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Tau PET and relative cerebral blood flow in dementia with Lewy bodies : A PET study

Wolters, E. E. ; van de Beek, M. ; Ossenkoppele, R. LU ; Golla, S. S.V. ; Verfaillie, S. C.J. ; Coomans, E. M. ; Timmers, T. ; Visser, D. ; Tuncel, H. and Barkhof, F. , et al. (2020) In NeuroImage: Clinical 28.
Abstract

Purpose: Alpha-synuclein often co-occurs with Alzheimer's disease (AD) pathology in Dementia with Lewy Bodies (DLB). From a dynamic [18F]flortaucipir PET scan we derived measures of both tau binding and relative cerebral blood flow (rCBF). We tested whether regional tau binding or rCBF differed between DLB patients and AD patients and controls and examined their association with clinical characteristics of DLB. Methods: Eighteen patients with probable DLB, 65 AD patients and 50 controls underwent a dynamic 130-minute [18F]flortaucipir PET scan. DLB patients with positive biomarkers for AD based on cerebrospinal fluid or amyloid PET were considered as DLB with AD pathology (DLB-AD+). Receptor parametric mapping... (More)

Purpose: Alpha-synuclein often co-occurs with Alzheimer's disease (AD) pathology in Dementia with Lewy Bodies (DLB). From a dynamic [18F]flortaucipir PET scan we derived measures of both tau binding and relative cerebral blood flow (rCBF). We tested whether regional tau binding or rCBF differed between DLB patients and AD patients and controls and examined their association with clinical characteristics of DLB. Methods: Eighteen patients with probable DLB, 65 AD patients and 50 controls underwent a dynamic 130-minute [18F]flortaucipir PET scan. DLB patients with positive biomarkers for AD based on cerebrospinal fluid or amyloid PET were considered as DLB with AD pathology (DLB-AD+). Receptor parametric mapping (cerebellar gray matter reference region) was used to extract regional binding potential (BPND) and R1, reflecting (AD-specific) tau pathology and rCBF, respectively. First, we performed regional comparisons of [18F]flortaucipir BPND and R1 between diagnostic groups. In DLB patients only, we performed regression analyses between regional [18F]flortaucipir BPND, R1 and performance on ten neuropsychological tests. Results: Regional [18F]flortaucipir BPND in DLB was comparable with tau binding in controls (p > 0.05). Subtle higher tau binding was observed in DLB-AD+ compared to DLB-AD- in the medial temporal and parietal lobe (both p < 0.05). Occipital and lateral parietal R1 was lower in DLB compared to AD and controls (all p < 0.01). Lower frontal R1 was associated with impaired performance on digit span forward (standardized beta, stβ = 0.72) and category fluency (stβ = 0.69) tests. Lower parietal R1 was related to lower delayed (stβ = 0.50) and immediate (stβ = 0.48) recall, VOSP number location (stβ = 0.70) and fragmented letters (stβ = 0.59) scores. Lower occipital R1 was associated to worse performance on VOSP fragmented letters (stβ = 0.61), all p < 0.05. Conclusion: The amount of tau binding in DLB was minimal and did not differ from controls. However, there were DLB-specific occipital and lateral parietal relative cerebral blood flow reductions compared to both controls and AD patients. Regional rCBF, but not tau binding, was related to cognitive impairment. This indicates that assessment of rCBF may give more insight into disease mechanisms in DLB than tau PET.

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type
Contribution to journal
publication status
published
subject
keywords
Cognition, Dementia with Lewy bodies, FDG PET, Relative cerebral blood flow, Tau
in
NeuroImage: Clinical
volume
28
article number
102504
publisher
Elsevier
external identifiers
  • scopus:85097206186
  • pmid:33395993
ISSN
2213-1582
DOI
10.1016/j.nicl.2020.102504
language
English
LU publication?
yes
id
33a54952-4b1b-458a-ba2e-2d9a44c70a02
date added to LUP
2020-12-16 13:09:22
date last changed
2024-06-13 02:20:18
@article{33a54952-4b1b-458a-ba2e-2d9a44c70a02,
  abstract     = {{<p>Purpose: Alpha-synuclein often co-occurs with Alzheimer's disease (AD) pathology in Dementia with Lewy Bodies (DLB). From a dynamic [<sup>18</sup>F]flortaucipir PET scan we derived measures of both tau binding and relative cerebral blood flow (rCBF). We tested whether regional tau binding or rCBF differed between DLB patients and AD patients and controls and examined their association with clinical characteristics of DLB. Methods: Eighteen patients with probable DLB, 65 AD patients and 50 controls underwent a dynamic 130-minute [<sup>18</sup>F]flortaucipir PET scan. DLB patients with positive biomarkers for AD based on cerebrospinal fluid or amyloid PET were considered as DLB with AD pathology (DLB-AD+). Receptor parametric mapping (cerebellar gray matter reference region) was used to extract regional binding potential (BP<sub>ND</sub>) and R<sub>1</sub>, reflecting (AD-specific) tau pathology and rCBF, respectively. First, we performed regional comparisons of [<sup>18</sup>F]flortaucipir BP<sub>ND</sub> and R<sub>1</sub> between diagnostic groups. In DLB patients only, we performed regression analyses between regional [<sup>18</sup>F]flortaucipir BP<sub>ND</sub>, R<sub>1</sub> and performance on ten neuropsychological tests. Results: Regional [<sup>18</sup>F]flortaucipir BP<sub>ND</sub> in DLB was comparable with tau binding in controls (p &gt; 0.05). Subtle higher tau binding was observed in DLB-AD+ compared to DLB-AD- in the medial temporal and parietal lobe (both p &lt; 0.05). Occipital and lateral parietal R<sub>1</sub> was lower in DLB compared to AD and controls (all p &lt; 0.01). Lower frontal R<sub>1</sub> was associated with impaired performance on digit span forward (standardized beta, stβ = 0.72) and category fluency (stβ = 0.69) tests. Lower parietal R<sub>1</sub> was related to lower delayed (stβ = 0.50) and immediate (stβ = 0.48) recall, VOSP number location (stβ = 0.70) and fragmented letters (stβ = 0.59) scores. Lower occipital R<sub>1</sub> was associated to worse performance on VOSP fragmented letters (stβ = 0.61), all p &lt; 0.05. Conclusion: The amount of tau binding in DLB was minimal and did not differ from controls. However, there were DLB-specific occipital and lateral parietal relative cerebral blood flow reductions compared to both controls and AD patients. Regional rCBF, but not tau binding, was related to cognitive impairment. This indicates that assessment of rCBF may give more insight into disease mechanisms in DLB than tau PET.</p>}},
  author       = {{Wolters, E. E. and van de Beek, M. and Ossenkoppele, R. and Golla, S. S.V. and Verfaillie, S. C.J. and Coomans, E. M. and Timmers, T. and Visser, D. and Tuncel, H. and Barkhof, F. and Boellaard, R. and Windhorst, A. D. and van der Flier, W. M. and Scheltens, Ph and Lemstra, A. W. and van Berckel, B. N.M.}},
  issn         = {{2213-1582}},
  keywords     = {{Cognition; Dementia with Lewy bodies; FDG PET; Relative cerebral blood flow; Tau}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{NeuroImage: Clinical}},
  title        = {{Tau PET and relative cerebral blood flow in dementia with Lewy bodies : A PET study}},
  url          = {{http://dx.doi.org/10.1016/j.nicl.2020.102504}},
  doi          = {{10.1016/j.nicl.2020.102504}},
  volume       = {{28}},
  year         = {{2020}},
}