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European Journal of Nuclear Medicine and Molecular Imaging
Erschienen in:

13.02.2020 | Original Article

Brain PET amyloid and neurodegeneration biomarkers in the context of the 2018 NIA-AA research framework: an individual approach exploring clinical-biomarker mismatches and sociodemographic parameters

verfasst von: Artur Martins Coutinho, Geraldo F. Busatto, Fábio Henrique de Gobbi Porto, Daniele de Paula Faria, Carla Rachel Ono, Alexandre Teles Garcez, Paula Squarzoni, Fábio Luiz de Souza Duran, Maira Okada de Oliveira, Eduardo Sturzeneker Tres, Sonia Maria Dozzi Brucki, Orestes Vicente Forlenza, Ricardo Nitrini, Carlos Alberto Buchpiguel

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 11/2020

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Abstract

Purpose

[18F]FDG-PET and [11C]PIB-PET are validated as neurodegeneration and amyloid biomarkers of Alzheimer’s disease (AD). We used a PET staging system based on the 2018 NIA-AA research framework to compare the proportion of amyloid positivity (A+) and hypometabolism ((N)+) in cases of mild probable AD, amnestic mild cognitive impairment (aMCI), and healthy controls, incorporating an additional classification of abnormal [18F]FDG-PET patterns and investigating the co-occurrence of such with A+, exploring [18F]FDG-PET to generate hypotheses in cases presenting with clinical-biomarker “mismatches.”

Methods

Elderly individuals (N = 108) clinically classified as controls (N = 27), aMCI (N = 43) or mild probable AD (N = 38) were included. Authors assessed their A(N) profiles and classified [18F]FDG-PET neurodegenerative patterns as typical or non-typical of AD, performing re-assessments of images whenever clinical classification was in disagreement with the PET staging (clinical-biomarker “mismatches”). We also investigated associations between “mismatches” and sociodemographic and educational characteristics.

Results

AD presented with higher rates of A+ and (N)+. There was also a higher proportion of A+ and (N)+ individuals in the aMCI group in comparison to controls, however without statistical significance regarding the A staging. There was a significant association between amyloid positivity and AD (N)+ hypometabolic patterns typical of AD. Non-AD (N)+ hypometabolism was seen in all A− (N)+ cases in the mild probable AD and control groups and [18F]FDG-PET patterns classified such individuals as “SNAP” and one as probable frontotemporal lobar degeneration. All A− (N)− cases in the probable AD group had less than 4 years of formal education and lower socioeconomic status (SES).

Conclusion

The PET-based staging system unveiled significant A(N) differences between AD and the other groups, whereas aMCI and controls had different (N) staging, explaining the cognitive impairment in aMCI. [18F]FDG-PET could be used beyond simple (N) staging, since it provided alternative hypotheses to cases with clinical-biomarker “mismatches.” An AD hypometabolic pattern correlated with amyloid positivity. Low education and SES were related to dementia in the absence of biomarker changes.
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Metadaten
Titel
Brain PET amyloid and neurodegeneration biomarkers in the context of the 2018 NIA-AA research framework: an individual approach exploring clinical-biomarker mismatches and sociodemographic parameters
verfasst von
Artur Martins Coutinho
Geraldo F. Busatto
Fábio Henrique de Gobbi Porto
Daniele de Paula Faria
Carla Rachel Ono
Alexandre Teles Garcez
Paula Squarzoni
Fábio Luiz de Souza Duran
Maira Okada de Oliveira
Eduardo Sturzeneker Tres
Sonia Maria Dozzi Brucki
Orestes Vicente Forlenza
Ricardo Nitrini
Carlos Alberto Buchpiguel
Publikationsdatum
13.02.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 11/2020
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-020-04714-0

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