Document Detail

Abeta amyloid and glucose metabolism in three variants of primary progressive aphasia.
MedLine Citation:
PMID:  18991338     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Alzheimer's disease (AD) is found at autopsy in up to one third of patients with primary progressive aphasia (PPA), but clinical features that predict AD pathology in PPA are not well defined. We studied the relationships between language presentation, Abeta amyloidosis, and glucose metabolism in three PPA variants using [11C]-Pittsburgh compound B ([11C]PIB) and [18F]-labeled fluorodeoxyglucose positron emission tomography ([18F]FDG-PET).
METHODS: Patients meeting PPA criteria (N = 15) were classified as logopenic aphasia (LPA), progressive nonfluent aphasia (PNFA), or semantic dementia (SD) based on language testing. [11C]PIB distribution volume ratios were calculated using Logan graphical analysis (cerebellar reference). [18F]FDG images were normalized to pons. Partial volume correction was applied.
RESULTS: Elevated cortical PIB (by visual inspection) was more common in LPA (4/4 patients) than in PNFA (1/6) and SD (1/5) (p < 0.02). In PIB-positive PPA, PIB uptake was diffuse and indistinguishable from the pattern in matched AD patients (n = 10). FDG patterns were focal and varied by PPA subtype, with left temporoparietal hypometabolism in LPA, left frontal hypometabolism in PNFA, and left anterior temporal hypometabolism in SD. FDG uptake was significant asymmetric (favoring left hypometabolism) in PPA (p < 0.005) but not in AD.
INTERPRETATION: LPA is associated with Abeta amyloidosis, suggesting that subclassification of PPA based on language features can help predict the likelihood of AD pathology. Language phenotype in PPA is closely related to metabolic changes that are focal and anatomically distinct between subtypes, but not to amyloid deposition patterns that are diffuse and similar to AD.
Gil D Rabinovici; William J Jagust; Ansgar J Furst; Jennifer M Ogar; Caroline A Racine; Elizabeth C Mormino; James P O'Neil; Rayhan A Lal; Nina F Dronkers; Bruce L Miller; Maria Luisa Gorno-Tempini
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of neurology     Volume:  64     ISSN:  1531-8249     ISO Abbreviation:  Ann. Neurol.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-11-13     Completed Date:  2008-12-24     Revised Date:  2014-09-10    
Medline Journal Info:
Nlm Unique ID:  7707449     Medline TA:  Ann Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  388-401     Citation Subset:  IM    
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MeSH Terms
Aged, 80 and over
Alzheimer Disease / metabolism,  radionuclide imaging
Amyloid beta-Peptides / metabolism*
Analysis of Variance
Aniline Compounds / metabolism
Aphasia, Primary Progressive / classification*,  metabolism*,  radionuclide imaging
Carbon Isotopes / metabolism
Dementia / metabolism,  radionuclide imaging
Fluorodeoxyglucose F18 / metabolism
Glucose / metabolism*
Image Processing, Computer-Assisted
Language Tests
Middle Aged
Positron-Emission Tomography / methods
Thiazoles / metabolism
Grant Support
AG027859/AG/NIA NIH HHS; K23 AG031861/AG/NIA NIH HHS; P01-AG1972403/AG/NIA NIH HHS; P50-AG023501/AG/NIA NIH HHS; R01 AG027859/AG/NIA NIH HHS; R01 AG027859-01A1/AG/NIA NIH HHS; R01-NS050915/NS/NINDS NIH HHS
Reg. No./Substance:
0/2-(4'-(methylamino)phenyl)-6-hydroxybenzothiazole; 0/Amyloid beta-Peptides; 0/Aniline Compounds; 0/Carbon Isotopes; 0/Thiazoles; 0Z5B2CJX4D/Fluorodeoxyglucose F18; IY9XDZ35W2/Glucose

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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