Abstract Details

Title Heterogeneity of Brain Glucose Metabolism in Single Subjects with Mild Cognitive Impairment: The Predictive Role of [18F]FDG PET Voxel-Based Imaging

Topic Aging and Dementia

Presentation(s) P06 - (-)

Poster/Presentation
Number 040

Objective

Background BACKGROUND: [18F]FDG-PET imaging has been suggested as valid biomarker able to predict the progression from Mild Cognitive Impairment (MCI) to Alzheimer's Disease (AD) (Sperling et al., 2011). In clinical practice, however, [18F]FDG-PET scans are mostly evaluated through visual inspection with doubtful diagnostic results. Standardized voxel-based procedure can increase diagnostic accuracy (Della Rosa et al., 2012), particularly in MCI, allowing to detect altered metabolic patterns predictive of conversion to AD and other dementias.

Design/Methods DESIGN/METHODS: 28 MCI (8 amnestic single-domain (a-MCI), 13 amnestic multi-domain (md-MCI) and 7 (4 visuo-spatial and 3 dysexecutive) non-amnestic (na-MCI)) were enrolled in the study. A large population (112 scans) of normal subjects was included in a database for single-subjects [18F]FDG-PET analysis. Two years clinical follow-up revealed subsequent clinical evolution.

Results RESULTS: At baseline, 16 MCI patients (8 md-MCI, 5 a-MCI and 3 na-MCI visuo-spatial) showed the typical hypometabolic pattern suggestive for AD. At the clinical follow-up, 13 out of these 16 progressed to AD. Three MCI subjects showed a selective hypometabolism in the orbitofrontal/anterior cingulate cortex and/or temporal lobe (1 md-MCI and 2 na-MCI dysexecutive). After 2 years, these 3 MCI subjects with selective frontotemporal hypometabolism fulfilled diagnostic criteria for frontotemporal dementia. Nine subjects (4 md-MCI, 3 a-MCI and 2 na-MCI) had normal brain metabolism. None of these patients converted to dementia.

Conclusions CONCLUSIONS: Our results suggest that voxel-based [18F]FDG-PET imaging can reveal heterogeneous metabolic patterns in single subjects with MCI. The reported specific AD vs. FTD hypometabolism support its role for a more accurate differential diagnosis in early, even preclinical phase. Furthermore, a negative [18F]FDG-PET scan seems to be a powerful exclusionary test.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Stefano F. Cappa, MD	Dr. Cappa has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elservier. The institution of Dr. Cappa has received research support from Italian Minsitry of Health.
Daniela Perani	No disclosure on file
Richard B. Lipton, MD, FAAN (Albert Einstein College of Medicine)	Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Amgen. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biohaven. Dr. Lipton has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for GlaxoSmithKline. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Teva. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Vedanta. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Grifols. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axon. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Satsuma. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cool Tech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BDSI. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axsome. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Clexio. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shiratronics. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Lipton has or had stock in Biohaven.Dr. Lipton has or had stock in Manistee.Dr. Lipton has or had stock in Axon.Dr. Lipton has or had stock in CoolTech. The institution of Dr. Lipton has received research support from Teva. The institution of Dr. Lipton has received research support from Amgen. The institution of Dr. Lipton has received research support from Allergan/Abbvie. The institution of Dr. Lipton has received research support from Gammacore. The institution of Dr. Lipton has received research support from Axsome. The institution of Dr. Lipton has received research support from Charleston Labs. The institution of Dr. Lipton has received research support from Eli Lilly. The institution of Dr. Lipton has received research support from Satsuma. The institution of Dr. Lipton has received research support from NIH . The institution of Dr. Lipton has received research support from Veterans Administration. Dr. Lipton has received publishing royalties from a publication relating to health care.

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