Functional pattern of brain FDG-PET in amyotrophic lateral sclerosis

Autor: Marco Pagani, PhD, Adriano Chiò, FAAN, Maria Consuelo Valentini, Johanna Öberg, Flavio Nobili, Andrea Calvo, Cristina Moglia, Davide Bertuzzo, Silvia Morbelli, Fabrizio De Carli, Med Phys, Piercarlo Fania, Angelina Cistaro
Rok vydání: 2014
Předmět:
Adult
Male
Cerebellum
Pathology
medicine.medical_specialty
Hippocampus
Sensitivity and Specificity
Midbrain
White matter
Young Adult
Fluorodeoxyglucose F18
Cortex (anatomy)
Neural Pathways
80 and over
medicine
Humans
Amyotrophic lateral sclerosis
FDG-PET
radionuclide imaging
Aged
Aged
80 and over
Medicine (all)
Amyotrophic Lateral Sclerosis
Brain
Discriminant Analysis
Middle Aged
medicine.disease
Neurology (clinical)
medicine.anatomical_structure
Case-Control Studies
Positron-Emission Tomography
Hypermetabolism
Biomarker (medicine)
Female
Radiopharmaceuticals
Adult
Aged
Aged
80 and over
Amyotrophic Lateral Sclerosis
radionuclide imaging
Brain
radionuclide imaging
Case-Control Studies
Discriminant Analysis
Female
Fluorodeoxyglucose F18
diagnostic use
Humans
Male
Middle Aged
Neural Pathways
radionuclide imaging
Positron-Emission Tomography
Radiopharmaceuticals
diagnostic use
Sensitivity and Specificity
Young Adult
diagnostic use
Psychology
Zdroj: Scopus-Elsevier
Neurology (Online) 83 (2014): 1067–1074. doi:10.1212/WNL.0000000000000792
info:cnr-pdr/source/autori:Marco Pagani, MD, PhD, Adriano Chiò, MD, FAAN, Maria Consuelo Valentini, MD, Johanna Öberg, PhD, Flavio Nobili, MD, Andrea Calvo, MD, PhD, Cristina Moglia, MD, PhD, Davide Bertuzzo, MD, Silvia Morbelli, MD, PhD, Fabrizio De Carli, Med Phys, Piercarlo Fania and Angelina Cistaro, MD/titolo:Functional pattern of brain FDG-PET in amyotrophic lateral sclerosis./doi:10.1212%2FWNL.0000000000000792/rivista:Neurology (Online)/anno:2014/pagina_da:1067/pagina_a:1074/intervallo_pagine:1067–1074/volume:83
ISSN: 1526-632X
0028-3878
DOI: 10.1212/wnl.0000000000000792
Popis: Objective: We investigated a large sample of patients with amyotrophic lateral sclerosis (ALS) at rest in order to assess the value of 18 F-2-fluoro-2-deoxy-d-glucose ( 18 F-FDG) PET as a biomarker to discriminate patients from controls. Methods: A total of 195 patients with ALS and 40 controls underwent brain 18 F-FDG-PET, most within 5 months of diagnosis. Spinal and bulbar subgroups of ALS were also investigated. Twenty-five bilateral cortical and subcortical volumes of interest and cerebellum were taken into account, and 18 F-FDG uptakes were individually normalized by whole-brain values. Group analyses investigated the ALS-related metabolic changes. Discriminant analysis investigating sensitivity and specificity was performed using the 51 volumes of interest as well as age and sex. Metabolic connectivity was explored by voxel-wise interregional correlation analysis. Results: Hypometabolism was found in frontal, motor, and occipital cortex and hypermetabolism in midbrain, temporal pole, and hippocampus in patients with ALS compared to controls. A similar metabolic pattern was also found in the 2 subgroups. Discriminant analysis showed a sensitivity of 95% and a specificity of 83% in separating patients from controls. Connectivity analysis found a highly significant positive correlation between midbrain and white matter in corticospinal tracts in patients with ALS. Conclusions: 18 F-FDG distribution changes in ALS showed a clear pattern of hypometabolism in frontal and occipital cortex and hypermetabolism in midbrain. The latter might be interpreted as the neurobiological correlate of diffuse subcortical gliosis. Discriminant analysis resulted in high sensitivity and specificity in differentiating patients with ALS from controls. Once validated by diseased-control studies, the present methodology might represent a potentially useful biomarker for ALS diagnosis. Classificaton of evidence: This study provides Class III evidence that 18 F-FDG-PET accurately distinguishes patients with ALS from normal controls (sensitivity 95.4%, specificity 82.5%).
Databáze: OpenAIRE
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