mengmeng Song
- grid.411095.80000 0004 0477 2585Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Olivia Wagemann
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany ,grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Carla Palleis
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany ,grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany ,grid.452617.3Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Endy Weidinger
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany ,grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Anne Nack
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Urban Fietzek
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Carolin Kurz
- grid.411095.80000 0004 0477 2585Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Jan Häckert
- grid.411095.80000 0004 0477 2585Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany ,grid.7307.30000 0001 2108 9006Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, BKH Augsburg, Augsburg, Germany
| | - Theresa Stapf
- grid.411095.80000 0004 0477 2585Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Christian Ferschmann
- grid.411095.80000 0004 0477 2585Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Maximilian Scheifele
- grid.411095.80000 0004 0477 2585Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Florian Eckenweber
- grid.411095.80000 0004 0477 2585Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Gloria Biechele
- grid.411095.80000 0004 0477 2585Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Nicolai Franzmeier
- grid.411095.80000 0004 0477 2585Institute for Stroke and Dementia Research, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Anna Dewenter
- grid.411095.80000 0004 0477 2585Institute for Stroke and Dementia Research, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Sonja Schönecker
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Dorothee Saur
- grid.9647.c0000 0004 7669 9786Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany
| | - Matthias L. Schroeter
- grid.9647.c0000 0004 7669 9786Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany ,grid.9647.c0000 0004 7669 9786LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany ,grid.419524.f0000 0001 0041 5028Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Jost-Julian Rumpf
- grid.9647.c0000 0004 7669 9786Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany
| | - Michael Rullmann
- grid.411339.d0000 0000 8517 9062Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Andreas Schildan
- grid.411339.d0000 0000 8517 9062Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Marianne Patt
- grid.411339.d0000 0000 8517 9062Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | | | - Thilo van Eimeren
- grid.411097.a0000 0000 8852 305XDepartment of Nuclear Medicine, University Hospital Cologne, Cologne, Germany
| | - Bernd Neumaier
- grid.411097.a0000 0000 8852 305XDepartment of Nuclear Medicine, University Hospital Cologne, Cologne, Germany ,grid.8385.60000 0001 2297 375XInstitute for Neuroscience and Medicine (INM-3), Cognitive Neuroscience, Research Centre Juelich, Juelich, Germany
| | - Alexander Drzezga
- grid.411097.a0000 0000 8852 305XDepartment of Nuclear Medicine, University Hospital Cologne, Cologne, Germany ,Molecular Organization of the Brain, Institute for Neuroscience and Medicine, INM-2), Jülich, Germany ,grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Adrian Danek
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany ,grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Joseph Classen
- grid.9647.c0000 0004 7669 9786Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany
| | - Katharina Bürger
- grid.411095.80000 0004 0477 2585Institute for Stroke and Dementia Research, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Daniel Janowitz
- grid.411095.80000 0004 0477 2585Institute for Stroke and Dementia Research, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Boris-Stephan Rauchmann
- grid.7307.30000 0001 2108 9006Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, BKH Augsburg, Augsburg, Germany ,grid.411095.80000 0004 0477 2585Department of Radiology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Sophia Stöcklein
- grid.411095.80000 0004 0477 2585Department of Radiology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Robert Perneczky
- grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany ,grid.452617.3Munich Cluster for Systems Neurology (SyNergy), Munich, Germany ,grid.7307.30000 0001 2108 9006Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, BKH Augsburg, Augsburg, Germany ,grid.7445.20000 0001 2113 8111Ageing Epidemiology Research Unit (AGE), School of Public Health, Imperial College, London, UK
| | - Florian Schöberl
