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Cerebral perfusion and glucose metabolism in Alzheimer's disease and frontotemporal dementia: two sides of the same coin?

Verfaillie SC, Adriaanse SM, Binnewijzend MA, Benedictus MR, Ossenkoppele R, Wattjes MP, Pijnenburg YA, van der Flier WM, Lammertsma AA, Kuijer JP, Boellaard R, Scheltens P, van Berckel BN, Barkhof F - Eur Radiol (2015)

Bottom Line: Voxel-wise comparisons showed decreased CBF and FDG uptake in AD compared with controls and FTD in both precuneus and inferior parietal lobule (IPL).ROC analyses indicated comparable performance of perfusion and metabolism in the precuneus (AUC, 0.72 and 0.74), IPL (0.85 and 0.94) for AD relative to FTD, and in the mPFC in FTD relative to AD (both 0.68).Similar patterns of hypoperfusion and hypometabolism were observed in regions typically associated with AD and FTD, suggesting that ASL-MRI provides information comparable to FDG-PET. • Similar patterns of hypoperfusion and hypometabolism were observed in patients with dementia. • For both imaging modalities, parietal abnormalities were found in Alzheimer's disease. • For both imaging modalities, prefrontal abnormalities were found in frontotemporal dementia.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology & Nuclear Medicine, VU University Medical Centre, Amsterdam, The Netherlands, s.verfaillie@vumc.nl.

ABSTRACT

Objectives: Alzheimer's disease (AD) and frontotemporal (FTD) dementia can be differentiated using [(18)F]-2-deoxy-2-fluoro-D-glucose (FDG)-PET. Since cerebral blood flow (CBF) is related to glucose metabolism, our aim was to investigate the extent of overlap of abnormalities between AD and FTD.

Methods: Normalized FDG-PET and arterial spin labelling (ASL-MRI)-derived CBF was measured in 18 AD patients (age, 64 ± 8), 12 FTD patients (age, 61 ± 8), and 10 controls (age, 56 ± 10). Voxel-wise comparisons, region-of-interest (ROI), correlation, and ROC curve analyses were performed.

Results: Voxel-wise comparisons showed decreased CBF and FDG uptake in AD compared with controls and FTD in both precuneus and inferior parietal lobule (IPL). Compared with controls and AD, FTD patients showed both hypometabolism and hypoperfusion in medial prefrontal cortex (mPFC). ASL and FDG were related in precuneus (r = 0.62, p < 0.001), IPL (r = 0.61, p < 0.001), and mPFC across groups (r = 0.74, p < 001). ROC analyses indicated comparable performance of perfusion and metabolism in the precuneus (AUC, 0.72 and 0.74), IPL (0.85 and 0.94) for AD relative to FTD, and in the mPFC in FTD relative to AD (both 0.68).

Conclusions: Similar patterns of hypoperfusion and hypometabolism were observed in regions typically associated with AD and FTD, suggesting that ASL-MRI provides information comparable to FDG-PET.

Key points: • Similar patterns of hypoperfusion and hypometabolism were observed in patients with dementia. • For both imaging modalities, parietal abnormalities were found in Alzheimer's disease. • For both imaging modalities, prefrontal abnormalities were found in frontotemporal dementia.

No MeSH data available.


Related in: MedlinePlus

Transversal FDG and ASL images of an FTD (first and second rows, MMSE 26) and an AD (third and fourth rows, MMSE 17) patient with early-onset disease. Both transversal planes show predominantly prefrontal abnormalities in FTD and parietal abnormalities in AD. Red colour reflects normal metabolism and perfusion
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Fig1: Transversal FDG and ASL images of an FTD (first and second rows, MMSE 26) and an AD (third and fourth rows, MMSE 17) patient with early-onset disease. Both transversal planes show predominantly prefrontal abnormalities in FTD and parietal abnormalities in AD. Red colour reflects normal metabolism and perfusion

Mentions: Demographic and clinical variables are presented in Table 1. Age, gender, time intervals, and FDG SUV normalization variables (body weight and length, injected dose) did not differ among groups. Likewise, there was no difference in frequency distribution of PET systems (PET-CT and HR+) among the groups (χ2(2) = 1.6, p = 0.21). The combined dementia groups showed lower MMSE scores (F[38, 1]) = 1.8, p = 0.01) than controls, but did not differ between each other. All amyloid PET scans of the AD patient group were classified as consistent with abnormal amyloid load. All FTD patients had normal cerebrospinal fluid (CSF) Aß1-42 levels (n = 3) or negative amyloid PET scan (n = 8). In one FTD patient, amyloid-specific information was missing. Figure 1 shows raw ASL and FDG images with corresponding MRI of a typical AD and FTD patient.Table 1


Cerebral perfusion and glucose metabolism in Alzheimer's disease and frontotemporal dementia: two sides of the same coin?

