Validation of an optimized SPM procedure for FDG-PET in dementia diagnosis in a clinical setting

Perani, Daniela; Rosa, Pasquale Anthony Della; Cerami, Chiara; Gallivanone, Francesca; Fallanca, Federico; Vanoli, Emilia Giovanna; Panzacchi, A.; Nobili, Flavio; Pappatà, Sabina; Marcone, Alessandra; Garibotto, Valentina; Castiglioni, Isabella; Magnani, Giuseppe; Cappa, Stefano F.; Gianolli, Luigi

doi:10.1016/j.nicl.2014.10.009

Cited by 186 publications

(212 citation statements)

References 55 publications

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“…The comparison was performed by means of a two independent sample t tests. At the first level, each of the single-subject FDG images was analyzed by means of an optimized single-subject procedure (49,50), ending in a comparison of each AD case to a large dataset of healthy controls (SI Text). The comparison generated single SPM t-maps showing regions of hypometabolism with a strong level of significance (P < 0.05 FWE correction for multiple comparisons).…”

Section: Methodsmentioning

confidence: 99%

The impact of bilingualism on brain reserve and metabolic connectivity in Alzheimer's dementia

Perani

Farsad

Ballarini³

et al. 2017

Proc. Natl. Acad. Sci. U.S.A.

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Cognitive reserve (CR) prevents cognitive decline and delays neurodegeneration. Recent epidemiological evidence suggests that lifelong bilingualism may act as CR delaying the onset of dementia by ∼4.5 y. Much controversy surrounds the issue of bilingualism and its putative neuroprotective effects. We studied brain metabolism, a direct index of synaptic function and density, and neural connectivity to shed light on the effects of bilingualism in vivo in Alzheimer's dementia (AD). Eighty-five patients with probable AD and matched for disease duration (45 German-Italian bilingual speakers and 40 monolingual speakers) were included. Notably, bilingual individuals were on average 5 y older than their monolingual peers. In agreement with our predictions and with models of CR, cerebral hypometabolism was more severe in the group of bilingual individuals with AD. The metabolic connectivity analyses crucially supported the neuroprotective effect of bilingualism by showing an increased connectivity in the executive control and the default mode networks in the bilingual, compared with the monolingual, AD patients. Furthermore, the degree of lifelong bilingualism (i.e., high, moderate, or low use) was significantly correlated to functional modulations in crucial neural networks, suggesting both neural reserve and compensatory mechanisms. These findings indicate that lifelong bilingualism acts as a powerful CR proxy in dementia and exerts neuroprotective effects against neurodegeneration. Delaying the onset of dementia is a top priority of modern societies, and the present in vivo neurobiological evidence should stimulate social programs and interventions to support bilingual or multilingual education and the maintenance of the second language among senior citizens.bilingualism | Alzheimer's dementia | fluorine-18-fluorodeoxyglucose PET | brain reserve | brain metabolic connectivity

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Section: Methodsmentioning

confidence: 99%

The impact of bilingualism on brain reserve and metabolic connectivity in Alzheimer's dementia

Perani

Farsad

Ballarini³

et al. 2017

Proc. Natl. Acad. Sci. U.S.A.

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196

141

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“…Single-subject analysis was carried out with SPM5 software (www.fil.ion.ucl.ac.uk/spm) on MATLAB 8 (MathWorks Inc, Sherborn, Mass) as previously described [13, 14]. The significance threshold was set at p < 0.05, FWE-corrected for multiple comparisons at the voxel level.…”

Section: Quantification Of Functional and Structural Neuroimaging Chamentioning

confidence: 99%

A multimodal neuroimaging study of a case of crossed nonfluent/agrammatic primary progressive aphasia

et al. 2015

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Crossed aphasia has been reported mainly as post-stroke aphasia resulting from brain damage ipsilateral to the dominant right hand. Here, we described a case of a crossed nonfluent/agrammatic primary progressive aphasia (nfvPPA), who developed a corticobasal syndrome (CBS). We collected clinical, cognitive, and neuroimaging data for four consecutive years from a 55-year-old right-handed lady (JV) presenting with speech disturbances. 18-fluorodeoxyglucose positron emission tomography (18F-FDG PET) and DaT-scan with 123I-Ioflupane were obtained. Functional MRI (fMRI) during a verb naming task was acquired to characterize patterns of language lateralization. Diffusion tensor MRI was used to evaluate white matter damage within the language network. At onset, JV presented with prominent speech output impairment and right frontal atrophy. After 3 years, language deficits worsened, with the occurrence of a mild agrammatism. The patient also developed a left-sided mild extrapyramidal bradykinetic-rigid syndrome. The clinical picture was suggestive of nfvPPA with mild left-sided extrapyramidal syndrome. At this time, voxel-wise SPM analyses of 18F-FDG PET and structural MRI showed right greater than left frontal hypometabolism and damage, which included the Broca’s area. DaT-scan showed a reduced uptake in the right striatum. FMRI during naming task demonstrated bilateral language activations, and tractography showed right superior longitudinal fasciculus (SLF) involvement. Over the following year, JV became mute and developed frank left-sided motor signs and symptoms, evolving into a CBS clinical picture. Brain atrophy worsened in frontal areas bilaterally, and extended to temporo-parietal regions, still with a right-sided asymmetry. Tractography showed an extension of damage to the left SLF and right inferior longitudinal fasciculus. We report a case of crossed nfvPPA followed longitudinally and studied with advanced neuroimaging techniques. The results highlight a complex interaction between individual premorbid developmental differences and the clinical phenotype.

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“…FDG-PET (PET with 18F-fluorodeoxyglucose) is a sensitive and specific imaging biomarker for the diagnosis of AD and the best predictor of progression to dementia in mild cognitive impairment [8-11]. …”

Section: Introductionmentioning

confidence: 99%

Education-Adjusted Normality Thresholds for FDG-PET in the Diagnosis of Alzheimer Disease

et al. 2018

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Background: A corollary of the reserve hypothesis is that what is regarded as pathological cortical metabolism in patients might vary according to education. Objective: The aim of this study is to assess the incremental diagnostic value of education-adjusted over unadjusted thresholds on the diagnostic accuracy of FDG-PET as a biomarker for Alzheimer disease (AD). Methods: We compared cortical metabolism in 90 healthy controls and 181 AD patients from the Alzheimer Disease Neuroimaging Initiative (ADNI) database. The AUC of the ROC curve did not differ significantly between the whole group and the higher-education patients or the lower-education subjects. Results: The threshold of wMetaROI values providing 80% sensitivity was lower in higher-education patients and higher in the lower-education patients, compared to the standard threshold derived over the whole AD collective, without, however, significant changes in sensitivity and specificity. Conclusion: These data show that education, as a proxy of reserve, is not a major confounder in the diagnostic accuracy of FDG-PET in AD and the adoption of education-adjusted thresholds is not required in daily practice.

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Validation of an optimized SPM procedure for FDG-PET in dementia diagnosis in a clinical setting

Cited by 186 publications

References 55 publications

The impact of bilingualism on brain reserve and metabolic connectivity in Alzheimer's dementia

The impact of bilingualism on brain reserve and metabolic connectivity in Alzheimer's dementia

A multimodal neuroimaging study of a case of crossed nonfluent/agrammatic primary progressive aphasia

Education-Adjusted Normality Thresholds for FDG-PET in the Diagnosis of Alzheimer Disease

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