Visual and statistical analysis of 18F-FDG PET in primary progressive aphasia

Matías‐Guiu, Jordi A.; Cabrera‐Martín, María Nieves; Pérez-Castejón, M.J.; Moreno‐Ramos, Teresa; Rodríguez-Rey, Cristina; García-Ramos, R.; Ortega-Candil, A.; Fernández‐Matarrubia, Marta; Oreja‐Guevara, Celia; Carreras, José

doi:10.1007/s00259-015-2994-9

Cited by 36 publications

(23 citation statements)

References 37 publications

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“…Images were first transformed from DICOM to NifTI‐1 format using MRIConvert version 2.0 (Lewis Centre for Neuroimaging, University of Oregon, Eugene, OR, USA). The images of all subjects were spatially normalized to the reference space of the Montreal Neurological Institute employing our own workgroup template (Matías‐Guiu et al, ) and later underwent smoothing with full width at half maximum of 12 mm. Images were normalized to the whole cerebellum as reference region (cerebellum normalization) (Dukart et al, ).…”

Section: Methodsmentioning

confidence: 99%

Different apathy clinical profile and neural correlates in behavioral variant frontotemporal dementia and Alzheimer's disease

Fernández‐Matarrubia

Matías‐Guiu

Cabrera‐Martín

et al. 2017

Int J Geriat Psychiatry

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Objectives: Apathy is one of the most common and disabling syndromes of dementia. Clinical apathy expression and neuroanatomical basis of apathy seem to differ between behavioral variant frontotemporal dementia (bvFTD) and Alzheimer's disease (AD), although evidence is scarce and poorly understood. Our main purposes were to compare the clinical apathy profile from patients with bvFTD and AD and analyze the relationship between apathy and brain metabolism measured using positron emission tomography imaging with 18 F fluorodeoxyglucose (FDG-PET). Methods: Forty-two bvFTD, 42 AD, and 30 healthy volunteers without cognitive or behavioral complaints were included. Apathy was defined using Robert's 2009 diagnostic criteria, and specific apathy characteristics were assessed with the Lille Apathy Rating Scale. All participants underwent FDG-PET brain scan to provide data for voxel-based morphometric analysis. Results: Multivariate analysis showed that subjects affected by bvFTD displayed greater impairment of emotional apathy and self-awareness in comparison with AD sample. Additionally, FDG-PET imaging analyses revealed that apathy was associated with different neuroanatomical substrates in each dementia group: left lateral prefrontal, medial frontal/anterior cingulate, lateral orbitofrontal and anterior insular cortices in bvFTD, and right anterior cingulate in AD. Conclusions: These results support that apathy is a complex syndrome, with different clinical expressions across different pathological conditions. Those differences in qualitative aspects of apathy seem to be associated with differences in the damage sites, as shown by our FDG-PET imaging analysis. Our findings provide a better knowledge about pathophysiology of apathy in dementia, which could have practical implications for therapeutic management.

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Section: Methodsmentioning

confidence: 99%

Different apathy clinical profile and neural correlates in behavioral variant frontotemporal dementia and Alzheimer's disease

Fernández‐Matarrubia

Matías‐Guiu

Cabrera‐Martín

et al. 2017

Int J Geriat Psychiatry

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“…At QL in 6 of 18 (33.3%) patients (10)(11)(12)(13)(14)(15), the HA were in the frontoparietal and frontotemporal regions with the highest negative z score value at QN, in the prefrontal and temporal regions. However, in the remaining 3 of 18 (16.7%) patients (16)(17)(18) in whom the HA at QL appeared widespread and irregular in both cortical hemispheres, QN localized the highest z score negative value in the prefrontal and parietal areas bilaterally.…”

Section: Resultsmentioning

confidence: 91%

“…Globally, the combined use of QL and QN evidenced that the two procedures concordantly permitted to achieve a correct diagnosis in 8 of 18 (44.4%) cases, as lvPPA in 4 cases (5)(6)(7)(8) and as nfvPPA in 4 cases (12)(13)(14)(15). In the other 10 of 18 (55.6%) patients, only QN could be useful for the correct diagnosis, as lvPPA in 5 cases (1,2,3,11,16) and as nfvPPA in the remaining 5 cases (4,9,10,17,18). Case 3 is illustrated in Figure 1.…”

Section: Group a As Illustrated Inmentioning

confidence: 93%

“…Generally, all patterns predominate in the left hemisphere [15], but in lvPPA, when bilateral, temporoparietal hypometabolism is strongly suggestive of AD progression [16]. Moreover, a high diagnostic accuracy of 18 F-FDG PET in the differential diagnosis of PPA has been reported, especially in nfvPPA; thus, the inclusion of the procedure in PPA diagnostic criteria was suggested, in particular when quantitative (QN) analysis is associated with qualitative (QL) analysis [17,18].…”

Section: Introductionmentioning

confidence: 99%

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Qualitative and Quantitative Analyses of Brain <sup>18</sup>Fluoro-Deoxy-Glucose Positron Emission Tomography in Primary Progressive Aphasia

