Single photon tomography in Alzheimer's disease and the dementias

Bonte, Frederick J.; Hom, Jim; Tintner, Ron; Weiner, Myron

doi:10.1016/s0001-2998(05)80238-7

Cited by 52 publications

(21 citation statements)

References 29 publications

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“…Initial 18 F-FDG PET studies, comparing cerebral metabolic rate for glucose consumption (CMRGlc) in patients with AD with age-matched, healthy controls, showed that there is a 20%-30% decrease in whole-brain CMRGlc values in patients with AD when compared with healthy age-matched controls (6). Other studies showed that patients with AD have decreased CMRGlc, whereas the bilateral parietal and temporal lobes are particularly affected (7)(8)(9). In general, this classic pattern of temporoparietal lobe hypometabolism has demonstrated a sensitivity and specificity of approximately 80%-90%\ (10-13).…”

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confidence: 99%

Initial Clinical Comparison of ¹⁸F-Florbetapir and ¹⁸F-FDG PET in Patients with Alzheimer Disease and Controls

Newberg

Arnold²,

Wintering³

et al. 2012

J Nucl Med

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The purpose of this study was to determine how clinical interpretations of the 18 F-amyloid tracer florbetapir compares diagnostically with 18 F-FDG PET when evaluating patients with Alzheimer disease (AD) and controls. Methods: Nineteen patients with a clinical diagnosis of AD and 21 elderly controls were evaluated with both 18 F-florbetapir and 18 F-FDG PET scans. Scans were interpreted together by 2 expert readers masked to any case information and were assessed for tracer binding patterns consistent with AD. The criteria for interpreting the 18 F-florbetapir scan as positive for AD was the presence of binding in the cortical regions relative to the cerebellum. 18 F-FDG PET scans were interpreted as positive if they displayed the classic pattern of hypometabolism in the temporoparietal regions. Scans were interpreted as either positive or negative for AD. In addition, a relative scoring system was used to assess the degree of either hypometabolism or amyloid binding in specified regions. The metabolism and amyloid binding scores for each region were compared across subjects. An overall ratio was calculated on the basis of values in regions expected to be affected by AD and those not expected to be affected. The metabolic ratio and amyloid ratio were then correlated with the mini-mental status examination (MMSE) score. Results: The sensitivity and specificity, compared with the clinical diagnosis of AD or controls, for the 18 Fflorbetapir scans were 95% and 95%, respectively, and for the 18 F-FDG scans 89% and 86%, respectively. When a comparison with MMSE scores was made, 18 F-FDG significantly correlated with MMSE when both controls and AD patients were included (r 5 0.79, P , 0.0001) and in AD patients alone (r 5 0.70, P 5 0.001). The 18 F-florbetapir scores significantly correlated with MMSE scores only when both controls and AD patients were included (r 5 0.62, P , 0.001) but not in the AD group alone (r 5 0.12, P 5 0.66). Conclusion: Overall, both scans performed well in detecting AD in patients with known clinical AD. Both scans correlated well with cognitive status as determined by MMSE when the entire cohort of controls and AD patients was evaluated. However, only the 18 F-FDG scans correlated with cognitive status when AD patients were evaluated separately.

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confidence: 99%

Initial Clinical Comparison of ¹⁸F-Florbetapir and ¹⁸F-FDG PET in Patients with Alzheimer Disease and Controls

Newberg

Arnold²,

Wintering³

et al. 2012

J Nucl Med

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“…Cohen et al 5 showed similar accuracy of SPECT and PET in the differential diagnosis of dementia, being the former a much more affordable test. Using high sensitivity Xe-133 SPECT, Bonte et al 4 showed 88% of sensitivity and 76% of specificity studying 90 patients with Alzheimer's disease. They also showed that 14 of them had early disease according to the MMSE.…”

Section: Discussionmentioning

confidence: 99%

“…Regional alteration in cerebral blood flow and glucose metabolism has been seen in demented patients using single photon emission computerized tomography (SPECT) and positron emission tomography (PET) 10,17 -20,25 . Quite specific functional patterns have been described for multi-infarct dementia, frontal dementia and dementia of Alzheimer's type 4 .…”

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confidence: 99%

Brain SPECT in dementia a clinical-scintigraphic correlation

Buchpiguel¹,

Mathias

Itaya³

et al. 1996

Arq. Neuro-Psiquiatr.

