- Email: [email protected]
BRAIN FDG-PET IN MILD COGNITIVE IMPAIRMENT: A RETROSPECTIVE LONGITUDINAL STUDY
Poster Presentations: Monday, July 25, 2016 Table. l
Age (year/SD) Education (year/SD) Gender (female/%) HK-MoCA (mean/SD) Subtypes- Alzheimer’s Vascular Mixed
P2-218
Non-converter N¼37
Converter N¼31
Significance P
75.43/8.74 4.97/5.06 16/43.2 18.73 (3.91) 30 4 3
77.19/7.88 4.61/4.08 17/54.8 14.94/5.07 16 4 10
0.386 0.746 0.465 0.001 0.025
AMYLOID AND TAU PET FINDINGS IN DIABETESRELATED DEMENTIA
Haruo Hanyu, Raita Fukasawa, Soichiro Shimizu, Hirofumi Sakurai, Kenji Ishii, Hitoshi Shimada, Makoto Higuchi, Tetsuya Suhara, Tokyo Medical University, Tokyo, Japan. Contact e-mail: [email protected]. jp Background: We previously found that there was a dementia subgroup with characteristics predominantly associated with diabetes mellitus (DM)-related metabolic abnormalities rather than AD or vascular pathology in patients with dementia associated with DM, referred to as “diabetes-related dementia”. The identification of diabetes-related dementia may be necessary for considering an appropriate therapy and prevention. We studied amyoid (PiB) and Tau (PBB3) PET in subjects with diabetes-related dementia to investigate underlying pathological conditions. Methods: Eleven subjects with diabetes-related dementia underwent PiB PET to evaluate amyloid accumulation in the brain, and 5 subjects underwent PBB3 PET to evaluate tau accumulation. A trained neuroradiologist, who was blind to subjects’ clinical data, performed visual assessments of the accumulation on PiB and PBB3 PET images. Results: Four out of 11 subjects with diabetes-related dementia were rated as positive PiB, 5 as negative PiB, and 2 as equivocal PiB. Although subjects with negative PiB showed lower frequency of ApoE4 carrier than those with positive PiB, there were no significant differences in demographic characteristics. Most subjects who underwent PBB3 PET were positive PBB3, indicating tauopathy. However, the distribution of PBB3 accumulation showed various patterns. Conclusions: Our PET studies indicate that some subjects with diabetes-related dementia showed negative PiB, but positive PBB3. These findings suggest that tauopathy underlies in the brain of diabetes-related dementia. However, the distribution pattern were different from other tauopathies, such as frontotemporal dementia, argyrophilic grain disease, and others. We suspect that tauopathy and nonspecific brain damage due to glucose toxicity are associated with diabetes-related dementia. P2-219
ATROPHIC PATTERN USING MRI IN SEMANTIC DEMENTIA
Chigusa Watanabe1, Takako Makino1, Higaki Masahiro2, Sugiura Tomoyuki1, 1Hiroshimanishi Medical Center, Ootake, Japan; 2 Hirohshimanishi Medical Center, Ootake, Japan. Contact e-mail: [email protected] Background: Semantic dementia is a neurodegenerative disease with a distinct neuropsychiatric deficit. Neuroimaging studies revealed asymmetric atrophy in the temporal lobe. But the characteristic pattern of atrophy and the relation with cognitive deficits
P705
are not fully resolved. Objective: To identify the characteristics of patterns of cerebral atrophy associated with semantic dementia and to relate the findings to the cognitive profiles. Methods: Four patients with semantic dementia (58 M, 64M, 69 F, 75 M) were diagnosed based on the clinical criteria. MRI and SPECT were obtained for each patient. The regions of focal gray matter atrophy associated with semantic dementia were examined using voxel-based morphometry. Results: Regions of atrophy located in the ventromedial frontal cortex, the posterior orbital frontal regions, the insula bilaterally. The anterior temporal cortex and the amygdala and anterior hippocampal region showed prominent atrophy bilaterally. Hippocampal atrophy was asymmetric, more extensive on the left. Naming task likely to reflect anterior left temporal lobe atrophy. Episodic memory test did not likely to reflect temporal lobe atrophy. Conclusions: Semantic dementia shows characteristic pattern of temporal lobe atrophy, differentiating from Alzheimer’s disease. These regions in the left temporal lobe may contribute to the semantic memory function in semantic dementia.
