[18F]THK-5351 PET Patterns in Patients With Alzheimer’s Disease and Negative Amyloid PET Findings
- Authors
- 오민영; 오정수; 오승준; 이상주; 노지훈; 김우람; 서하은; 강재명; 서상원; 이재홍; 나덕렬; 노영; 김재승
- Issue Date
- Jul-2022
- Publisher
- 대한신경과학회
- Keywords
- [18F]THK-5351; Alzheimer’s disease; amyloid; neuropsychological test; positron-emission tomography.; [ 18F]THK-5351; Alzheimer’s disease; amyloid; neuropsychological test; positron-emission tomography.
- Citation
- Journal of Clinical Neurology, v.18, no.4, pp.437 - 446
- Journal Title
- Journal of Clinical Neurology
- Volume
- 18
- Number
- 4
- Start Page
- 437
- End Page
- 446
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/85150
- DOI
- 10.3988/jcn.2022.18.4.437
- ISSN
- 1738-6586
- Abstract
- Background and Purpose Alzheimer’s disease (AD) does not always mean amyloid posi tivity. [18F]THK-5351 has been shown to be able to detect reactive astrogliosis as well as tau accompanied by neurodegenerative changes. We evaluated the [18F]THK-5351 retention pat terns in positron-emission tomography (PET) and the clinical characteristics of patients clin ically diagnosed with AD dementia who had negative amyloid PET findings.
Methods We performed 3.0-T magnetic resonance imaging, [18F]THK-5351 PET, and amy loid PET in 164 patients with AD dementia. Amyloid PET was visually scored as positive or negative. [18F]THK-5351 PET were visually classified as having an intratemporal or extratem poral spread pattern.
Results The 164 patients included 23 (14.0%) who were amyloid-negative (age 74.9±8.3 years, mean±standard deviation; 9 males, 14 females). Amyloid-negative patients were older, had a higher prevalence of diabetes mellitus, and had better visuospatial and memory func tions. The frequency of the apolipoprotein E ε4 allele was higher and the hippocampal volume was smaller in amyloid-positive patients. [18F]THK-5351 uptake patterns of the amyloid-nega tive patients were classified into intratemporal spread (n=10) and extratemporal spread (n=13).
Neuropsychological test results did not differ significantly between these two groups. The standardized uptake value ratio of [18F]THK-5351 was higher in the extratemporal spread group (2.01±0.26 vs. 1.61±0.15, p=0.001). After 1 year, Mini Mental State Examination (MMSE) scores decreased significantly in the extratemporal spread group (-3.5±3.2, p=0.006) but not in the intratemporal spread group (-0.5±2.8, p=0.916). The diagnosis remained as AD (n=5, 50%) or changed to other diagnoses (n=5, 50%) in the intratemporal group, whereas it remained as AD (n=8, 61.5%) or changed to frontotemporal dementia (n=4, 30.8%) and other diagnoses (n=1, 7.7%) in the extratemporal spread group.
Conclusions Approximately 70% of the patients with amyloid-negative AD showed abnor mal [18F]THK-5351 retention. MMSE scores deteriorated rapidly in the patients with an ex tratemporal spread pattern.
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