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Andreas Zwergal
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Günter U. Höglinger
- grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany ,grid.452617.3Munich Cluster for Systems Neurology (SyNergy), Munich, Germany ,grid.10423.340000 0000 9529 9877Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Peter Bartenstein
- grid.452617.3Munich Cluster for Systems Neurology (SyNergy), Munich, Germany ,grid.411095.80000 0004 0477 2585Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Victor Villemagne
- grid.410678.c0000 0000 9374 3516Department of Molecular Imaging & Therapy, Austin Health, Heidelberg, VIC Australia ,grid.1008.90000 0001 2179 088XDepartment of Medicine, Austin Health, The University of Melbourne, Melbourne, VIC Australia ,grid.21925.3d0000 0004 1936 9000Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA USA
| | - John Seibyl
- grid.452597.8InviCRO, LLC, Boston, MA USA ,grid.452597.8Molecular Neuroimaging, A Division of inviCRO, New Haven, CT USA
| | - Osama Sabri
- grid.411339.d0000 0000 8517 9062Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Johannes Levin
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany ,grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany ,grid.452617.3Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Matthias Brendel
- grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany ,grid.452617.3Munich Cluster for Systems Neurology (SyNergy), Munich, Germany ,grid.411095.80000 0004 0477 2585Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
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7
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Messerschmidt K, Barthel H, Brendel M, Scherlach C, Hoffmann KT, Rauchmann BS, Rullmann M, Marek K, Villemagne VL, Rumpf JJ, Saur D, Schroeter ML, Schildan A, Patt M, Beyer L, Song M, Palleis C, Katzdobler S, Fietzek UM, Respondek G, Scheifele M, Nitschmann A, Zach C, Barret O, Madonia J, Russell D, Stephens AW, Koglin N, Roeber S, Herms J, Bötzel K, Bartenstein P, Levin J, Seibyl JP, Höglinger G, Classen J, Sabri O. 18F-PI-2620 Tau PET Improves the Imaging Diagnosis of Progressive Supranuclear Palsy. J Nucl Med 2022; 63:1754-1760. [PMID: 35422444 PMCID: PMC9635682 DOI: 10.2967/jnumed.121.262854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 03/09/2022] [Indexed: 11/16/2022] Open
Abstract
Progressive supranuclear palsy (PSP) is a 4-repeat tauopathy movement disorder that can be imaged by the 18F-labeled tau PET tracer 2-(2-([18F]fluoro)pyridin-4-yl)-9H-pyrrolo[2,3-b:4,5-c']dipyridine (18F-PI-2620). The in vivo diagnosis is currently established on clinical grounds and supported by midbrain atrophy estimation in structural MRI. Here, we investigate whether 18F-PI-2620 tau PET has the potential to improve the imaging diagnosis of PSP. Methods: In this multicenter observational study, dynamic (0-60 min after injection) 18F-PI-2620 PET and structural MRI data for 36 patients with PSP, 22 with PSP-Richardson syndrome, and 14 with a clinical phenotype other than Richardson syndrome (i.e., variant PSP) were analyzed along with data for 10 age-matched healthy controls (HCs). The PET data underwent kinetic modeling, which resulted in distribution volume ratio (DVR) images. These and the MR images were visually assessed by 3 masked experts for typical PSP signs. Furthermore, established midbrain atrophy parameters were measured in structural MR images, and regional DVRs were measured in typical tau-in-PSP target regions in the PET data. Results: Visual assessments discriminated PSP patients and HCs with an accuracy of 63% for MRI and 80% for the combination of MRI and 18F-PI-2620 PET. As compared with patients of the PSP-Richardson syndrome subgroup, those of the variant PSP subgroup profited more in terms of sensitivity from the addition of the visual 18F-PI-2620 PET to the visual MRI information (35% vs. 22%). In quantitative image evaluation, midbrain-to-pons area ratio and globus pallidus DVRs discriminated best between the PSP patients and HCs, with sensitivities and specificities of 83% and 90%, respectively, for MRI and 94% and 100%, respectively, for the combination of MRI and 18F-PI-2620 PET. The gain of sensitivity by adding 18F-PI-2620 PET to MRI data was more marked in clinically less affected patients than in more affected patients (37% vs. 19% for visual, and 16% vs. 12% for quantitative image evaluation). Conclusion: These results provide evidence for an improved imaging-based PSP diagnosis by adding 18F-PI-2620 tau PET to structural MRI. This approach seems to be particularly promising at earlier disease stages and could be of value both for improving early clinical PSP diagnosis and for enriching PSP cohorts for trials of disease-modifying drugs.