P2-220
BRAIN FDG-PET IN MILD COGNITIVE IMPAIRMENT: A RETROSPECTIVE LONGITUDINAL STUDY
Federica Barocco1, Marco Spallazzi1, Ernesto Migliorino1, Caterina Ghetti2, Livia Ruffini3, Simona Gardini4, Paolo Caffarra4,5, 1 Neuroscience Department, University of Parma, Parma, Italy; 2Medical Physic Department, Azienda Ospedaliero-Universitaria, Parma, Italy, Parma, Italy; 3Nuclear Medicine Department, Azienda Ospedaliero-Universitaria, Parma, Italy, Parma, Italy; 4Department of Neurosciences, University of Parma, Parma, Italy; 5Centre for Cognitive Disordes and Dementia (CDCD), AUSL, Parma, Italy. Contact e-mail: [email protected] Background: Brain metabolism alteration represents one of the earlier neuroimaging biomarkers of dementia. Methods: This study
aimed to verify the predictive role of FDG-PET in differential diagnosis in a cohort of Mild Cognitive Impairment (MCI) patients. Seventy-four MCI patients underwent brain F18-FDG-PET and clinical and neuropsychological follow-up for about two years and a half. Statistical comparisons of FDG-PET scans at baseline were compared between patients who convert to dementia (MCID), to Alzheimer’s type Dementia (MCI-AD) or to Fronto-Temporal Dementia (MCI-FTD) and those who remained Stable MCI. Results: Compared with Stable MCI, MCI-D patients at baseline presented hypometabolism in the left superior, middle and inferior temporal gyri and an higher metabolism in the left postcentral gyrus, putamen and in the right insula and claustrum. MCI-AD patients had hypometabolism in the left middle and inferior temporal gyri and a suspected increased metabolism in the bilateral postcentral gyri, in the right precentral gyrus, insula and in the left lentiform nucleus. MCI-FTD showed hypometabolism in the right inferior, middle, superior frontal gyri and inferior, middle and superior temporal gyri. Conclusions: In the prodromal phase, compared with stable MCI, AD was characterized by temporal hypometabolic activity indicating synaptic dysfunction and by higher sub-cortical metabolic activity as possible expression of compensatory mechanisms, whereas FTD by hypometabolic frontal and temporal regions. In MCI patients, FDG-PET is not only an excellent and early diagnostic biomarker, but also a good tool to describe neurobiological correlates of dementia subtypes in time.
Age (year/SD) Education (year/SD) Gender (female/%) HK-MoCA (mean/SD) Subtypes- Alzheimer’s Vascular Mixed
P2-218
Non-converter N¼37
Converter N¼31
Significance P
75.43/8.74 4.97/5.06 16/43.2 18.73 (3.91) 30 4 3
77.19/7.88 4.61/4.08 17/54.8 14.94/5.07 16 4 10
0.386 0.746 0.465 0.001 0.025
AMYLOID AND TAU PET FINDINGS IN DIABETESRELATED DEMENTIA
Haruo Hanyu, Raita Fukasawa, Soichiro Shimizu, Hirofumi Sakurai, Kenji Ishii, Hitoshi Shimada, Makoto Higuchi, Tetsuya Suhara, Tokyo Medical University, Tokyo, Japan. Contact e-mail: [email protected]. jp Background: We previously found that there was a dementia subgroup with characteristics predominantly associated with diabetes mellitus (DM)-related metabolic abnormalities rather than AD or vascular pathology in patients with dementia associated with DM, referred to as “diabetes-related dementia”. The identification of diabetes-related dementia may be necessary for considering an appropriate therapy and prevention. We studied amyoid (PiB) and Tau (PBB3) PET in subjects with diabetes-related dementia to investigate underlying pathological conditions. Methods: Eleven subjects with diabetes-related dementia underwent PiB PET to evaluate amyloid accumulation in the brain, and 5 subjects underwent PBB3 PET to evaluate tau accumulation. A trained neuroradiologist, who was blind to subjects’ clinical data, performed visual assessments of the accumulation on PiB and PBB3 PET images. Results: Four out of 11 subjects with diabetes-related dementia were rated as positive PiB, 5 as negative PiB, and 2 as equivocal PiB. Although subjects with negative PiB showed lower frequency of ApoE4 carrier than those with positive PiB, there were no significant differences in demographic characteristics. Most subjects who underwent PBB3 PET were positive PBB3, indicating tauopathy. However, the distribution of PBB3 accumulation showed various patterns. Conclusions: Our PET studies indicate that some subjects with diabetes-related dementia showed negative PiB, but positive PBB3. These findings suggest that tauopathy underlies in the brain of diabetes-related dementia. However, the distribution pattern were different from other tauopathies, such as frontotemporal dementia, argyrophilic grain disease, and others. We suspect that tauopathy and nonspecific brain damage due to glucose toxicity are associated with diabetes-related dementia. P2-219
