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Journal of Neurology
Published in: Journal of Neurology 5/2018

01-05-2018 | Original Communication

[18F] AV-1451 uptake in corticobasal syndrome: the influence of beta-amyloid and clinical presentation

Authors: F. Ali, J. L. Whitwell, P. R. Martin, M. L. Senjem, D. S. Knopman, C. R. Jack, V. J. Lowe, R. C. Petersen, B. F. Boeve, K. A. Josephs

Published in: Journal of Neurology | Issue 5/2018

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Abstract

Corticobasal syndrome (CBS) is a phenotypic manifestation of diverse pathologies, including Alzheimer’s disease and 4-repeat tauopathies. Predicting pathology in CBS is unreliable and, hence, molecular neuroimaging may prove to be useful. The aim of this study was to assess regional patterns of uptake on [18F] AV-1451 PET in CBS and determine whether patterns of uptake differ according to beta-amyloid deposition or differing clinical presentations. Fourteen patients meeting criteria for CBS underwent Pittsburgh Compound B (PiB) and [18F] AV-1451 PET. Seven patients presented as CBS and seven presented with apraxia of speech (AOS) and later evolved into CBS. A global PiB summary was calculated and used to classify patients as PiB (−) or PiB (+). AV-1451 uptake was calculated in fourteen regions-of-interest, with values divided by uptake in cerebellar crus grey matter to generate standard uptake value ratios. AV-1451 uptake was considered elevated if it fell above the 95th percentile from a group of 476 cognitively unimpaired normal controls. Six of the 14 CBS patients (43%) were PiB (+), with three of these patients showing strikingly elevated AV-1451 uptake across many cortical regions. Of the eight PiB (−) patients, only those with AOS showed elevated AV-1451 uptake in supplementary motor area and precentral cortex compared to controls. No region of elevated AV-1451 uptake were observed in PiB (−) typical CBS patients without AOS. These results suggest that regional [18F] AV-1451 is variable in CBS and depends on the presence of beta-amyloid as well as clinical presentation such as AOS. PiB (+) CBS does not necessarily reflect underlying Alzheimer’s disease; however, the possibility some of these patients will evolve into Alzheimer’s disease over time cannot be excluded.
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Metadata
Title
[18F] AV-1451 uptake in corticobasal syndrome: the influence of beta-amyloid and clinical presentation
Authors
F. Ali
J. L. Whitwell
P. R. Martin
M. L. Senjem
D. S. Knopman
C. R. Jack
V. J. Lowe
R. C. Petersen
B. F. Boeve
K. A. Josephs
Publication date
01-05-2018
Publisher
Springer Berlin Heidelberg
Published in
Journal of Neurology / Issue 5/2018
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-018-8815-x

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