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Affiliation(s)
| | - Henryk Barthel
- Department of Nuclear Medicine, Leipzig University Medical Center, Leipzig, Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases, Site Munich, Bonn, Germany
- Munich Cluster for Systems Neurology, Munich, Germany
| | - Cordula Scherlach
- Department of Neuroradiology, Leipzig University Medical Center, Leipzig, Germany
| | - Karl-Titus Hoffmann
- Department of Neuroradiology, Leipzig University Medical Center, Leipzig, Germany
| | | | - Michael Rullmann
- Department of Nuclear Medicine, Leipzig University Medical Center, Leipzig, Germany
| | | | - Victor L Villemagne
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jost-Julian Rumpf
- Department of Neurology, Leipzig University Medical Center, Leipzig, Germany
| | - Dorothee Saur
- Department of Neurology, Leipzig University Medical Center, Leipzig, Germany
| | - Matthias L Schroeter
- Clinic for Cognitive Neurology, Leipzig University Medical Center, Leipzig, Germany
| | - Andreas Schildan
- Department of Nuclear Medicine, Leipzig University Medical Center, Leipzig, Germany
| | - Marianne Patt
- Department of Nuclear Medicine, Leipzig University Medical Center, Leipzig, Germany
| | - Leonie Beyer
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Mengmeng Song
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Carla Palleis
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Sabrina Katzdobler
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Urban M Fietzek
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Gesine Respondek
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Maximilian Scheifele
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Alexander Nitschmann
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Christian Zach
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | | | | | | | | | | | - Sigrun Roeber
- Center for Neuropathology and Prion Research, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Jochen Herms
- Center for Neuropathology and Prion Research, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Kai Bötzel
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Johannes Levin
- German Center for Neurodegenerative Diseases, Site Munich, Bonn, Germany
- Munich Cluster for Systems Neurology, Munich, Germany
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | | | - Günter Höglinger
- German Center for Neurodegenerative Diseases, Site Munich, Bonn, Germany
- Munich Cluster for Systems Neurology, Munich, Germany
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Joseph Classen
- Department of Neurology, Leipzig University Medical Center, Leipzig, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, Leipzig University Medical Center, Leipzig, Germany
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8
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Reis MC, Patrun J, Ackl N, Winter P, Scheifele M, Danek A, Nolte D. A Severe Dementia Syndrome Caused by Intron Retention and Cryptic Splice Site Activation in STUB1 and Exacerbated by TBP Repeat Expansions. Front Mol Neurosci 2022; 15:878236. [PMID: 35493319 PMCID: PMC9048483 DOI: 10.3389/fnmol.2022.878236] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 03/08/2022] [Indexed: 11/23/2022] Open
Abstract
Heterozygous pathogenic variants in the STIP1 homologous and U-box containing protein 1 (STUB1) gene have been identified as causes of autosomal dominant inherited spinocerebellar ataxia type 48 (SCA48). SCA48 is characterized by an ataxic movement disorder that is often, but not always, accompanied by a cognitive affective syndrome. We report a severe early onset dementia syndrome that mimics frontotemporal dementia and is caused by the intronic splice donor variant c.524+1G>A in STUB1. Impaired splicing was demonstrated by RNA analysis and in minigene assays of mutated and wild-type constructs of STUB1. The most striking consequence of this splicing impairment was retention of intron 3 in STUB1, which led to an in-frame insertion of 63 amino acids (aa) (p.Arg175_Glu176ins63) into the highly conserved coiled-coil domain of its encoded protein, C-terminus of HSP70-interacting protein (CHIP). To a lesser extent, activation of two cryptic splice sites in intron 3 was observed. The almost exclusively used one, c.524+86, was not predicted by in silico programs. Variant c.524+86 caused a frameshift (p.Arg175fs*93) that resulted in a truncated protein and presumably impairs the C-terminal U-box of CHIP, which normally functions as an E3 ubiquitin ligase. The cryptic splice site c.524+99 was rarely used and led to an in-frame insertion of 33 aa (p.Arg175_Glu176ins33) that resulted in disruption of the coiled-coil domain, as has been previously postulated for complete intron 3 retention. We additionally detected repeat expansions in the range of reduced penetrance in the TATA box-binding protein (TBP) gene by excluding other genes associated with dementia syndromes. The repeat expansion was heterozygous in one patient but compound heterozygous in the more severely affected patient. Therefore, we concluded that the observed severe dementia syndrome has a digenic background, making STUB1 and TBP important candidate genes responsible for early onset dementia syndromes.
