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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

Functional brain abnormalities of AD and FTD compared to controls projected onto a MNI glass brain. Predominantly parietal, precuneus aberrant function is visible in AD compared to controls, while FTD compared to controls shows mostly prefrontal abnormalities with both FDG and ASL. For illustrative purposes, images were thresholded at p < 0.005
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Fig2: Functional brain abnormalities of AD and FTD compared to controls projected onto a MNI glass brain. Predominantly parietal, precuneus aberrant function is visible in AD compared to controls, while FTD compared to controls shows mostly prefrontal abnormalities with both FDG and ASL. For illustrative purposes, images were thresholded at p < 0.005

Mentions: Figure 2 shows regional abnormalities derived from group comparisons projected onto an MNI glass brain, while Fig. 3A shows z-scores for FTD and AD compared to controls (MNI coordinates with corresponding cluster sizes are displayed in Supplementary Table 2). In AD compared to controls, both lower metabolism (FDG) and lower perfusion (ASL) were found in the bilateral precuneus, bilateral inferior parietal lobule (IPL), and dorsolateral prefrontal cortex (DLPFC). In addition, AD patients showed lower perfusion in the orbitofrontal cortex (OFC). Compared with controls, FTD patients showed both lower metabolism and lower perfusion in mPFC, OFC, and temporal poles. In addition, hypoperfusion was found in the supplementary motor area (SMA) and hypometabolism in the DLPFC in FTD. Overall, mean age- and sex-adjusted z-scores (reflecting normal deviates) were comparable between ASL and FDG in patient groups relative to controls.Fig. 2


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)

Functional brain abnormalities of AD and FTD compared to controls projected onto a MNI glass brain. Predominantly parietal, precuneus aberrant function is visible in AD compared to controls, while FTD compared to controls shows mostly prefrontal abnormalities with both FDG and ASL. For illustrative purposes, images were thresholded at p < 0.005
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig2: Functional brain abnormalities of AD and FTD compared to controls projected onto a MNI glass brain. Predominantly parietal, precuneus aberrant function is visible in AD compared to controls, while FTD compared to controls shows mostly prefrontal abnormalities with both FDG and ASL. For illustrative purposes, images were thresholded at p < 0.005
Mentions: Figure 2 shows regional abnormalities derived from group comparisons projected onto an MNI glass brain, while Fig. 3A shows z-scores for FTD and AD compared to controls (MNI coordinates with corresponding cluster sizes are displayed in Supplementary Table 2). In AD compared to controls, both lower metabolism (FDG) and lower perfusion (ASL) were found in the bilateral precuneus, bilateral inferior parietal lobule (IPL), and dorsolateral prefrontal cortex (DLPFC). In addition, AD patients showed lower perfusion in the orbitofrontal cortex (OFC). Compared with controls, FTD patients showed both lower metabolism and lower perfusion in mPFC, OFC, and temporal poles. In addition, hypoperfusion was found in the supplementary motor area (SMA) and hypometabolism in the DLPFC in FTD. Overall, mean age- and sex-adjusted z-scores (reflecting normal deviates) were comparable between ASL and FDG in patient groups relative to controls.Fig. 2

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