Amyloid PET imaging in multiple sclerosis: an 18F-florbetaben study

Abstract

BackgroundPositron emission tomography (PET) images with amyloid tracers show normal uptake in healthy white matter, which suggests that amyloid tracers are potentially useful for studying such white matter diseases as multiple sclerosis (MS).MethodsTwelve patients diagnosed with MS (5 with RRMS, 5 with SPMS, and 2 with PPMS) and 3 healthy controls underwent studies with MRI and 18F-florbetaben-PET imaging. Images were preprocessed using Statistical Parametric Mapping software. We analysed 18F-florbetaben uptake in demyelinating plaques (appearing as hyperintense lesions in FLAIR sequences), in normal-appearing white matter, and in grey matter.ResultsMean standardized uptake value relative to cerebellum was higher in normally appearing white matter (NAWM) (1.51 ± 0.12) than in damaged white matter (DWM) (1.24 ± 0.12; P = .002). Mean percentage of change between NAWM and DWM was −17.56 % ± 6.22 %. This percentage of change correlated negatively with EDSS scores (r = −0.61, p < .05) and with age (r = −0.83, p < 0.01). Progressive forms of MS showed a more pronounced reduction of the uptake in DWM in comparison to relapsing-remitting form.ConclusionsUptake of 18F-florbetaben in damaged white matter is lower than that occurring in normally-appearing white matter. These findings indicate that amyloid tracers may be useful in studies of MS, although further research is needed to evaluate the utility of amyloid-PET in monitoring MS progression.Electronic supplementary materialThe online version of this article (doi:10.1186/s12883-015-0502-2) contains supplementary material, which is available to authorized users.

Amyloid PET as a marker of normal-appearing white matter early damage in multiple sclerosis: correlation with CSF β-amyloid levels and brain volumes

“…Positron emission tomography (PET) with amyloid tracers (e.g. Pittsburg Compund-B, florbetapir, florbetaben, flutemetamol) was originally developed to image amyloid deposition in neurodegenerative disorders and dementia [7], but it has been recently repurposed as an imaging marker for quantification of myelin loss and repair in MS [5,[8][9][10]. Amyloid tracers bind extensively to WM and its uptake decreases with demyelination [8].…”

Vitamina D y remielinización en la esclerosis múltiple

“…La megalina participa en la endocitosis y la internalización de la APP 122 y de los péptidos A␤, y se ha descrito en neuronas hipocámpicas un complejo entre megalina-APP y Fe65 que actuaría como regulador en la toxicidad por los péptidos A␤ 123 . El potencial papel de la APP y su vía de señalización ha sido revisado recientemente por parte de los autores de este artículo 124 , partiendo del hallazgo de que la mielina fija trazadores de amiloide en PET 125 . La APP está sobrerregulada en axones desmielinizados y supone la activación de la cascada amiloide favoreciendo la producción de A␤ 126,127 .…”

Amyloid Imaging: Poised for Integration into Medical Practice

“…While this study only utilized 12 patients, this may serve as a future area of research for studies to find other utilities of amyloid imaging outside the realm of dementia [46].…”