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- Title
[<sup>18</sup> F]AV-1451 tau-PET and primary progressive aphasia.
- Authors
Josephs, Keith A.; Martin, Peter R.; Botha, Hugo; Schwarz, Christopher G.; Duffy, Joseph R.; Clark, Heather M.; Machulda, Mary M.; Graff‐Radford, Jonathan; Weigand, Stephen D.; Senjem, Matthew L.; Utianski, Rene L.; Drubach, Daniel A.; Boeve, Bradley F.; Jones, David T.; Knopman, David S.; Petersen, Ronald C.; Jack, Jr, Clifford R.; Lowe, Val J.; Whitwell, Jennifer L.; Graff-Radford, Jonathan
- Abstract
<bold>Objectives: </bold>To assess [18 F]AV-1451 tau-PET (positron emission tomography) uptake patterns across the primary progressive aphasia (PPA) variants (logopenic, semantic, and agrammatic), examine regional uptake patterns of [18 F]AV-1451 independent of clinical diagnosis, and compare the diagnostic utility of [18 F]AV-1451, [18 F]-fluorodeoxygluclose (FDG)-PET and MRI (magnetic resonance imaging) to differentiate the PPA variants.<bold>Methods: </bold>We performed statistical parametric mapping of [18 F]AV-1451 across 40 PPA patients (logopenic-PPA = 14, semantic-PPA = 13, and agrammatic-PPA = 13) compared to 80 cognitively normal, Pittsburgh compound B-negative controls, age and gender matched 2:1. Principal component analysis of regional [18 F]AV-1451 tau-PET standard uptake value ratio was performed to understand underlying patterns of [18 F]AV-1451 uptake independent of clinical diagnosis. Penalized multinomial regression analyses were utilized to assess diagnostic utility.<bold>Results: </bold>Logopenic-PPA showed striking uptake throughout neocortex, particularly temporoparietal, compared to controls, semantic-PPA, and agrammatic-PPA. Semantic-PPA and agrammatic-PPA showed milder patterns of focal [18 F]AV-1451 uptake. Semantic-PPA showed elevated uptake (left>right) in anteromedial temporal lobes, compared to controls and agrammatic-PPA. Agrammatic-PPA showed elevated uptake (left>right) throughout prefrontal white matter and in subcortical gray matter structures, compared to controls and semantic-PPA. The principal component analysis of regional [18 F]AV-1451 indicated two primary dimensions, a severity dimension that distinguished logopenic-PPA from agrammatic-PPA and semantic-PPA, and a frontal versus temporal contrast that distinguishes agrammatic-PPA and semantic-PPA cases. Diagnostic utility of [18 F]AV-1451was superior to MRI and at least equal to FDG-PET.<bold>Interpretation: </bold>[18 F]AV-1451binding characteristics differ across the PPA variants and were excellent at distinguishing between the variants. [18 F]AV-1451binding characteristics were as good or better than other brain imaging modalities utilized in clinical practice, suggesting that [18 F]AV-1451 may have clinical diagnostic utility in PPA. Ann Neurol 2018 Ann Neurol 2018;83:599-611.
- Subjects
APHASIC persons; APHASIA; MEDICAL quality control; MAGNETIC resonance imaging; MULTIPLE correspondence analysis (Statistics); THERAPEUTICS
- Publication
Annals of Neurology, 2018, Vol 83, Issue 3, p599
- ISSN
0364-5134
- Publication type
journal article
- DOI
10.1002/ana.25183