Verfaillie SC, Adriaanse SM, Binnewijzend MA, Benedictus MR, Ossenkoppele R, Wattjes MP, Pijnenburg YA, van der Flier WM, Lammertsma AA, Kuijer JP, Boellaard R, Scheltens P, van Berckel BN, Barkhof F - Eur Radiol (2015)

Transversal FDG and ASL images of an FTD (first and second rows, MMSE 26) and an AD (third and fourth rows, MMSE 17) patient with early-onset disease. Both transversal planes show predominantly prefrontal abnormalities in FTD and parietal abnormalities in AD. Red colour reflects normal metabolism and perfusion
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4562004&req=5

Fig1: Transversal FDG and ASL images of an FTD (first and second rows, MMSE 26) and an AD (third and fourth rows, MMSE 17) patient with early-onset disease. Both transversal planes show predominantly prefrontal abnormalities in FTD and parietal abnormalities in AD. Red colour reflects normal metabolism and perfusion
Mentions: Demographic and clinical variables are presented in Table 1. Age, gender, time intervals, and FDG SUV normalization variables (body weight and length, injected dose) did not differ among groups. Likewise, there was no difference in frequency distribution of PET systems (PET-CT and HR+) among the groups (χ2(2) = 1.6, p = 0.21). The combined dementia groups showed lower MMSE scores (F[38, 1]) = 1.8, p = 0.01) than controls, but did not differ between each other. All amyloid PET scans of the AD patient group were classified as consistent with abnormal amyloid load. All FTD patients had normal cerebrospinal fluid (CSF) Aß1-42 levels (n = 3) or negative amyloid PET scan (n = 8). In one FTD patient, amyloid-specific information was missing. Figure 1 shows raw ASL and FDG images with corresponding MRI of a typical AD and FTD patient.Table 1

Bottom Line: Voxel-wise comparisons showed decreased CBF and FDG uptake in AD compared with controls and FTD in both precuneus and inferior parietal lobule (IPL).ROC analyses indicated comparable performance of perfusion and metabolism in the precuneus (AUC, 0.72 and 0.74), IPL (0.85 and 0.94) for AD relative to FTD, and in the mPFC in FTD relative to AD (both 0.68).Similar patterns of hypoperfusion and hypometabolism were observed in regions typically associated with AD and FTD, suggesting that ASL-MRI provides information comparable to FDG-PET. • Similar patterns of hypoperfusion and hypometabolism were observed in patients with dementia. • For both imaging modalities, parietal abnormalities were found in Alzheimer's disease. • For both imaging modalities, prefrontal abnormalities were found in frontotemporal dementia.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology & Nuclear Medicine, VU University Medical Centre, Amsterdam, The Netherlands, s.verfaillie@vumc.nl.

ABSTRACT

Objectives: Alzheimer's disease (AD) and frontotemporal (FTD) dementia can be differentiated using [(18)F]-2-deoxy-2-fluoro-D-glucose (FDG)-PET. Since cerebral blood flow (CBF) is related to glucose metabolism, our aim was to investigate the extent of overlap of abnormalities between AD and FTD.

Methods: Normalized FDG-PET and arterial spin labelling (ASL-MRI)-derived CBF was measured in 18 AD patients (age, 64 ± 8), 12 FTD patients (age, 61 ± 8), and 10 controls (age, 56 ± 10). Voxel-wise comparisons, region-of-interest (ROI), correlation, and ROC curve analyses were performed.

Results: Voxel-wise comparisons showed decreased CBF and FDG uptake in AD compared with controls and FTD in both precuneus and inferior parietal lobule (IPL). Compared with controls and AD, FTD patients showed both hypometabolism and hypoperfusion in medial prefrontal cortex (mPFC). ASL and FDG were related in precuneus (r = 0.62, p < 0.001), IPL (r = 0.61, p < 0.001), and mPFC across groups (r = 0.74, p < 001). ROC analyses indicated comparable performance of perfusion and metabolism in the precuneus (AUC, 0.72 and 0.74), IPL (0.85 and 0.94) for AD relative to FTD, and in the mPFC in FTD relative to AD (both 0.68).

Conclusions: Similar patterns of hypoperfusion and hypometabolism were observed in regions typically associated with AD and FTD, suggesting that ASL-MRI provides information comparable to FDG-PET.

Key points: • Similar patterns of hypoperfusion and hypometabolism were observed in patients with dementia. • For both imaging modalities, parietal abnormalities were found in Alzheimer's disease. • For both imaging modalities, prefrontal abnormalities were found in frontotemporal dementia.

No MeSH data available.


Related in: MedlinePlus