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-The aim of this study was to compare the accuracy of computed tomography (CT) and single photon emission computerized tomography (SPECT) in the diagnosis of dementia. Fifty-two patients with clinical diagnosis of dementia and 11 controls were studied. The scans were interpreted by one experienced neuroradiologist and one nuclear radiologist, both blinded to the clinical data. In the diagnosis of dementia, CT and SPECT showed equal sensitivity (82.7%) and statistically similar specificity (63.8 and 81.8%, respectively). The specificity of SPECT in diagnosing Alzheimer's disease (100%) was statistically superior to CT (69%). However, both methods showed similar sensitivity in detecting Alzheimer's disease. In conclusion, SPECT and CT showed similar accuracy in the diagnosis of dementia. The quite high specificity of SPECT in Alzheimer's disease may be useful for confirming that diagnosis, particularly for patients with presenile onset of the disease.KEY WORDS: SPECT, computed tomography, dementia, Alzheimer's disease, HMPAO-Tc99m.SPECT cerebral na demência: uma correlação clínico-cintilográfica RESUMO -O objetivo deste estudo foi comparar a acurácia da tomografia computadorizada (TC) e da tomografia computadorizada por emissão de fóton único (SPECT) no diagnóstico de demência. Cinquenta e dois pacientes com diagnóstico clínico de demência e 11 controles foram estudados. Os exames foram interpretados por um neuroradiologista e um radiologista nuclear, ambos cegos quanto aos dados clínicos. No diagnóstico de demência, a TC e a SPECT mostraram sensibilidades iguais (82,7%) e estatisticamente especificidades semelhantes (63,8 e 81,8%, respectivamente). A especificidade da SPECT no diagnóstico da doença de Alzheimer (100%) foi significativamente superior à da TC (69%). Contudo, ambos os métodos mostraram sensibilidades semelhantes na detecção de doença de Alzheimer. Em conclusão, TC e SPECT mostraram acurácia similar no diagnóstico de demência. A alta especificidade observada no diagnóstico de doença de Alzheimer pode ser útil na confirmação do diagnóstico clínico, especialmente na forma pré-senil da doença. PALAVRAS-CHAVE: SPECT, tomografia computadorizada, demência, doença de Alzheimer, HMPAO-Tc99m.The clinical confirmation of dementia consists of two main distinct phases. The first is designed for confirming the cognitive decline and the second for determining the involved etiology. However, the lack of a gold-standard test is the main obstacle for establishing the diagnosis of dementia.Anatomical imaging modalities such as X-ray computed tomography (CT) and magnetic resonance imaging (MRI) are useful in the work up of patients with dementia. They can detect space-occupying lesions, neoplasm, stroke, hydrocephalus and frontal lobe atrophy that might be found in association with trauma or Pick's disease 18 . However, neither of those techniques is valuable nor specific for the diagnosis of Alzheimer's disease.

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“…Under these circumstances, P-amyloid mediated inhibition of the astrocytic nitric oxide release would have a down regulatory effect on cerebral blood flow in AD patients. Indeed, a reduction in cerebral blood flow in AD patients has been already reported (Bonte et al, 1990;Bonteetal., 1993;HohnanetaL, 1992).…”

Section: B-amvloid Andmentioning

confidence: 82%

“…It is conceivable that suppressive action of B-amyloid on astrocytic release of nitric oxide may interfere with regxilation of regional cerebral blood flow and could be responsible for the reduction in regional cerebral blood flow known to occur in AD patients (Bonte et al, 1990;Bonte et aL, 1993;Holman et al, 1992). Human astrocytes release nitric oxide upon stimulation with a combination of DL-IB and EFN-y , and increased levels of cytokines ( EL-l, TNF-a, EFN-y) have been detected in the brain of AD patients Griffin et al, 1989;Haga et al, 1989;Huberman et al, 1994).…”

