Marco Pagani1,2, Adriano Chiò3,4,5,1, Antonio Canosa6,7, Andrea Calvo3,4,5, Cristina Moglia3,4, Umberto Manera3, Rosario Vasta3, Francesca Di Pede3, Sara Cabras3, Davide Nardo8, Vincenzo Arena9, Maurizio Grassano3, Fabrizio D'Ovidio3, Koen Van Laere10,11, Philip Van Damme12,13,14. 1. Institute of Cognitive Sciences and Technologies, C.N.R., Rome, Italy. 2. Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden. 3. ALS Centre, "Rita Levi Montalcini" Department of Neuroscience, University of Turin, Via Cherasco 15, 10126, Turin, Italy. 4. Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy. 5. Neuroscience Institute of Turin (NIT), Turin, Italy. 6. ALS Centre, "Rita Levi Montalcini" Department of Neuroscience, University of Turin, Via Cherasco 15, 10126, Turin, Italy. antonio.canosa@unito.it. 7. Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy. antonio.canosa@unito.it. 8. MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK. 9. Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A, Turin, Italy. 10. Department of Imaging and Pathology, Nuclear Medicine and Molecular Imaging, KU Leuven - University of Leuven, Leuven, Belgium. 11. Division of Nuclear Medicine, University Hospitals Leuven, Leuven, Belgium. 12. Department of Neurosciences, Experimental Neurology, and Leuven Brain Institute (LBI), KU Leuven - University of Leuven, Leuven, Belgium. 13. VIB, Center for Brain & Disease Research, Laboratory of Neurobiology, Leuven, Belgium. 14. Department of Neurology, University Hospitals Leuven, Leuven, Belgium.
Abstract
PURPOSE: To assess the brain metabolic correlates of the different regional extent of ALS, evaluated with the King's staging system, using brain 18F-2-fluoro-2-deoxy-D-glucose-PET (18F-FDG-PET). METHODS: Three hundred ninety ALS cases with King's stages 1, 2, and 3 (n = 390), i.e., involvement of 1, 2, and 3 body regions respectively, underwent brain 18F-FDG-PET at diagnosis. King's stage at PET was derived from ALSFRS-R and was regressed out against whole-brain metabolism in the whole sample. The full factorial design confirmed the hypothesis that differences among groups (King's 1, King's 2, King's 3, and 40 healthy controls (HC)) existed overall. Comparisons among stages and between each group and HC were performed. We included age at PET and sex as covariates. RESULTS: Brain metabolism was inversely correlated with stage in medial frontal gyrus bilaterally, and right precentral and postcentral gyri. The full factorial design resulted in a significant main effect of groups. There was no significant difference between stages 1 and 2. Comparing stage 3 to stage 1+2, a significant relative hypometabolism was highlighted in the former in the left precentral and medial frontal gyri, and in the right medial frontal, postcentral, precentral, and middle frontal gyri. The comparisons between each group and HC showed the extension of frontal metabolic changes from stage 1 to stage 3, with the larger metabolic gap between stages 2 and 3. CONCLUSIONS: Our findings support the hypothesis that in ALS, the propagation of neurodegeneration follows a corticofugal, regional ordered pattern, extending from the motor cortex to posterior and anterior regions.
PURPOSE: To assess the brain metabolic correlates of the different regional extent of ALS, evaluated with the King's staging system, using brain 18F-2-fluoro-2-deoxy-D-glucose-PET (18F-FDG-PET). METHODS: Three hundred ninety ALS cases with King's stages 1, 2, and 3 (n = 390), i.e., involvement of 1, 2, and 3 body regions respectively, underwent brain 18F-FDG-PET at diagnosis. King's stage at PET was derived from ALSFRS-R and was regressed out against whole-brain metabolism in the whole sample. The full factorial design confirmed the hypothesis that differences among groups (King's 1, King's 2, King's 3, and 40 healthy controls (HC)) existed overall. Comparisons among stages and between each group and HC were performed. We included age at PET and sex as covariates. RESULTS: Brain metabolism was inversely correlated with stage in medial frontal gyrus bilaterally, and right precentral and postcentral gyri. The full factorial design resulted in a significant main effect of groups. There was no significant difference between stages 1 and 2. Comparing stage 3 to stage 1+2, a significant relative hypometabolism was highlighted in the former in the left precentral and medial frontal gyri, and in the right medial frontal, postcentral, precentral, and middle frontal gyri. The comparisons between each group and HC showed the extension of frontal metabolic changes from stage 1 to stage 3, with the larger metabolic gap between stages 2 and 3. CONCLUSIONS: Our findings support the hypothesis that in ALS, the propagation of neurodegeneration follows a corticofugal, regional ordered pattern, extending from the motor cortex to posterior and anterior regions.
Entities:
Keywords:
18F-FDG-PET; Amyotrophic lateral sclerosis; King’s staging system
Authors: Clifford R Jack; Prashanthi Vemuri; Heather J Wiste; Stephen D Weigand; Timothy G Lesnick; Val Lowe; Kejal Kantarci; Matt A Bernstein; Matthew L Senjem; Jeffrey L Gunter; Bradley F Boeve; John Q Trojanowski; Leslie M Shaw; Paul S Aisen; Michael W Weiner; Ronald C Petersen; David S Knopman Journal: Arch Neurol Date: 2012-07
Authors: Freimut D Juengling; Frank Wuest; Sanjay Kalra; Federica Agosta; Ralf Schirrmacher; Alexander Thiel; Wolfgang Thaiss; Hans-Peter Müller; Jan Kassubek Journal: Front Neurol Date: 2022-08-17 Impact factor: 4.086