Amyloid- and FDG-PET imaging in amyotrophic lateral sclerosis

作者：Matias Guiu Jordi A; Pytel Vanesa; Nieves Cabrera Martin Maria; Galan Lucia; Valles Salgado Maria; Guerrero Antonio; Moreno Ramos Teresa; Matias Guiu Jorge; Luis Carreras Jose

来源：European Journal of Nuclear Medicine and Molecular Imaging, 2016, 43(11): 2050-2060.

DOI：10.1007/s00259-016-3434-1

• Amyloid
• Amyotrophic lateral sclerosis
• Brain metabolism
• Positron emission tomography
• Cognitive impairment
• Alzheimer's disease

We aimed to study brain metabolism and presence of beta-amyloid deposits using positron emission tomography (PET) in patients with amyotrophic lateral sclerosis (ALS).
This prospective cross-sectional study included 18 patients with definite or probable ALS according to the revised El Escorial diagnostic criteria, and 24 healthy controls. Patients underwent neurological and neuropsychological assessments, PET with F-18-fluorodeoxyglucose (FDG), and amyloid-PET with F-18-florbetaben.
Patients with ALS showed hypometabolism in the frontal area and hypermetabolism in the cerebellum compared to healthy controls. Four patients (22 %) displayed cognitive impairment and decreased metabolism in the frontal area extending bilaterally to the parietal regions, and increased metabolism in the posterior area of the cerebellum. In patients with no cognitive impairment, metabolism was lower in the left superior frontal gyrus and higher in the anterior and posterior lobes of the cerebellum. In the individual analysis, six patients (35 %) displayed more anterior involvement with hypometabolism affecting the superior frontal, medial, and inferior gyri; six patients (35 %) exhibited a more posterior pattern with hypometabolism in the precentral and postcentral gyri and in the superior and inferior parietal lobules; two patients (11 %) showed a mixed pattern; and three patients (17 %) showed no alterations in brain metabolism. Three (16 %) showed increased F-18-florbetaben uptake compared to controls.
We have identified two main patterns of brain metabolism with an association to cognitive status. Only a subgroup of patients showed an increased uptake of the amyloid tracer. Our results suggest that ALS is heterogeneous from a clinical, metabolic, and molecular standpoint.

• 出版日期2016-10