Section: Discussionmentioning

confidence: 99%

The role of astrocytes in Alzheimer's disease

Parpura-Gill

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This manuscript has been reproduced from the microfilm master. UMI films the text directly from the original or copy submitted. Thus, some thesis and dissertation copies are in typewriter face, while others may be from any type of computer printer.The quality of this reproduction is dependent upon the quality of the copy submitted. Broken or indistinct print, colored or poor quality illustrations and photographs, print bleedthrough, substandard margins, and improper alignment can adversely affect reproduction.In the unlikely event that the author did not send UME a complete manuscript and there are missing pages, these will be noted. Also, if unauthorized copyright material had to be removed, a note will indicate the deletion.Oversize materials (e.g., maps, drawings, charts) are reproduced by sectioning the original, beginning at the upper left-hand comer and continuing from left to right in equal sections with small overlaps. Each original is also photographed in one exposure and is included in reduced form at the back of the book.Photographs included in the original manuscript have been reproduced xerographically in this copy. Kgher quality 6" x 9" black and white photographic prints are available for any photographs or illustrations appearing in this copy for an additional charge. Contact UMI directly to order. Copyright © Aleksandra Parpura-Gill, 1998. All rights reserved Signature was redacted for privacy. UMISignature was redacted for privacy.Signature was redacted for privacy.Signature was redacted for privacy. has not been confirmed, but is a possibility (Roses et al., 1990;Goate et aL, 1990).There are two subtypes of Alzheimer's disease determined by the age of onset (American Psychiatric Association, 1997). In Early Onset AD, symptoms of the disease begin before 65 years of age while in Late Onset AD they start after the age of 65. LateOnset AD is much more common than Early Onset. The course of Alzheimer's disease is characterized by an insidious beginning and progressive nature. Early deficits in memory are followed by other cognitive disturbances and personality changes, as well as loss of judgment and spatial orientation (American Psychiatric Association, 1997). Clinical Si^s of Alzheimer's DiseaseThe onset of dementia is an essential clinical feature of Alzheimer's disease and also a requirement for the diagnosis of the disease. Dementia is a syndrome characterized by progressive mental deterioration resulting from multiple cognitive deficits. The cognitive deficit must be severe enough to cause an inability of the patient to carry out occupational or social activities, and it has to represent a decline in the level of fiinctioning from a previous existing level (American Psychiatric Association, 1997;Terry and Katzman, 1983).Memory impairment as a component of dementia affects both short-term and long-term memory. Individuals suffering from dementia not only forget previously learned material, but also have significantly decreased ability to leam new material. Most often patients exhibit both for...

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Single photon tomography in Alzheimer's disease and the dementias

Cited by 52 publications

References 29 publications

Initial Clinical Comparison of ¹⁸F-Florbetapir and ¹⁸F-FDG PET in Patients with Alzheimer Disease and Controls

Initial Clinical Comparison of ¹⁸F-Florbetapir and ¹⁸F-FDG PET in Patients with Alzheimer Disease and Controls

Brain SPECT in dementia a clinical-scintigraphic correlation

The role of astrocytes in Alzheimer's disease

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Single photon tomography in Alzheimer's disease and the dementias

Cited by 52 publications

References 29 publications

Initial Clinical Comparison of 18F-Florbetapir and 18F-FDG PET in Patients with Alzheimer Disease and Controls

Initial Clinical Comparison of 18F-Florbetapir and 18F-FDG PET in Patients with Alzheimer Disease and Controls

Brain SPECT in dementia a clinical-scintigraphic correlation

The role of astrocytes in Alzheimer's disease

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Initial Clinical Comparison of ¹⁸F-Florbetapir and ¹⁸F-FDG PET in Patients with Alzheimer Disease and Controls

Initial Clinical Comparison of ¹⁸F-Florbetapir and ¹⁸F-FDG PET in Patients with Alzheimer Disease and Controls