ATROPHIC PATTERN USING MRI IN SEMANTIC DEMENTIA
Chigusa Watanabe1, Takako Makino1, Higaki Masahiro2, Sugiura Tomoyuki1, 1Hiroshimanishi Medical Center, Ootake, Japan; 2 Hirohshimanishi Medical Center, Ootake, Japan. Contact e-mail: [email protected] Background: Semantic dementia is a neurodegenerative disease with a distinct neuropsychiatric deficit. Neuroimaging studies revealed asymmetric atrophy in the temporal lobe. But the characteristic pattern of atrophy and the relation with cognitive deficits
P705
are not fully resolved. Objective: To identify the characteristics of patterns of cerebral atrophy associated with semantic dementia and to relate the findings to the cognitive profiles. Methods: Four patients with semantic dementia (58 M, 64M, 69 F, 75 M) were diagnosed based on the clinical criteria. MRI and SPECT were obtained for each patient. The regions of focal gray matter atrophy associated with semantic dementia were examined using voxel-based morphometry. Results: Regions of atrophy located in the ventromedial frontal cortex, the posterior orbital frontal regions, the insula bilaterally. The anterior temporal cortex and the amygdala and anterior hippocampal region showed prominent atrophy bilaterally. Hippocampal atrophy was asymmetric, more extensive on the left. Naming task likely to reflect anterior left temporal lobe atrophy. Episodic memory test did not likely to reflect temporal lobe atrophy. Conclusions: Semantic dementia shows characteristic pattern of temporal lobe atrophy, differentiating from Alzheimer’s disease. These regions in the left temporal lobe may contribute to the semantic memory function in semantic dementia.
P2-220
BRAIN FDG-PET IN MILD COGNITIVE IMPAIRMENT: A RETROSPECTIVE LONGITUDINAL STUDY
Federica Barocco1, Marco Spallazzi1, Ernesto Migliorino1, Caterina Ghetti2, Livia Ruffini3, Simona Gardini4, Paolo Caffarra4,5, 1 Neuroscience Department, University of Parma, Parma, Italy; 2Medical Physic Department, Azienda Ospedaliero-Universitaria, Parma, Italy, Parma, Italy; 3Nuclear Medicine Department, Azienda Ospedaliero-Universitaria, Parma, Italy, Parma, Italy; 4Department of Neurosciences, University of Parma, Parma, Italy; 5Centre for Cognitive Disordes and Dementia (CDCD), AUSL, Parma, Italy. Contact e-mail: [email protected] Background: Brain metabolism alteration represents one of the earlier neuroimaging biomarkers of dementia. Methods: This study
aimed to verify the predictive role of FDG-PET in differential diagnosis in a cohort of Mild Cognitive Impairment (MCI) patients. Seventy-four MCI patients underwent brain F18-FDG-PET and clinical and neuropsychological follow-up for about two years and a half. Statistical comparisons of FDG-PET scans at baseline were compared between patients who convert to dementia (MCID), to Alzheimer’s type Dementia (MCI-AD) or to Fronto-Temporal Dementia (MCI-FTD) and those who remained Stable MCI. Results: Compared with Stable MCI, MCI-D patients at baseline presented hypometabolism in the left superior, middle and inferior temporal gyri and an higher metabolism in the left postcentral gyrus, putamen and in the right insula and claustrum. MCI-AD patients had hypometabolism in the left middle and inferior temporal gyri and a suspected increased metabolism in the bilateral postcentral gyri, in the right precentral gyrus, insula and in the left lentiform nucleus. MCI-FTD showed hypometabolism in the right inferior, middle, superior frontal gyri and inferior, middle and superior temporal gyri. Conclusions: In the prodromal phase, compared with stable MCI, AD was characterized by temporal hypometabolic activity indicating synaptic dysfunction and by higher sub-cortical metabolic activity as possible expression of compensatory mechanisms, whereas FTD by hypometabolic frontal and temporal regions. In MCI patients, FDG-PET is not only an excellent and early diagnostic biomarker, but also a good tool to describe neurobiological correlates of dementia subtypes in time.