Brain PET amyloid and neurodegeneration biomarkers in the context of the 2018 NIA-AA research framework: an individual a
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ORIGINAL ARTICLE
Brain PET amyloid and neurodegeneration biomarkers in the context of the 2018 NIA-AA research framework: an individual approach exploring clinical-biomarker mismatches and sociodemographic parameters Artur Martins Coutinho 1,2,3 & Geraldo F. Busatto 2,4 & Fábio Henrique de Gobbi Porto 2,4 & Daniele de Paula Faria 1,2 & Carla Rachel Ono 1,3 & Alexandre Teles Garcez 1,2 & Paula Squarzoni 2,4 & Fábio Luiz de Souza Duran 2,4 & Maira Okada de Oliveira 5 & Eduardo Sturzeneker Tres 5 & Sonia Maria Dozzi Brucki 5 & Orestes Vicente Forlenza 6 & Ricardo Nitrini 5 & Carlos Alberto Buchpiguel 1,2,3 Received: 24 September 2019 / Accepted: 3 February 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose [18F]FDG-PET and [11C]PIB-PET are validated as neurodegeneration and amyloid biomarkers of Alzheimer’s disease (AD). We used a PET staging system based on the 2018 NIA-AA research framework to compare the proportion of amyloid positivity (A+) and hypometabolism ((N)+) in cases of mild probable AD, amnestic mild cognitive impairment (aMCI), and healthy controls, incorporating an additional classification of abnormal [18F]FDG-PET patterns and investigating the cooccurrence of such with A+, exploring [18F]FDG-PET to generate hypotheses in cases presenting with clinical-biomarker “mismatches.” Methods Elderly individuals (N = 108) clinically classified as controls (N = 27), aMCI (N = 43) or mild probable AD (N = 38) were included. Authors assessed their A(N) profiles and classified [18F]FDG-PET neurodegenerative patterns as typical or nontypical of AD, performing re-assessments of images whenever clinical classification was in disagreement with the PET staging (clinical-biomarker “mismatches”). We also investigated associations between “mismatches” and sociodemographic and educational characteristics. Results AD presented with higher rates of A+ and (N)+. There was also a higher proportion of A+ and (N)+ individuals in the aMCI group in comparison to controls, however without statistical significance regarding the A staging. There was a significant association between amyloid positivity and AD (N)+ hypometabolic patterns typical of AD. Non-AD (N)+ hypometabolism was seen in all A− (N)+ cases in the mild probable AD and control groups and [18F]FDG-PET patterns classified such individuals as
This article is part of the Topical Collection on Neurology Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00259-020-04714-0) contains supplementary material, which is available to authorized users. * Artur Martins Coutinho [email protected] 1
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Laboratory of Nuclear Medicine (LIM 43), Department of Radiology and Oncology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil Nucleo de Apoio a Pesquisa em Neurociência Aplicada (NAPNA), Universidade de Sao Paulo, Sao Paulo, SP, Brazil Centro de Medicina Nuclear do Instituto de Radiologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, 2° an
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