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Affiliation(s)
- Marlen Colleen Reis
- Institut für Humangenetik, Justus-Liebig-Universität Giessen, Giessen, Germany
| | - Julia Patrun
- Institut für Humangenetik, Justus-Liebig-Universität Giessen, Giessen, Germany
| | - Nibal Ackl
- Psychiatrische Dienste Thurgau, Münsterlingen, Switzerland
- Neurologische Klinik und Poliklinik, Klinikum der Universität München, Munich, Germany
| | - Pia Winter
- Institut für Humangenetik, Justus-Liebig-Universität Giessen, Giessen, Germany
| | | | - Adrian Danek
- Neurologische Klinik und Poliklinik, Klinikum der Universität München, Munich, Germany
| | - Dagmar Nolte
- Institut für Humangenetik, Justus-Liebig-Universität Giessen, Giessen, Germany
- *Correspondence: Dagmar Nolte,
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9
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Franzmeier N, Brendel M, Beyer L, Arzberger T, Kovacs GG, Rubinski A, Palleis C, Katzdobler S, Finze A, Song M, Biechele G, Kern M, Scheifele M, Rauchmann B, Perneczky R, Rullmann M, Schildan A, Barthel H, Sabri O, Classen J, Lukic MJ, Irwin DJ, Lee EB, Coughlin D, Giese A, Grossman M, Kurz C, McMillan CT, Gelpi E, Compta Y, Swieten JC, Troakes C, Al‐Sarraj S, Roeber S, Xie SX, Lee VM, Herms J, Bartenstein P, Haass C, Dichgans M, Trojanowski JQ, Levin J, Höglinger G, Ewers M. Tau spreads across connected brain regions in progressive supranuclear palsy and corticobasal syndrome. Alzheimers Dement 2021. [DOI: 10.1002/alz.051668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | - Matthias Brendel
- Department of Nuclear Medicine University Hospital LMU Munich Munich Germany
- Department of Nuclear Medicine University Hospital LMU Munich Munich Germany
| | | | | | | | - Anna Rubinski
- Institute for Stroke and Dementia Research (ISD) University Hospital LMU Munich Munich Germany
| | | | | | - Anika Finze
- University Hospital LMU Munich Munich Germany
| | - Mengmeng Song
- Ludwig‐Maximilians‐Universität Munich Munich Germany
| | | | - Maike Kern
- University Hospital of Munich Munich Germany
| | | | | | | | - Michael Rullmann
- Department of Nuclear Medicine University of Leipzig Leipzig Germany
| | - Andreas Schildan
- Department of Nuclear Medicine University of Leipzig Leipzig Germany
| | - Henryk Barthel
- Department of Nuclear Medicine University of Leipzig Leipzig Germany
| | - Osama Sabri
- Department of Nuclear Medicine University of Leipzig Leipzig Germany
| | | | | | - David J. Irwin
- Digital Neuropathology Laboratory Perelman School of Medicine University of Pennsylvania Philadelphia PA USA
| | - Eddie B. Lee
- Center for Neurodegenerative Disease Research University of Pennsylvania Philadelphia PA USA
| | | | | | - Murray Grossman
- Perelman School of Medicine University of Pennsylvania Philadelphia PA USA
| | - Carolin Kurz
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
| | | | - Ellen Gelpi
- Neurological Tissue Bank‐IDIBAPS/Hospital Clínic Barcelona Barcelona Spain
| | | | - John C. Swieten
- Department of Neurology Erasmus Medical Center Rotterdam Netherlands
| | - Claire Troakes
- King's College London MRC London Neurodegenerative Diseases Brain Bank London United Kingdom
| | - Safa Al‐Sarraj
- Kings College NHS Foundation Trust London United Kingdom
| | | | | | - Virginia M‐Y Lee
- Perelman School of Medicine at the University of Pennsylvania Philadelphia PA USA
| | | | | | - Christian Haass
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD) University Hospital LMU Munich Munich Germany
| | | | | | - Günter Höglinger
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
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10
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Song M, Scheifele M, Barthel H, van Eimeren T, Beyer L, Marek K, Eckenweber F, Palleis C, Finze A, Kaiser L, Kern M, Nitschmann A, Biechele G, Katzdobler S, Bischof GN, Hammes J, Jessen F, Saur D, Schroeter ML, Rumpf J, Rullmann M, Schildan A, Patt M, Neumaier B, Stephens AW, Rauchmann B, Perneczky R, Levin J, Classen J, Höglinger G, Bartenstein P, Boening G, Ziegler S, Villemagne VLL, Drzezga A, Seibyl JP, Sabri O, Brendel M. Feasibility of short imaging protocols for [
18
F]PI‐2620 tau‐PET in progressive supranuclear palsy. Alzheimers Dement 2021. [DOI: 10.1002/alz.052563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Mengmeng Song
- Ludwig‐Maximilians‐Universität Munich Munich Germany
| | | | - Henryk Barthel
- Department of Nuclear Medicine, University of Leipzig Leipzig Germany
| | - Thilo van Eimeren
- Cognitive Neuroscience, Institute for Neuroscience and Medicine (INM‐3), Research Centre Juelich Juelich Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology Cologne Germany
- German Center for Neurodegenerative Diseases (DZNE) Bonn/Cologne Germany
| | | | - Ken Marek
- Molecular Neuroimaging, A Division of inviCRO New Haven CT USA
- Institute for Neurodegenerative Disorders New Haven CT USA
| | | | - Carla Palleis
