Journal article
In vivo staging of regional amyloid deposition
Neurology, Vol.89(20), pp.2031-2038
11/14/2017
DOI: 10.1212/WNL.0000000000004643
PMCID: PMC5711511
PMID: 29046362
Abstract
To estimate a regional progression pattern of amyloid deposition from cross-sectional amyloid-sensitive PET data and evaluate its potential for in vivo staging of an individual's amyloid pathology.
Multiregional analysis of florbetapir (
F-AV45)-PET data was used to determine individual amyloid distribution profiles in a sample of 667 participants from the Alzheimer's Disease Neuroimaging Initiative cohort, including cognitively normal older individuals (CN) as well as patients with mild cognitive impairment and Alzheimer disease (AD) dementia. The frequency of regional amyloid positivity across CN individuals was used to construct a 4-stage model of progressing amyloid pathology, and individual distribution profiles were used to evaluate the consistency of this hierarchical stage model across the full cohort.
According to a 4-stage model, amyloid deposition begins in temporobasal and frontomedial areas, and successively affects the remaining associative neocortex, primary sensory-motor areas and the medial temporal lobe, and finally the striatum. Amyloid deposition in these brain regions showed a highly consistent hierarchical nesting across participants, where only 2% exhibited distribution profiles that deviated from the staging scheme. The earliest in vivo amyloid stages were mostly missed by conventional dichotomous classification approaches based on global florbetapir-PET signal, but were associated with significantly reduced CSF Aβ42 levels. Advanced in vivo amyloid stages were most frequent in patients with AD and correlated with cognitive impairment in individuals without dementia.
The highly consistent regional hierarchy of PET-evidenced amyloid deposition across participants resembles neuropathologic observations and suggests a predictable regional sequence that may be used to stage an individual's progress of amyloid pathology in vivo.
Details
- Title: Subtitle
- In vivo staging of regional amyloid deposition
- Creators
- Michel J Grothe - From the German Center for Neurodegenerative Diseases (DZNE) (M.J.G., M.D., S.J.T.), Rostock; Department of Nuclear Medicine (H.B., O.S.), University of Leipzig, Germany; Gordon Center for Medical Imaging (J.S.), Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston; Athinoula A. Martinos Center for Biomedical Imaging (J.S.), Charlestown, MA; and Department of Psychosomatic Medicine (S.J.T.), University of Rostock, Germany. michel.grothe@dzne.deHenryk Barthel - From the German Center for Neurodegenerative Diseases (DZNE) (M.J.G., M.D., S.J.T.), Rostock; Department of Nuclear Medicine (H.B., O.S.), University of Leipzig, Germany; Gordon Center for Medical Imaging (J.S.), Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston; Athinoula A. Martinos Center for Biomedical Imaging (J.S.), Charlestown, MA; and Department of Psychosomatic Medicine (S.J.T.), University of Rostock, GermanyJorge Sepulcre - From the German Center for Neurodegenerative Diseases (DZNE) (M.J.G., M.D., S.J.T.), Rostock; Department of Nuclear Medicine (H.B., O.S.), University of Leipzig, Germany; Gordon Center for Medical Imaging (J.S.), Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston; Athinoula A. Martinos Center for Biomedical Imaging (J.S.), Charlestown, MA; and Department of Psychosomatic Medicine (S.J.T.), University of Rostock, GermanyMartin Dyrba - From the German Center for Neurodegenerative Diseases (DZNE) (M.J.G., M.D., S.J.T.), Rostock; Department of Nuclear Medicine (H.B., O.S.), University of Leipzig, Germany; Gordon Center for Medical Imaging (J.S.), Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston; Athinoula A. Martinos Center for Biomedical Imaging (J.S.), Charlestown, MA; and Department of Psychosomatic Medicine (S.J.T.), University of Rostock, GermanyOsama Sabri - From the German Center for Neurodegenerative Diseases (DZNE) (M.J.G., M.D., S.J.T.), Rostock; Department of Nuclear Medicine (H.B., O.S.), University of Leipzig, Germany; Gordon Center for Medical Imaging (J.S.), Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston; Athinoula A. Martinos Center for Biomedical Imaging (J.S.), Charlestown, MA; and Department of Psychosomatic Medicine (S.J.T.), University of Rostock, GermanyStefan J Teipel - From the German Center for Neurodegenerative Diseases (DZNE) (M.J.G., M.D., S.J.T.), Rostock; Department of Nuclear Medicine (H.B., O.S.), University of Leipzig, Germany; Gordon Center for Medical Imaging (J.S.), Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston; Athinoula A. Martinos Center for Biomedical Imaging (J.S.), Charlestown, MA; and Department of Psychosomatic Medicine (S.J.T.), University of Rostock, GermanyAlzheimer's Disease Neuroimaging Initiative
- Contributors
- Laura L Boles-Ponto (Contributor) - University of Iowa, Radiology
- Resource Type
- Journal article
- Publication Details
- Neurology, Vol.89(20), pp.2031-2038
- Publisher
- United States
- DOI
- 10.1212/WNL.0000000000004643
- PMID
- 29046362
- PMCID
- PMC5711511
- ISSN
- 0028-3878
- eISSN
- 1526-632X
- Grant note
- P30 AG010129 / NIA NIH HHS P41 EB015922 / NIBIB NIH HHS
- Language
- English
- Date published
- 11/14/2017
- Academic Unit
- Radiology; Pharmaceutical Sciences and Experimental Therapeutics
- Record Identifier
- 9984051797702771
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