Regions of Interest–Based Discriminant Analysis of DaTSCAN SPECT and FDG-PET for the Classification of Dementia

Garibotto, Valentina; Montandon, Marie Louise; Viaud, Claire Tabouret; Allaoua, Mohamed; Assal, Frédéric; Burkhard, Pierre; Ratib, Osman; Zaidi, Habib

doi:10.1097/rlu.0b013e318279b991

Cited by 33 publications

(18 citation statements)

References 29 publications

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“…Post hoc tests between these 2 groups showed no significant differences in PC cog and PC mot expression values. This finding in some sense contradicts the results presented in a discriminant analysis study (33) in which the DLB and PDD groups were clearly distinguishable by their 18 F-FDG PET measurements. The reason for this discrepancy may be a result of the low subject sample size (8 DLB patients and 4 PDD patients) in this previous study, which was discussed as a major limitation of the study.…”

Section: Discussioncontrasting

confidence: 56%

Metabolic Topology of Neurodegenerative Disorders: Influence of Cognitive and Motor Deficits

et al. 2015

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Parkinson disease with and without dementia (PDD and PD, respectively), dementia with Lewy bodies (DLB), and Alzheimer dementia (AD) traditionally have been viewed as distinct clinical and pathologic entities. However, intriguing overlaps in biochemical, clinical, and imaging findings question the concept of distinct entities and suggest a continuous spectrum in which individual patients express PD-typical patterns and AD-typical patterns to a variable degree. Methods: Following this concept, we built a topological map based on regional patterns of the cerebral metabolic rate of glucose as measured with 18 F-FDG PET to rank and localize single subjects' disease status according to PD-typical (PD vs. controls) and ADtypical (AD vs. controls) pattern expression in patients clinically characterized as PD, PDD, DLB, amnestic mild cognitive impairment, and AD. Results: The topology generally confirmed an indivisible spectrum of disease manifestation according to 2 separable expression patterns. The expression values derived from the first pattern were highly correlated with individual cognitive, but not motor, disability. The opposite was found for the corresponding expression values of the second pattern. Conclusion: The metabolic imaging analysis supports the notion that there is a continuous spectrum of neurodegeneration between AD and PD. Furthermore, PDD and DLB may in fact represent 1 overlapping disease entity, characterized by the presence of mixed neuropathology and only different by the time course.Key Words: Alzheimer; Parkinson; FDG PET; dementia; motor deficits J Nucl Med 2015; 56:1916 56: -1921 56: DOI: 10.2967 Age-related neuropsychiatric disorders such as Parkinson disease with and without dementia (PDD and PD, respectively), dementia with Lewy bodies (DLB), amnestic mild cognitive impairment (aMCI), and Alzheimer disease dementia (AD) represent a growing socioeconomic challenge. However, these disorders show substantial clinical and neuropathologic overlap, limiting diagnostic accuracy and questioning the concept of distinct clinical entities (1-3). Indeed, the notion that PD and AD may be extremes of a spectrum of neurodegenerative diseases-with DLB and PDD presenting overlapping neuropathologic and clinical features within this spectrum-has received growing attention in recent years (4).Although pathophysiologically and clinically different, PD and AD share some aspects in common: both are age-related neurodegenerative disorders characterized by aggregation of pathologic proteins leading to dysfunction of cerebral networks and distinct patterns of metabolic changes (3-6). Cases characterized by pure PD (a-synuclein aggregation) or pure AD (amyloid and tau aggregation) pathology do not represent most affected patients. Biologically and histopathologically, there is an overlap of these age-associated proteinopathies. They form a continuum with concomitant amyloid-, tau-, and a-synuclein aggregation as well as microvascular changes (6,7).aMCI represents an intermediate clinical state of cognitive de...