- University Hospital, LMU Munich Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
| | - Anika Finze
- University Hospital, LMU Munich Munich Germany
| | - Lena Kaiser
- University Hospital of Munich Munich Germany
| | - Maike Kern
- University Hospital of Munich Munich Germany
| | | | | | | | - Gerard N Bischof
- Cognitive Neuroscience, Institute for Neuroscience and Medicine (INM‐3), Research Centre Juelich Juelich Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine Cologne Germany
| | - Jochen Hammes
- Department of Nuclear Medicine, University Hospital Cologne Cologne Germany
| | - Frank Jessen
- Department of Psychiatry, University Hospital Cologne Cologne Germany
- German Center for Neurodegenerative Diseases (DZNE) Cologne Germany
- Center for Memory Disorders, University Hospital Cologne Cologne Germany
| | | | - Matthias L. Schroeter
- Clinic for Cognitive Neurology, University Clinic Leipzig Leipzig Germany
- LIFE ‐ Leipzig Research Center for Civilization Diseases, University of Leipzig Leipzig Germany
- Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
| | | | - Michael Rullmann
- Department of Nuclear Medicine, University of Leipzig Leipzig Germany
| | - Andreas Schildan
- Department of Nuclear Medicine, University of Leipzig Leipzig Germany
| | - Marianne Patt
- Department of Nuclear Medicine, University of Leipzig Leipzig Germany
| | - Bernd Neumaier
- Institute of Neuroscience and Medicine, Research Center Jülich Jülich Germany
- Medical Faculty and University Hospital of Cologne Cologne Germany
| | | | | | - Robert Perneczky
- University Hospital, LMU Munich Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
- Imperial College London London United Kingdom
| | - Johannes Levin
- LMU Munich Germany
- Munich Cluster for Systems Neurology (SyNergy) Munich Germany
| | | | - Günter Höglinger
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
- Technical University Munich Munich Germany
- Hannover Medical School Hannover Germany
| | | | | | | | - Victor L L Villemagne
- Departments of Medicine and Molecular Imaging, University of Melbourne, Austin Health Melbourne VIC Australia
- The University of Pittsburgh Pittsburgh PA USA
| | - Alexander Drzezga
- German Center for Neurodegenerative Diseases (DZNE) Bonn/Cologne Germany
- Medical Faculty and University Hospital of Cologne Cologne Germany
| | - John P Seibyl
- Molecular Neuroimaging, LLC New Haven CT USA
- Instit for Neurodegenerative Disorders New Haven CT USA
| | - Osama Sabri
- Department of Nuclear Medicine, University of Leipzig Leipzig Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital, LMU Munich Munich Germany
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11
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Song M, Beyer L, Kaiser L, Barthel H, van Eimeren T, Marek K, Nitschmann A, Scheifele M, Palleis C, Respondek G, Kern M, Biechele G, Hammes J, Bischof G, Barbe M, Onur Ö, Jessen F, Saur D, Schroeter ML, Rumpf JJ, Rullmann M, Schildan A, Patt M, Neumaier B, Barret O, Madonia J, Russell DS, Stephens AW, Mueller A, Roeber S, Herms J, Bötzel K, Danek A, Levin J, Classen J, Höglinger GU, Bartenstein P, Villemagne V, Drzezga A, Seibyl J, Sabri O, Boening G, Ziegler S, Brendel M. Binding characteristics of [ 18F]PI-2620 distinguish the clinically predicted tau isoform in different tauopathies by PET. J Cereb Blood Flow Metab 2021; 41:2957-2972. [PMID: 34044665 PMCID: PMC8545042 DOI: 10.1177/0271678x211018904] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The novel tau-PET tracer [18F]PI-2620 detects the 3/4-repeat-(R)-tauopathy Alzheimer's disease (AD) and the 4R-tauopathies corticobasal syndrome (CBS) and progressive supranuclear palsy (PSP). We determined whether [18F]PI-2620 binding characteristics deriving from non-invasive reference tissue modelling differentiate 3/4R- and 4R-tauopathies. Ten patients with a 3/4R tauopathy (AD continuum) and 29 patients with a 4R tauopathy (CBS, PSP) were evaluated. [18F]PI-2620 PET scans were acquired 0-60 min p.i. and the distribution volume ratio (DVR) was calculated. [18F]PI-2620-positive clusters (DVR ≥ 2.5 SD vs. 11 healthy controls) were evaluated by non-invasive kinetic modelling. R1 (delivery), k2 & k2a (efflux), DVR, 30-60 min standardized-uptake-value-ratios (SUVR30-60) and the linear slope of post-perfusion phase SUVR (9-60 min p.i.) were compared between 3/4R- and 4R-tauopathies. Cortical clusters of 4R-tau cases indicated higher delivery (R1SRTM: 0.92 ± 0.21 vs. 0.83 ± 0.10, p = 0.0007), higher efflux (k2SRTM: 0.17/min ±0.21/min vs. 0.06/min ± 0.07/min, p < 0.0001), lower DVR (1.1 ± 0.1 vs. 1.4 ± 0.2, p < 0.0001), lower SUVR30-60 (1.3 ± 0.2 vs. 1.8 ± 0.3, p < 0.0001) and flatter slopes of the post-perfusion phase (slope9-60: 0.006/min ± 0.007/min vs. 0.016/min ± 0.008/min, p < 0.0001) when compared to 3/4R-tau cases. [18F]PI-2620 binding characteristics in cortical regions differentiate 3/4R- and 4R-tauopathies. Higher tracer clearance indicates less stable binding in 4R tauopathies when compared to 3/4R-tauopathies.
