Alz Res Therapy: Data-driven PET analysis is conducive to the classification of dementia

Previous studies have demonstrated the heterogeneity of Alzheimer’s disease (AD), which is related to the different neuropathological subtypes of AD, which is characterized by the marginal area as the main area and the hippocampus as the auxiliary, or quite balanced ("typical" ) The pathological spatial distribution of neurofibrillary tangles
.

The analysis of ante-mortem (ante-) structural MRI data shows that the neuropathologically defined AD subtype also shows the in vivo pattern characteristics of regional brain atrophy
.

Recent studies have used clustering methods on structural MRI data to determine the atrophy subtypes of AD in a data-driven manner

In addition to the volume information of structural MRI, the low metabolism in FDG-PET is also a recognized imaging marker of neurodegeneration recognized by the recently revised AD research standards
.

The application of FDG-PET in dementia and neurodegenerative cognitive impairment has also recently been unanimously recommended by the European Association for Nuclear Medicine and the European Society of Neurology

In view of the fact that the "AD typical" hypermetabolic pattern detected by visual inspection of individual patients' FDGPET scans is usually used for differential dementia diagnosis in research and clinical settings , systematically assess whether and how specific AD neurodegenerative subtypes are reflected in FDG-PET The data may have important diagnostic significance
.

The diagnostic system assesses whether and how specific AD neurodegenerative subtypes are reflected in FDG-PET data may have important diagnostic significance
.

With this, Fedor Levin and others of the German Center for Neurodegenerative Diseases, Germany, applied a large data set of FDG-PET scans of AD patients confirmed by biomarkers registered in the Alzheimer’s Disease Neuroimaging Program (ADNI).

The hierarchical clustering method investigated the hypometabolic subtypes of AD patients

They performed hierarchical clustering on the voxel-PET data of 177 amyloid-positive AD dementia patients who participated in the Alzheimer’s Disease Neuroimaging Program (ADNI) to identify different AD hypermetabolic subtypes, and then based on clinical And biomarker characteristics to further describe these subtypes
.

Then, according to the identified subtypes, the FDG-PET scans of 217 amyloid-positive patients with mild cognitive impairment ("prodromal AD") were classified, and their follow-up time of up to 72 months was studied.

And studied their cognitive trajectory and the development of dementia in a specific area during a 72-month follow-up period

(i) "Typical" (48.
6%), showing a typical posterior temporal-parietal hypometabolism pattern;

(ii) "Edge-led" (44.
6%), characterized by older age and memory-led cognitive characteristics;

(iii) The relatively rare "cortex-dominant" subtype (6.
8%) is characterized by younger age and more severe executive dysfunction
.

The subtypes classified in the precursor AD samples showed similar subtype characteristics to the AD dementia samples, and further showed different cognitive decline processes

This research is based on the work of MRI to identify different subtypes of AD atrophy, and may provide a potentially more sensitive molecular imaging tool for the early detection and description of AD-related neurodegeneration variants in the precursor disease stage
.

This research is based on the work of MRI to identify different subtypes of AD atrophy and may provide a potentially more sensitive molecular imaging tool

Original source:
Levin F, Ferreira D, Lange C, et al.

Data-driven FDG-PET subtypes of Alzheimer's disease-related neurodegeneration.
Alz Res Therapy .

Data-driven FDG-PET subtypes of Alzheimer's disease-related neurodegeneration.
Alz Res Therapy

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