Dement Neurocogn Disord.  2018 Dec;17(4):163-173. 10.12779/dnd.2018.17.4.163.

¹⁸F-THK5351 PET Imaging in the Behavioral Variant of Frontotemporal Dementia

Affiliations
  • 1College of Medicine, Gachon University, Incheon, Korea.
  • 2Neuroscience Research Institute, Gachon University, Incheon, Korea.
  • 3Department of Psychiatry, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
  • 4Department of Neuroscience, Gachon University College of Medicine, Incheon, Korea.
  • 5Department of Neurology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea. ynoh@gachon.ac.kr, djshin@gilhospital.com
  • 6Department of Health Science and Technology, Gachon Advanced Institute for Health Sciences & Technology, Gachon University, Incheon, Korea.

Abstract

BACKGROUND AND PURPOSE
Behavioral variant frontotemporal dementia (bvFTD) is a subtype of frontotemporal dementia, which has clinical symptoms of progressive personality and behavioral changes with deterioration of social cognition and executive functions. The pathology of bvFTD is known to be tauopathy or TDP-43 equally. We analyzed the 18F-THK5351 positron emission tomography (PET) scans, which were recently developed tau PET, in patients with clinically-diagnosed bvFTD.
METHODS
Forty-eight participants, including participants with behavioral variant frontotemporal dementia (bvFTD, n=3), Alzheimer's disease (AD, n=21) and normal cognition (NC, n=24) who completed 3T magnetic resonance images, 18F-THK5351 PET scans, and detailed neuropsychological tests were included in the study. Voxel-wise statistical analysis and region of interest (ROI)-based analyses were performed to evaluate the retention of THK in bvFTD patients.
RESULTS
In the voxel-based and ROI-based analyses, patients with bvFTD showed greater THK retention in the prefrontal, medial frontal, orbitofrontal, anterior cingulate, insula, anterior inferior temporal and striatum regions compared to NC participants. Left-right asymmetry was noted in the bvFTD patients. A patient with extrapyramidal symptoms showed much greater THK retention in the brainstem.
CONCLUSIONS
The distribution of THK retention in the bvFTD patients was mainly in the frontal, insula, anterior temporal, and striatum regions which are known to be the brain regions corresponding to the clinical symptoms of bvFTD. Our study suggests that 18F-THK5351 PET imaging could be a supportive tool for diagnosis of bvFTD.

Keyword

Frontotemporal Dementia; Tauopathies; Positron-Emission Tomography

MeSH Terms

Alzheimer Disease
Brain
Brain Stem
Cognition
Diagnosis
Executive Function
Frontotemporal Dementia*
Gyrus Cinguli
Humans
Neuropsychological Tests
Pathology
Positron-Emission Tomography
Tauopathies

Figure

  • Fig. 1 18F-THK5351 PET SUV and magnetic resonance images of bvFTD patients. Representative slices in the horizontal direction of 18F-THK5351 PET and 3D T1-MPRAGE scans taken of three patients diagnosed with bvFTD. PET: positron emission tomography, SUV: standardized uptake value, bvFTD: behavioral variant frontotemporal dementia, MPRAGE: magnetization-prepared rapid gradient-echo.

  • Fig. 2 Group comparison of 18F-THK5351 positron emission tomography. Colored areas represent brain regions corresponding to increased THK retention from voxel-wise statistical analyses in (A) the bvFTD group compared to the NC group (bvFTD > NC) and (B) the AD group compared to the NC group (AD > NC). The results are presented at a threshold of p<0.001, adjusted for age, gender, and years of education, and a cluster >100. bvFTD: behavioral variant frontotemporal dementia, NC: normal cognition, AD: Alzheimer's disease.


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