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Affiliation(s)
- Mengmeng Song
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Leonie Beyer
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Lena Kaiser
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Henryk Barthel
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Thilo van Eimeren
- Cognitive Neuroscience, Institute for Neuroscience and Medicine (INM-3), Research Centre Juelich, Juelich, Germany.,Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany.,Department of Neurology, University Hospital Cologne, Cologne, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Ken Marek
- InviCRO, LLC, Boston, MA, USA.,Molecular Neuroimaging, A Division of inviCRO, New Haven, CT, USA
| | - Alexander Nitschmann
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Maximilian Scheifele
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Carla Palleis
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Gesine Respondek
- Department of Neurology, Medizinische Hochschule Hannover, Hannover, Germany
| | - Maike Kern
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Gloria Biechele
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Jochen Hammes
- Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany
| | - Gèrard Bischof
- Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany
| | - Michael Barbe
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Özgür Onur
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Department of Psychiatry, University Hospital Cologne, Cologne, Germany.,Center for Memory Disorders, University Hospital Cologne, Cologne, Germany
| | - Dorothee Saur
- Department of Neurology, University of Leipzig, Leipzig, Germany
| | - Matthias L Schroeter
- Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany.,LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Max- Planck-Institute of Human Cognitive and Brain Sciences, Leipzig, Germany.,FTLD Consortium Germany, Ulm, Germany
| | | | - Michael Rullmann
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Andreas Schildan
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Marianne Patt
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Bernd Neumaier
- Cognitive Neuroscience, Institute for Neuroscience and Medicine (INM-3), Research Centre Juelich, Juelich, Germany.,Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany
| | - Olivier Barret
- InviCRO, LLC, Boston, MA, USA.,Molecular Neuroimaging, A Division of inviCRO, New Haven, CT, USA.,Laboratoire des Maladies Neurodégénératives, Université Paris-Saclay, CEA, CNRS, MIRCen, Fontenay-aux-Roses, France
| | - Jennifer Madonia
- InviCRO, LLC, Boston, MA, USA.,Molecular Neuroimaging, A Division of inviCRO, New Haven, CT, USA
| | - David S Russell
- InviCRO, LLC, Boston, MA, USA.,Molecular Neuroimaging, A Division of inviCRO, New Haven, CT, USA
| | | | | | - Sigrun Roeber
- Center for Neuropathology and Prion Research, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Jochen Herms
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Center for Neuropathology and Prion Research, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Kai Bötzel
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Adrian Danek
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Johannes Levin
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Joseph Classen
- Department of Neurology, University of Leipzig, Leipzig, Germany
| | - Günter U Höglinger
- Department of Neurology, Medizinische Hochschule Hannover, Hannover, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Department of Neurology, Technical University Munich, Munich, Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Victor Villemagne
- Department of Molecular Imaging & Therapy, Austin Health, Heidelberg, VIC, Australia.,The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, VIC, Australia.,Department of Medicine, Austin Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Alexander Drzezga
- Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - John Seibyl
- InviCRO, LLC, Boston, MA, USA.,Molecular Neuroimaging, A Division of inviCRO, New Haven, CT, USA
| | - Osama Sabri
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Guido Boening
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Sibylle Ziegler
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
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12
