Probing the Role of a Regional Quantitative Assessment of Amyloid PET

Article type: Research Article

Authors: Peira, Enrico^{a; b; *} | Grazzini, Matteo^b | Bauckneht, Matteo^{c; d} | Sensi, Francesco^a | Bosco, Paolo^e | Arnaldi, Dario^{b; f} | Morbelli, Silvia^{c; d} | Chincarini, Andrea^a | Pardini, Matteo^{b; f} | Nobili, Flavio^{b; f}

Affiliations: [a] INFN, Genoa, Italy | [b] Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Child and Maternal Health (DINOGMI), University of Genoa, Genoa, Italy | [c] IRCCS Ospedale Policlinico San Martino, Genoa, Italy | [d] Nuclear Medicine Unit, Dept. of Health Sciences (DISSAL), University of Genoa, Genoa, Italy | [e] IRCCS Stella Maris Foundation, Pisa, Italy | [f] Neurology Clinic, IRCCS Ospedale Policlinico San Martino, Genoa, Italy

Correspondence: [*] Correspondence to: Enrico Peira, Via Dodecaneso 33, I-16146, Genova, Italy. Tel.: +39 010 353 6496; E-mail: enrico.peira@gmail.com. ORCID: 0000-0002-5834-8101.

Abstract: Background:In clinical practice, the amy-PET is globally inspected to provide a binary outcome, but the role of a regional assessment has not been fully investigated yet. Objective:To deepen the role of regional amyloid burden and its implication on clinical-neuropsychological features. Materials:Amy-PET and a complete neuropsychological assessment (Trail Making Test, Rey Auditory Verbal Learning Test, semantic verbal fluency, Symbol Digit, Stroop, visuoconstruction) were available in 109 patients with clinical suspicion of Alzheimer’s disease. By averaging the standardized uptake value ratio and ELBA, a regional quantification was calculated for each scan. Patients were grouped according to their overall amyloid load: correlation maps, based on regional quantification, were calculated and compared. A regression analysis between neuropsychological assessment and the regional amyloid-β (Aβ) load was carried out. Results:Significant differences were observed between the correlation maps of patients at increasing levels of Aβ and the overall dataset. The Aβ uptake of the subcortical gray matter resulted not related to other brain regions independently of the global Aβ level. A significant association of semantic verbal fluency was observed with ratios of cortical and subcortical distribution of Aβ which represent a coarse measure of differences in regional distribution of Aβ. Conclusion:Our observations confirmed the different susceptibility to Aβ accumulation among brain regions. The association between cognition and Aβ distribution deserves further investigations: it is possibly due to a direct local effect or it represents a proxy marker of a more aggressive disease subtype. Regional Aβ assessment represents an available resource on amy-PET scan with possibly clinical and prognostic implications.

Keywords: Amyloid PET, ELBA, regional amyloid, semi-quantification, standardized uptake value ratio

DOI: 10.3233/JAD-201156

Journal: Journal of Alzheimer's Disease, vol. 80, no. 1, pp. 383-396, 2021