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European Journal of Nuclear Medicine and Molecular Imaging

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01-05-2019 | Alzheimer's Disease | Original Article

Diagnostic manifestations of total hemispheric glucose metabolism ratio in neuronal network diaschisis: diagnostic implications in Alzheimer’s disease and mild cognitive impairment

Authors: Eivind A. Segtnan, Alireza Majdi, Caius Constantinescu, Peter Grupe, Oke Gerke, Heini í Dali, Olaf Emil Strøm, Jorun Holm, Abass Alavi, Saeed Sadigh-Eteghad, Lene Wermuth, Malene G. Hildebrandt, Albert Gjedde, Poul Flemming Høilund-Carlsen

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 5/2019

Abstract

Purpose

We tested the hypothesis that lateralized hemispheric glucose metabolism may have diagnostic implications in Alzheimer’s disease (AD) and mild cognitive impairment (MCI).

Methods

We performed FDG-PET/CT in 23 patients (mean age 63.7 years, range 50–78, 17 females) diagnosed with AD (n = 15) or MCI (n = 8) during a six-month period in 2014. Ten neurologically healthy individuals (HIs) (mean age 62.5 years, range 43–75, 5 females) served as controls. A neuroimaging expert provided visual assessment of diaschisis. The total hemispheric glucose metabolism ratio (THGr) was calculated, and with area-under the curve of receiver operating characteristics (AUC-ROC) we generated a “Network Diaschisis Test (NDT)”.

Results

The qualitative detection of cerebral (Ce) and cerebellar (Cb) diaschisis was 7/15 (47%), 0/8 (0%), and 0/10 (0%) in AD, MCI, and HI groups, respectively. Median cerebral THGr was 0.68 (range 0.43–0.99), 0.86 (range 0.64–0.98), and 0.95 (range 0.65–1.00) for AD, MCI, and HI groups, respectively (p = 0.04). Median cerebellar THGr was, respectively, 0.70 (range 0.18–0.98), 0.70 (range 0.48–0.81), and 0.84 (range 0.75–0.96) (p = 0.0138). A positive NDT yielded a positive predictive value of 100% for the presence of AD or MCI and a 86% negative predictive value for healthy brain. Moreover, the diagnostic manifestation of THGr between MCI and AD led to a positive predictive value of 100% for AD, but a negative predictive value of 42.9% for MCI.

Conclusion

Patients with AD or MCI had more pronounced diaschisis, lateralized hemispheric glucose metabolism and lower THGr compared to healthy controls. The NDT distinguished AD and MCI patients from HIs, and AD from MCI patients with a high positive predictive value and moderate and low negative predictive values. THGr can be a straightforward source of investigating neuronal network diaschisis in AD and MCI and in other cerebral diseases, across institutions.

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Title: Diagnostic manifestations of total hemispheric glucose metabolism ratio in neuronal network diaschisis: diagnostic implications in Alzheimer’s disease and mild cognitive impairment
Authors: Eivind A. Segtnan
Alireza Majdi
Caius Constantinescu
Peter Grupe
Oke Gerke
Heini í Dali
Olaf Emil Strøm
Jorun Holm
Abass Alavi
Saeed Sadigh-Eteghad
Lene Wermuth
Malene G. Hildebrandt
Albert Gjedde
Poul Flemming Høilund-Carlsen
Publication date: 01-05-2019
Publisher: Springer Berlin Heidelberg
Keywords: Alzheimer's Disease
Alzheimer's Disease
Mild Neurocognitive Disorder
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 5/2019
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-018-4248-0

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Diagnostic manifestations of total hemispheric glucose metabolism ratio in neuronal network diaschisis: diagnostic implications in Alzheimer’s disease and mild cognitive impairment

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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