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Willroider M, Roeber S, Horn AKE, Arzberger T, Scheifele M, Respondek G, Sabri O, Barthel H, Patt M, Mishchenko O, Schildan A, Mueller A, Koglin N, Stephens A, Levin J, Höglinger GU, Bartenstein P, Herms J, Brendel M, Beyer L. Superiority of Formalin-Fixed Paraffin-Embedded Brain Tissue for in vitro Assessment of Progressive Supranuclear Palsy Tau Pathology With [ 18 F]PI-2620. Front Neurol 2021; 12:684523. [PMID: 34276540 PMCID: PMC8282895 DOI: 10.3389/fneur.2021.684523] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/25/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: Autoradiography on brain tissue is used to validate binding targets of newly discovered radiotracers. The purpose of this study was to correlate quantification of autoradiography signal using the novel next-generation tau positron emission tomography (PET) radiotracer [18F]PI-2620 with immunohistochemically determined tau-protein load in both formalin-fixed paraffin-embedded (FFPE) and frozen tissue samples of patients with Alzheimer's disease (AD) and Progressive Supranuclear Palsy (PSP). Methods: We applied [18F]PI-2620 autoradiography to postmortem cortical brain samples of six patients with AD, five patients with PSP and five healthy controls, respectively. Binding intensity was compared between both tissue types and different disease entities. Autoradiography signal quantification (CWMR = cortex to white matter ratio) was correlated with the immunohistochemically assessed tau load (AT8-staining, %-area) for FFPE and frozen tissue samples in the different disease entities. Results: In AD tissue, relative cortical tracer binding was higher in frozen samples when compared to FFPE samples (CWMRfrozen vs. CWMRFFPE: 2.5-fold, p < 0.001), whereas the opposite was observed in PSP tissue (CWMRfrozen vs. CWMRFFPE: 0.8-fold, p = 0.004). In FFPE samples, [18F]PI-2620 autoradiography tracer binding and immunohistochemical tau load correlated significantly for both PSP (R = 0.641, p < 0.001) and AD tissue (R = 0.435, p = 0.016), indicating a high agreement of relative tracer binding with underlying pathology. In frozen tissue, the correlation between autoradiography and immunohistochemistry was only present in AD (R = 0.417, p = 0.014) but not in PSP tissue (R = -0.115, p = n.s.). Conclusion: Our head-to-head comparison indicates that FFPE samples show superiority over frozen samples for autoradiography assessment of PSP tau pathology by [18F]PI-2620. The [18F]PI-2620 autoradiography signal in FFPE samples reflects AT8 positive tau in samples of both PSP and AD patients.
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Affiliation(s)
- Marie Willroider
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Sigrun Roeber
- Center for Neuropathology and Prion Research, LMU Munich, Munich, Germany
| | - Anja K E Horn
- Institute of Anatomy and Cell Biology, LMU Munich, Munich, Germany
| | - Thomas Arzberger
- Center for Neuropathology and Prion Research, LMU Munich, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Maximilian Scheifele
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Gesine Respondek
- Department of Neurology, Hannover Medical School, Hanover, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Henryk Barthel
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Marianne Patt
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Olena Mishchenko
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Andreas Schildan
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | | | | | | | - Johannes Levin
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Department of Neurology, University Hospital Munich, LMU Munich, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Günter U Höglinger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Department of Neurology, Hannover Medical School, Hanover, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.,Department of Neurology, Technical University Munich, Munich, Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Jochen Herms
- Center for Neuropathology and Prion Research, LMU Munich, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Leonie Beyer
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany.,Center for Neuropathology and Prion Research, LMU Munich, Munich, Germany
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Kreuzer A, Sauerbeck J, Scheifele M, Stockbauer A, Schönecker S, Prix C, Wlasich E, Loosli SV, M Kazmierczak P, Unterrainer M, Catak C, Janowitz D, Pogarell O, Palleis C, Perneczky R, Albert NL, Bartenstein P, Danek A, Buerger K, Levin J, Zwergal A, Rominger A, Brendel M, Beyer L. Detection Gap of Right-Asymmetric Neuronal Degeneration by CERAD Test Battery in Alzheimer's Disease. Front Aging Neurosci 2021; 13:611595. [PMID: 33603657 PMCID: PMC7884314 DOI: 10.3389/fnagi.2021.611595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 01/04/2021] [Indexed: 01/18/2023] Open
Abstract
