Daniela Perani1,2,3, Chiara Cerami4,5,6, Silvia Paola Caminiti4,5, Roberto Santangelo7, Elisabetta Coppi7, Laura Ferrari7, Patrizia Pinto8, Gabriella Passerini9, Andrea Falini4,5,10, Sandro Iannaccone6, Stefano Francesco Cappa5,11, Giancarlo Comi4,7, Luigi Gianolli12, Giuseppe Magnani13. 1. Vita-Salute San Raffaele University, Via Olgettina, 58, 20132, Milan, Italy. perani.daniela@hsr.it. 2. Division of Neuroscience, San Raffaele Scientific Institute, Via Olgettina, 58, 20132, Milan, Italy. perani.daniela@hsr.it. 3. Nuclear Medicine Unit, San Raffaele Hospital, Via Olgettina, 60, 20132, Milan, Italy. perani.daniela@hsr.it. 4. Vita-Salute San Raffaele University, Via Olgettina, 58, 20132, Milan, Italy. 5. Division of Neuroscience, San Raffaele Scientific Institute, Via Olgettina, 58, 20132, Milan, Italy. 6. Clinical Neuroscience Department, San Raffaele Hospital, Via Olgettina, 60, 20132, Milan, Italy. 7. Department of Neurology, San Raffaele Hospital, Via Olgettina, 60, 20132, Milan, Italy. 8. Department of Neurology, Papa Giovanni XXIII Hospital, Piazza OMS, 1, 24127, Bergamo, Italy. 9. Servizio di Medicina di Laboratorio OSR, Via Olgettina, 60, 20132, Milan, Italy. 10. CERMAC - Department of Neuroradiology, San Raffaele Hospital, Via Olgettina, 60, 20132, Milan, Italy. 11. IUSS Pavia, Piazza della Vittoria, 15, 27100, Pavia, Italy. 12. Nuclear Medicine Unit, San Raffaele Hospital, Via Olgettina, 60, 20132, Milan, Italy. 13. Department of Neurology, San Raffaele Hospital, Via Olgettina, 60, 20132, Milan, Italy. magnani.giuseppe@hsr.it.
Abstract
PURPOSE: The aim of this study was to evaluate the supportive role of molecular and structural biomarkers (CSF protein levels, FDG PET and MRI) in the early differential diagnosis of dementia in a large sample of patients with neurodegenerative dementia, and in determining the risk of disease progression in subjects with mild cognitive impairment (MCI). METHODS: We evaluated the supportive role of CSF Aβ42, t-Tau, p-Tau levels, conventional brain MRI and visual assessment of FDG PET SPM t-maps in the early diagnosis of dementia and the evaluation of MCI progression. RESULTS: Diagnosis based on molecular biomarkers showed the best fit with the final diagnosis at a long follow-up. FDG PET SPM t-maps had the highest diagnostic accuracy in Alzheimer's disease and in the differential diagnosis of non-Alzheimer's disease dementias. The p-tau/Aβ42 ratio was the only CSF biomarker providing a significant classification rate for Alzheimer's disease. An Alzheimer's disease-positive metabolic pattern as shown by FDG PET SPM in MCI was the best predictor of conversion to Alzheimer's disease. CONCLUSION: In this clinical setting, FDG PET SPM t-maps and the p-tau/Aβ42 ratio improved clinical diagnostic accuracy, supporting the importance of these biomarkers in the emerging diagnostic criteria for Alzheimer's disease dementia. FDG PET using SPM t-maps had the highest predictive value by identifying hypometabolic patterns in different neurodegenerative dementias and normal brain metabolism in MCI, confirming its additional crucial exclusionary role.
PURPOSE: The aim of this study was to evaluate the supportive role of molecular and structural biomarkers (CSF protein levels, FDG PET and MRI) in the early differential diagnosis of dementia in a large sample of patients with neurodegenerative dementia, and in determining the risk of disease progression in subjects with mild cognitive impairment (MCI). METHODS: We evaluated the supportive role of CSF Aβ42, t-Tau, p-Tau levels, conventional brain MRI and visual assessment of FDG PET SPM t-maps in the early diagnosis of dementia and the evaluation of MCI progression. RESULTS: Diagnosis based on molecular biomarkers showed the best fit with the final diagnosis at a long follow-up. FDG PET SPM t-maps had the highest diagnostic accuracy in Alzheimer's disease and in the differential diagnosis of non-Alzheimer's disease dementias. The p-tau/Aβ42 ratio was the only CSF biomarker providing a significant classification rate for Alzheimer's disease. An Alzheimer's disease-positive metabolic pattern as shown by FDG PET SPM in MCI was the best predictor of conversion to Alzheimer's disease. CONCLUSION: In this clinical setting, FDG PET SPM t-maps and the p-tau/Aβ42 ratio improved clinical diagnostic accuracy, supporting the importance of these biomarkers in the emerging diagnostic criteria for Alzheimer's disease dementia. FDG PET using SPM t-maps had the highest predictive value by identifying hypometabolic patterns in different neurodegenerative dementias and normal brain metabolism in MCI, confirming its additional crucial exclusionary role.
Authors: K Herholz; E Salmon; D Perani; J C Baron; V Holthoff; L Frölich; P Schönknecht; K Ito; R Mielke; E Kalbe; G Zündorf; X Delbeuck; O Pelati; D Anchisi; F Fazio; N Kerrouche; B Desgranges; F Eustache; B Beuthien-Baumann; C Menzel; J Schröder; T Kato; Y Arahata; M Henze; W D Heiss Journal: Neuroimage Date: 2002-09 Impact factor: 6.556
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Authors: Artur Martins Coutinho; Geraldo F Busatto; Fábio Henrique de Gobbi Porto; Daniele de Paula Faria; Carla Rachel Ono; Alexandre Teles Garcez; Paula Squarzoni; Fábio Luiz de Souza Duran; Maira Okada de Oliveira; Eduardo Sturzeneker Tres; Sonia Maria Dozzi Brucki; Orestes Vicente Forlenza; Ricardo Nitrini; Carlos Alberto Buchpiguel Journal: Eur J Nucl Med Mol Imaging Date: 2020-02-13 Impact factor: 9.236
Authors: Matteo Pardini; Edward D Huey; Salvatore Spina; William C Kreisl; Silvia Morbelli; Eric M Wassermann; Flavio Nobili; Bernardino Ghetti; Jordan Grafman Journal: Neurology Date: 2019-01-30 Impact factor: 9.910