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European Journal of Nuclear Medicine and Molecular Imaging

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01-02-2020 | Alzheimer's Disease | Original Article

The A/T/N model applied through imaging biomarkers in a memory clinic

Authors: Alessandra Dodich, Aline Mendes, Frédéric Assal, Christian Chicherio, Barinjaka Rakotomiaramanana, Paulina Andryszak, Cristina Festari, Federica Ribaldi, Max Scheffler, Roger Schibli, Adam J. Schwarz, Dina Zekry, Karl-Olof Lövblad, Marina Boccardi, Paul G. Unschuld, Gabriel Gold, Giovanni B. Frisoni, Valentina Garibotto

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 2/2020

Abstract

Purpose

The A/T/N model is a research framework proposed to investigate Alzheimer’s disease (AD) pathological bases (i.e., amyloidosis A, neurofibrillary tangles T, and neurodegeneration N). The application of this system on clinical populations is still limited. The aim of the study is to evaluate the topography of T distribution by 18F-flortaucipir PET in relation to A and N and to describe the A/T/N status through imaging biomarkers in memory clinic patients.

Methods

Eighty-one patients with subjective and objective cognitive impairment were classified as A+/A− and N+/N− through amyloid PET and structural MRI. Tau deposition was compared across A/N subgroups at voxel level. T status was defined through a global cut point based on A/N subgroups and subjects were categorized following the A/T/N model.

Results

A+N+ and A+N− subgroups showed higher tau burden compared to A−N− group, with A+N− showing significant deposition limited to the medial and lateral temporal regions. Global cut point discriminated A+N+ and A+N− from A−N− subjects. On A/T/N classification, 23% of patients showed a negative biomarker profile, 58% fell within the Alzheimer’s continuum, and 19% of the sample was characterized by non-AD pathologic change.

Conclusion

Medial and lateral temporal regions represent a site of significant tau accumulation in A+ subjects and possibly a useful marker of early clinical changes. This is the first study in which the A/T/N model is applied using 18F-flortaucipir PET in a memory clinic population. The majority of patients showed a profile consistent with the Alzheimer’s continuum, while a minor percentage showed a profile suggestive of possible other neurodegenerative diseases. These results support the applicability of the A/T/N model in clinical practice.

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Title: The A/T/N model applied through imaging biomarkers in a memory clinic
Authors: Alessandra Dodich
Aline Mendes
Frédéric Assal
Christian Chicherio
Barinjaka Rakotomiaramanana
Paulina Andryszak
Cristina Festari
Federica Ribaldi
Max Scheffler
Roger Schibli
Adam J. Schwarz
Dina Zekry
Karl-Olof Lövblad
Marina Boccardi
Paul G. Unschuld
Gabriel Gold
Giovanni B. Frisoni
Valentina Garibotto
Publication date: 01-02-2020
Publisher: Springer Berlin Heidelberg
Keywords: Alzheimer's Disease
Alzheimer's Disease
Mild Cognitive Impairment
Biomarkers
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 2/2020
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-019-04536-9

At a glance: The STEP trials

Springer Medicine

The A/T/N model applied through imaging biomarkers in a memory clinic

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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