Document Detail


Distinct clinical and metabolic deficits in PCA and AD are not related to amyloid distribution.
MedLine Citation:
PMID:  21525424     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background/ OBJECTIVE: Patients with posterior cortical atrophy (PCA) often have Alzheimer disease (AD) at autopsy, yet are cognitively and anatomically distinct from patients with clinical AD. We sought to compare the distribution of β-amyloid and glucose metabolism in PCA and AD in vivo using Pittsburgh compound B (PiB) and FDG-PET. METHODS: Patients with PCA (n = 12, age 57.5 ± 7.4, Mini-Mental State Examination [MMSE] 22.2 ± 5.1), AD (n = 14, age 58.8 ± 9.6, MMSE 23.8 ± 6.7), and cognitively normal controls (NC, n = 30, age 73.6 ± 6.4) underwent PiB and FDG-PET. Group differences in PiB distribution volume ratios (DVR, cerebellar reference) and FDG uptake (pons-averaged) were assessed on a voxel-wise basis and by comparing binding in regions of interest (ROIs). RESULTS: Compared to NC, both patients with AD and patients with PCA showed diffuse PiB uptake throughout frontal, temporoparietal, and occipital cortex (p < 0.0001). There were no regional differences in PiB binding between PCA and AD even after correcting for atrophy. FDG patterns in PCA and AD were distinct: while both groups showed hypometabolism compared to NC in temporoparietal cortex and precuneus/posterior cingulate, patients with PCA further showed hypometabolism in inferior occipitotemporal cortex compared to both NC and patients with AD (p < 0.05). Patients with AD did not show areas of relative hypometabolism compared to PCA. CONCLUSIONS: Fibrillar amyloid deposition in PCA is diffuse and similar to AD, while glucose hypometabolism extends more posteriorly into occipital cortex. Further studies are needed to determine the mechanisms of selective network degeneration in focal variants of AD.
Authors:
M H Rosenbloom; A Alkalay; N Agerwal; S L Baker; J P O'Neil; M Janabi; I V Yen; M Growdon; J Jang; C Madison; E C Mormino; H J Rosen; M L Gorno-Tempini; M W Weiner; B L Miller; W J Jagust; G D Rabinovici
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-27
Journal Detail:
Title:  Neurology     Volume:  -     ISSN:  1526-632X     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From the Memory and Aging Center and Department of Neurology (M.H.R., A.A., M.G., J.J., H.J.R., M.L.G.-T., B.L.M., W.J.J., G.D.R.), University of California San Francisco, San Francisco; Helen Wills Neuroscience Institute (A.A., N.A., C.M., E.C.M., W.J.J., G.D.R.), University of California Berkeley, Berkeley; Lawrence Berkeley National Laboratory (S.L.B., J.P.O., M.J., I.V.Y., W.J.J., G.D.R.), Berkeley; and Center for Imaging of Neurodegenerative Diseases (M.W.W.), Department of Veterans Affairs Medical Center, San Francisco, CA.
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