Objectives: Asymmetric disease characteristics on neuroimaging are common in structural and functional imaging of neurodegenerative diseases, particularly in Alzheimer‘s disease (AD). However, a standardized clinical evaluation of asymmetric neuronal degeneration and its impact on clinical findings has only sporadically been investigated for F-18-fluorodeoxyglucose positron emission tomography (F-18-FDG-PET). This study aimed to evaluate the impact of lateralized neuronal degeneration on the detection of AD by detailed clinical testing. Furthermore, we compared associations between clinical evaluation and lateralized neuronal degeneration between FDG-PET hypometabolism and hippocampal atrophy. Finally, we investigated if specific subtests show associations with lateralized neuronal degeneration. Methods: One-hundred and forty-six patients with a clinical diagnosis of AD (age 71 ± 8) were investigated by FDG-PET and the “Consortium to Establish a Registry for Alzheimer’s disease” (CERAD) test battery. For assessment of neuronal degeneration, FDG-PET hypometabolism in brain regions typically affected in AD were graded by visual (3D-surface projections) and semiquantitative analysis. Asymmetry of the hippocampus (left-right) in magnetic resonance tomography (MRI) was rated visually by the Scheltens scale. Measures of asymmetry were calculated to quantify lateralized neuronal degeneration and asymmetry scores were subsequently correlated with CERAD. Results: Asymmetry with left-dominant neuronal degeneration to FDG-PET was an independent predictor of cognitive impairment (visual: β = −0.288, p < 0.001; semiquantitative: β = −0.451, p < 0.001) when controlled for age, gender, years of education and total burden of neuronal degeneration, whereas hippocampal asymmetry to MRI was not (β = −0.034; p = 0.731). Direct comparison of CERAD-PET associations in cases with right- and left-lateralized neuronal degeneration estimated a detection gap of 2.7 years for right-lateralized cases. Left-hemispheric neuronal degeneration was significantly associated with the total CERAD score and multiple subscores, whereas only MMSE (semiquantitative: β = 0.429, p < 0.001) and constructional praxis (semiquantitative: β = 0.292, p = 0.008) showed significant associations with right-hemispheric neuronal degeneration. Conclusions: Asymmetry of deteriorated cerebral glucose metabolism has a significant impact on the coupling between neuronal degeneration and cognitive function. Right dominant neuronal degeneration shows a delayed detection by global CERAD testing and requires evaluation of specific subdomains of cognitive testing.
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Affiliation(s)
- Annika Kreuzer
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Julia Sauerbeck
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Maximilian Scheifele
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Anna Stockbauer
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Sonja Schönecker
- Department of Neurology, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Catharina Prix
- Department of Neurology, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Elisabeth Wlasich
- Department of Neurology, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Sandra V Loosli
- Department of Neurology, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Philipp M Kazmierczak
- Department of Radiology, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Marcus Unterrainer
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.,Department of Radiology, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Cihan Catak
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Oliver Pogarell
- Department of Psychiatry, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Carla Palleis
- Department of Neurology, University Hospital, Ludwig-Maximilians-University, Munich, Germany.,DZNE-German Center for Neurodegenerative Diseases, Munich, Germany
| | - Robert Perneczky
- Department of Psychiatry, University Hospital, Ludwig-Maximilians-University, Munich, Germany.,DZNE-German Center for Neurodegenerative Diseases, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.,Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College, London, United Kingdom
| | - Nathalie L Albert
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Adrian Danek
- Department of Neurology, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Katharina Buerger
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilians-University, Munich, Germany.,DZNE-German Center for Neurodegenerative Diseases, Munich, Germany
| | - Johannes Levin
- Department of Neurology, University Hospital, Ludwig-Maximilians-University, Munich, Germany.,DZNE-German Center for Neurodegenerative Diseases, Munich, Germany
| | - Andreas Zwergal
- Department of Neurology, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Axel Rominger
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.,Department of Nuclear Medicine Inselspital, University of Bern, Bern, Switzerland
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Leonie Beyer
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
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Conway J, Conroy L, Harper L, Scheifele M, Smith W, Graham T, Phan T, Li H, Olivotto I. PO-0870: DIBH produces a meaningful reduction in lung dose for some women with right-sided breast cancer. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31307-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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