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Section: Discussioncontrasting

confidence: 56%

Metabolic Topology of Neurodegenerative Disorders: Influence of Cognitive and Motor Deficits

et al. 2015

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“…All patients underwent physical and neurological examination, neuropsychological studies, assessment of depression, cerebral magnetic resonance, blood test, lumbar puncture (LP), and cerebral DAT‐SCAN when LBD was suspected. Subjects were scanned on a triple‐head gamma camera (Toshiba Medical Systems, Tokyo, Japan) with fan‐beam, low‐energy, high‐resolution collimators, 4 h after intravenous injection of about 185 MBq of 123 I‐ioflupane SPECT, following a standard protocol described in detail elsewhere (Garibotto et al ). Brain MRI 1.5 Tesla General Electrics was performed on all patients to assess medial temporal lobe atrophy according to Korf criteria (2004) (Korf et al ) and to rule out brain injuries responsible for the clinical presentation, particularly those of vascular origin.…”

Section: Methodsmentioning

confidence: 99%

Measurement of CSF α‐synuclein improves early differential diagnosis of mild cognitive impairment due to Alzheimer’s disease

García‐Ayllón

Monge-Argilés

Monge‐García

et al. 2019

Journal of Neurochemistry

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Previous studies have indicated the potential of cerebrospinal fluid (CSF) a-synuclein (a-syn) to be an additional biomarker for improving differential diagnosis of Alzheimer's disease (AD). We evaluated a-syn diagnostic performance across a well-characterized patient cohort with long-term follow-up. For this purpose, CSF a-syn levels were determined in 25 subjects diagnosed with stable mild cognitive impairment (stable MCI; n = 25), 27 MCI cases due to AD (MCI-AD; n = 32), 24 MCI cases due to Lewy body disease (MCI-LBD; n = 24) and control subjects (Ctrl; n = 18). CSF a-syn levels discriminate between the four groups. There were higher a-syn levels in MCI-AD patients and lower levels in MCI-LBD patients. The combination of a-syn and P-tau resulted in a specificity of 99% and a sensitivity of 97% for MCI-AD. MCI-AD patients with early psychotic symptoms (n = 9) displayed a trend towards a decrease in P-tau and a-syn compared to the MCI-AD patients without psychotic symptoms (n = 23). We conclude that adding CSF a-syn to central core AD biomarkers improves an early differential diagnosis of MCI-AD from other forms of MCI.

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“…Neuroimaging, showing reduced occipital metabolism and perfusion and reduced striatal dopaminergic innervation, is increasingly used to supplement the clinical diagnosis of DLB [60].…”

Section: Dementia With Lewy Bodiesmentioning

confidence: 99%

FDG PET and cognitive symptoms of dementia

Perani

2013

Clin Transl Imaging

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The fundamentals of FDG PET are well established, and are based on extensively explored molecular mechanisms. The existing methods for semiquantitative assessment of brain functional changes provide topographical maps of molecular alterations both for group and single-subject comparisons. This functional brain-based approach to derangement of high-order cognition has provided and will continue to provide highquality findings that will help further understanding of brain cognitive activity and of the brain-cognition correlates and their importance in the diagnosis of the underlying pathology. This article examines the relationship between changes in brain metabolic activity and the resulting impairment of high-order cognition in dementia conditions. FDG PET imaging in subjects with underlying neurodegenerative pathology has emerged as a crucial tool available to the fields of cognitive neurology and neuroscience for both diagnosis and evaluation of the involved neural systems, extending the neuropsychology-based understanding of the brain/cognition relationship. As an effect of the multiple underlying pathologies, the cognitive deficits encountered encompass different aspects of neuropsychology: language, memory, performance monitoring, decision making, reasoning, and even ''personality.'' It is to be noted that FDG PET studies of brain cognitive reserve have so far supported the existence of functional reserve phenomena in neurodegenerative dementia, and specifically in AD. The newly integrated PET/MRI techniques will likely become crucial clinical and research tools in neurology, nuclear medicine and in the neuroscience field generally. Hybrid PET/MRI will allow integration of the molecular information provided by PET with the various morphological and functional parameters measured by MRI, in the same subject and in a single study session. Future progress depends on exploration of these relationships to pave the way for new insights into neuroscience and neurology.

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Regions of Interest–Based Discriminant Analysis of DaTSCAN SPECT and FDG-PET for the Classification of Dementia

Cited by 33 publications

References 29 publications

Metabolic Topology of Neurodegenerative Disorders: Influence of Cognitive and Motor Deficits

Metabolic Topology of Neurodegenerative Disorders: Influence of Cognitive and Motor Deficits

Measurement of CSF α‐synuclein improves early differential diagnosis of mild cognitive impairment due to Alzheimer’s disease

FDG PET and cognitive symptoms of dementia

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