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Alzheimer's Research & Therapy
Published in: Alzheimer's Research & Therapy 1/2020

01-12-2020 | Alzheimer's Disease | Research

Clinical significance of focal ß-amyloid deposition measured by 18F-flutemetamol PET

Authors: Si Eun Kim, Byungju Lee, Seongbeom Park, Soo Hyun Cho, Seung Joo Kim, Yeshin Kim, Hyemin Jang, Jee Hyang Jeong, Soo Jin Yoon, Kyung Won Park, Eun-Joo Kim, Na Yeon Jung, Bora Yoon, Jae-Won Jang, Jin Yong Hong, Jihye Hwang, Duk L. Na, Sang Won Seo, Seong Hye Choi, Hee Jin Kim

Published in: Alzheimer's Research & Therapy | Issue 1/2020

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Abstract

Background

Although amyloid PET of typical Alzheimer’s disease (AD) shows diffuse ß-amyloid (Aß) deposition, some patients show focal deposition. The clinical significance of this focal Aß is not well understood. We examined the clinical significance of focal Aß deposition in terms of cognition as well as Aß and tau cerebrospinal fluid (CSF) levels. We further evaluated the order of Aß accumulation by visual assessment.

Methods

We included 310 subjects (125 cognitively unimpaired, 125 mild cognitive impairment, and 60 AD dementia) from 9 referral centers. All patients underwent neuropsychological tests and 18F-flutemetamol (FMM) PET. Seventy-seven patients underwent CSF analysis. Each FMM scan was visually assessed in 10 regions (frontal, precuneus and posterior cingulate, lateral temporal, parietal, and striatum of each hemisphere) and was classified into three groups: No-FMM, Focal-FMM (FMM uptake in 1–9 regions), and Diffuse-FMM (FMM uptake in all 10 regions).

Results

53/310 (17.1%) subjects were classified as Focal-FMM. The cognitive level of the Focal-FMM group was better than that of Diffuse-FMM group and worse than that of No-FMM group. Among the Focal-FMM group, those who had FMM uptake to a larger extent or in the striatum had worse cognitive levels. Compared to the Diffuse-FMM group, the Focal-FMM group had a less AD-like CSF profile (increased Aß42 and decreased t-tau, t-tau/Aß42). Among the Focal-FMM group, Aß deposition was most frequently observed in the frontal (62.3%) and least frequently observed in the striatum (43.4%) and temporal (39.6%) regions.

Conclusions

We suggest that focal Aß deposition is an intermediate stage between no Aß and diffuse Aß deposition. Furthermore, among patients with focal Aß deposition, those who have Aß to a larger extent and striatal involvement show clinical features close to diffuse Aß deposition. Further longitudinal studies are needed to evaluate the disease progression of patients with focal Aß deposition.
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Metadata
Title
Clinical significance of focal ß-amyloid deposition measured by 18F-flutemetamol PET
Authors
Si Eun Kim
Byungju Lee
Seongbeom Park
Soo Hyun Cho
Seung Joo Kim
Yeshin Kim
Hyemin Jang
Jee Hyang Jeong
Soo Jin Yoon
Kyung Won Park
Eun-Joo Kim
Na Yeon Jung
Bora Yoon
Jae-Won Jang
Jin Yong Hong
Jihye Hwang
Duk L. Na
Sang Won Seo
Seong Hye Choi
Hee Jin Kim
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Alzheimer's Research & Therapy / Issue 1/2020
Electronic ISSN: 1758-9193
DOI
https://doi.org/10.1186/s13195-019-0577-x

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