The Role of Single-Subject Brain Metabolic Patterns in the Early Differential Diagnosis of Primary Progressive Aphasias and in Prediction of Progression to Dementia
| Autor: | Alessandra Marcone, Giuseppe Magnani, Daniela Perani, Elisabetta Pelagallo, Stefano F. Cappa, Roberto Santangelo, Alessandra Dodich, Sandro Iannaccone, Chiara Cerami, Lucia Greco |
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| Přispěvatelé: | Cerami, C., Dodich, A., Greco, L., Iannaccone, S., Magnani, G., Marcone, A., Pelagallo, E., Santangelo, R., Cappa, STEFANO FRANCESCO, Perani, DANIELA FELICITA L. |
| Rok vydání: | 2016 |
| Předmět: |
Male
0301 basic medicine positron emission tomography non fluent variant of primary progressive aphasia Aphasiology Neuropsychological Tests Primary progressive aphasia Cognition 0302 clinical medicine Corticobasal degeneration logopenic variant of primary progressive aphasia Precision Medicine FDG-PET Anarthria biology General Neuroscience Brain General Medicine respiratory system Psychiatry and Mental health Clinical Psychology Disease Progression Female Research Article Frontotemporal dementia semantic variant of primary progressive aphasia Progressive supranuclear palsy Diagnosis Differential 03 medical and health sciences Fluorodeoxyglucose F18 medicine Humans Dementia Aged Retrospective Studies business.industry medicine.disease biology.organism_classification Aphasia Primary Progressive Early Diagnosis 030104 developmental biology Positron-Emission Tomography primary progressive aphasia Radiopharmaceuticals Geriatrics and Gerontology Differential diagnosis business Neuroscience 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Journal of Alzheimer's Disease |
| ISSN: | 1875-8908 1387-2877 |
| Popis: | Background and Objective: Primary progressive aphasia (PPA) is a clinical syndrome due to different neurodegenerative conditions in which an accurate early diagnosis needs to be supported by a reliable diagnostic tool at the individual level. In this study, we investigated in PPA the FDG-PET brain metabolic patterns at the single-subject level, in order to assess the case-to-case variability and its relationship with clinical-neuropsychological findings. Material and Methods: 55 patients (i.e., 11 semantic variant/sv-PPA, 19 non fluent variant/nfv-PPA, 17 logopenic variant/lv-PPA, 3 slowly progressive anarthria/SPA, and 5 mixed PPA/m-PPA) were included. Clinical-neuropsychological information and FDG-PET data were acquired at baseline. A follow-up of 27.4±12.55 months evaluated the clinical progression. Brain metabolism was analyzed using an optimized and validated voxel-based SPM method at the single-subject level. Results: FDG-PET voxel-wise metabolic assessment revealed specific metabolic signatures characterizing each PPA variant at the individual level, reflecting the underlying neurodegeneration in language networks. Notably, additional dysfunctional patterns predicted clinical progression to specific dementia conditions. In the case of nfv-PPA, a metabolic pattern characterized by involvement of parietal, subcortical and brainstem structures predicted progression to a corticobasal degeneration syndrome or to progressive supranuclear palsy. lv-PPA and sv-PPA cases who progressed to Alzheimer’s disease and frontotemporal dementia at the follow-up presented with extended bilateral patterns at baseline. Discussion: Our results indicate that FDG-PET voxel-wise imaging is a valid biomarker for the early differential diagnosis of PPAs and for the prediction of progression to specific dementia condition. This study supports the use of FDG-PET imaging quantitative assessment in clinical settings for a better characterization of PPA individuals and prognostic definition of possible endo-phenotypes. |
| Databáze: | OpenAIRE |
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