Nuvoli

Tanda

Stazza

et al. 2019

Dement Geriatr Cogn Disord

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KeywordsPrimary progressive aphasia · Dementia · Brain 18 fluoro-deoxy-glucose positron emission neuroimaging Abstract Background: A primary progressive aphasia (PPA) diagnosis is generally based on clinical criteria, but often symptoms and signs may overlap in the different forms. Recent data have evidenced that brain 18 fluoro-deoxy-glucose positron emission tomography ( 18 F-FDG PET) could support the clinical diagnosis, since specific metabolic patterns are described for the different variants. Aims: We further evaluated the usefulness of 18 F-FDG PET, by both visual qualitative (QL) and quantitative (QN) methods in the initial diagnosis of PPA, focusing on the classification of different variants. Moreover, we also analyzed the role of 18 F-FDG PET in clarifying the association of PPA with the early phase of Alzheimer's disease (AD) or frontotemporal (FTD) dementias. Methods: We consecutively enrolled 35 patients with clinical symptoms of aphasia, suspect of or attributable to PPA. Patients were classified into two groups: 18 cases with clinical symptoms of aphasia but normal neuropsychological tests and an unclear classification of a specific PPA variant (group A) and 17 cases with clinical and neuropsychological signs attributable to PPA with an uncertain differential diagnosis between AD and FTD (group B). All patients underwent brain 18 F-FDG PET/CT, and images were evaluated both by QL and QN, the latter applying an automated analysis program that produced brain regional metabolic maps and normal age-matched control group comparative analysis (z score). Results: 18 F-FDG PET showed different patterns of bilateral cortical hypometabo-lism in the two groups. The combined use of QL and QN permitted to achieved a correct PPA variant diagnosis in 8 of 18 (44.4%) cases of group A and in 14 of 17 (82.3%) of group B, while only QN could support the correct classification of PPA variants in 10 of 18 (55.6%) cases of group A and in 3 of 17 (17.7%) cases of group B in whom the procedure better localized the hypometabolic areas. Conclusions: Brain 18 F-FDG PET had an elevated performance in the early diagnosis of PPA variants and in the advanced PPA AD/FTD classification. QL clarified the development of AD or FTD in advanced PPA cases and supported the differential diagnosis of a PPA variant in a few early cases. QN 18 F-FDG PET evaluation better contributed to the early diagnosis of an unclear metabolic pattern. To correctly identify all cases, patients with diffuse cortical hypometabolism were also included. Larger series are necessary to confirm these data.A total of 35 consecutive patients (15 males, 20 females, aged 53-80 years, mean ± SD value: 69 ± 6.0) with clinical symptoms of aphasia, suspect of or attributable to PPA, were enrolled retrospectively. All patients were investigated for neurological familiar diseases, neurological non-PPA affections, and generally related diseases (hypertension and diabetes mellitus). Laboratory analyses excluded secondary cognitive disorders.Neurological examinations, basal...

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“…Del Sole et al skills during the initial phase of the disease. [ 18 F]FDG PET detects areas of hypometabolism lateralized to the left, consistent with the aphasic disorder, in the frontal and/or in the temporal lobe, in relation to the different clinical variants (Matías-Guiu et al, 2015). The less frequent semantic variant of FTD is characterized by progressive anomia, reflecting a fundamental loss of semantic memory, with less impairment of executive functions, while memory and visuospatial functions are generally normal.…”

Section: @ C I C E D I Z I O N I I N T E R N a Z I O N A L Imentioning

confidence: 99%

Magnetic resonance imaging and positron emission tomography in the diagnosis of neurodegenerative dementias

Sole¹,

Malaspina²,

A³

2016

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SummaryNeuroimaging, both with magnetic resonance imaging (MRI) and positron emission tomography (PET), has gained a pivotal role in the diagnosis of primary neurodegenerative diseases. These two techniques are used as biomarkers of both pathology and progression of Alzheimer's disease (AD) and to differentiate AD from other neurodegenerative diseases. MRI is able to identify structural changes including patterns of atrophy characterizing neurodegenerative diseases, and to distinguish these from other causes of cognitive impairment, e.g. infarcts, space-occupying lesions and hydrocephalus. PET is widely used to identify regional patterns of glucose utilization, since distinct patterns of distribution of cerebral glucose metabolism are related to different subtypes of neurodegenerative dementia. The use of PET in mild cognitive impairment, though controversial, is deemed helpful for predicting conversion to dementia and the dementia clinical subtype. Recently, new radiopharmaceuticals for the in vivo imaging of amyloid burden have been licensed and more tracers are being developed for the assessment of tauopathies and inflammatory processes, which may underlie the onset of the amyloid cascade. At present, the cerebral amyloid burden, imaged with PET, may help to exclude the presence of AD as well as forecast its possible onset. Finally PET imaging may be particularly useful in ongoing clinical trials for the development of dementia treatments. In the near future, the use of the above methods, in accordance with specific guidelines, along with the use of effective treatments will likely lead to more timely and successful treatment of neurodegenerative dementias.

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Visual and statistical analysis of 18F-FDG PET in primary progressive aphasia

Cited by 36 publications

References 37 publications

Different apathy clinical profile and neural correlates in behavioral variant frontotemporal dementia and Alzheimer's disease

Different apathy clinical profile and neural correlates in behavioral variant frontotemporal dementia and Alzheimer's disease

Qualitative and Quantitative Analyses of Brain <sup>18</sup>Fluoro-Deoxy-Glucose Positron Emission Tomography in Primary Progressive Aphasia

Magnetic resonance imaging and positron emission tomography in the diagnosis of neurodegenerative dementias

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