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Brain metabolic patterns in patients with suspected non-Alzheimer’s pathophysiology (SNAP) and Alzheimer’s disease (AD): is [18F] FDG a specific biomarker in these patients?

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The present study was conducted to compare the pattern of brain [18F] FDG uptake in suspected non-Alzheimer’s pathophysiology (SNAP), AD, and healthy controls using 2-deoxy-2-[18F]fluoroglucose ([18F] FDG) positron emission tomography imaging. Cerebrospinal fluid (CSF) biomarkers amyloid-β1-42 peptide (Aβ1-42) and tau were used in order to differentiate AD from SNAP.

Methods

The study included 43 newly diagnosed AD patients (female = 23; male = 20) according to the NINCDS-ADRDA criteria, 15 SNAP patients (female = 12; male =3), and a group of 34 healthy subjects that served as the control group (CG), who were found to be normal at neurological evaluation (male = 20; female = 14). A battery of neuropsychological tests was administrated in AD and SNAP subjects; cerebrospinal fluid assay was conducted in both AD and SNAP as well. Brain PET/CT acquisition was started 30 ± 5 min after [18F] FDG injection in all subjects. SPM12 [statistical parametric mapping] implemented in MATLAB 2018a was used for the analysis of PET scans in this study.

Results

As compared to SNAP, AD subjects showed significant hypometabolism in a wide cortical area involving the right frontal, parietal, and temporal lobes. As compared to CG, AD subjects showed a significant reduction in [18F] FDG uptake in the parietal, limbic, and frontal cortex, while a more limited reduction in [18F] FDG uptake in the same areas was found when comparing SNAP to CG.

Conclusions

SNAP subjects show milder impairment of brain [18F] FDG uptake as compared to AD. The partial overlap of the metabolic pattern between SNAP and AD limits the use of [18F] FDG PET/CT in effectively discriminating these clinical entities.

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Abbreviations

[18F] FDG:

2-Deoxy-2-[18F]fluoroglucose

PET:

Positron emission tomography

CT:

Computed tomography

CSF:

Cerebrospinal fluid

T-tau:

Total tau

P-tau:

Phosphorylated tau

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Acknowledgments

The authors wish to thank Tiziana Martino (IRCCS Neuromed) for data collection. This work was funded in part by the European Commission Horizon 2020 programme, grant 689209: PICASO, A Personalised Integrated Care Approach for Service Organisations and Care Models for Patients with Multi-Morbidity and Chronic Conditions.

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Authors and Affiliations

  1. Department of Biomedicine and Prevention, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy

    Agostino Chiaravalloti & Orazio Schillaci

  2. IRCCS Neuromed, Pozzilli, Italy

    Agostino Chiaravalloti, Anna Elisa Castellano & Orazio Schillaci

  3. Institute of Neurology, University Magna Graecia of Catanzaro, Catanzaro, Italy

    Gaetano Barbagallo

  4. UOSD Centro Demenze, Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy

    Alessandro Martorana

  5. Department of Medical Sciences, University of Ferrara, Ferrara, Italy

    Francesco Ursini

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  1. Agostino Chiaravalloti
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Correspondence to Agostino Chiaravalloti.

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Chiaravalloti, A., Barbagallo, G., Martorana, A. et al. Brain metabolic patterns in patients with suspected non-Alzheimer’s pathophysiology (SNAP) and Alzheimer’s disease (AD): is [18F] FDG a specific biomarker in these patients?. Eur J Nucl Med Mol Imaging 46, 1796–1805 (2019). https://doi.org/10.1007/s00259-019-04379-4

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