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.

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.

Coutinho, Artur Martins;Busatto, Geraldo F;de Gobbi Porto, Fábio Henrique;de Paula Faria, Daniele;Ono, Carla Rachel;Garcez, Alexandre Teles;Squarzoni, Paula;de Souza Duran, Fábio Luiz;de Oliveira, Maira Okada;Tres, Eduardo Sturzeneker;Brucki, Sonia Maria Dozzi;Forlenza, Orestes Vicente;Nitrini, Ricardo;Buchpiguel, Carlos Alberto;
European journal of nuclear medicine and molecular imaging 2020
290
coutinho2020braineuropean

Abstract

[F]FDG-PET and [C]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 [F]FDG-PET patterns and investigating the co-occurrence of such with A+, exploring [F]FDG-PET to generate hypotheses in cases presenting with clinical-biomarker "mismatches."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 [F]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.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 [F]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).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. [F]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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ID: 97522
Ref Key: coutinho2020braineuropean
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97522
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10.1007/s00259-020-04714-0
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