Exp Neurobiol.  2022 Dec;31(6):401-408. 10.5607/en22022.

Regional Comparison of Imaging Biomarkers in the Striatum between Early- and Late-onset Alzheimer’s Disease

Affiliations
  • 1Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
  • 2Department of Neurology, Inje University Ilsan Paik Hospital, Goyang 10380, Korea
  • 3Department of Biomedical Engineering, Hanyang University, Seoul 04763, Korea
  • 4Department of Neurology, Keimyung University Daegu Dongsan Hospital, Daegu 42601, Korea
  • 5Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
  • 6Department of Artificial Intelligence, Hanyang University, Seoul 04763, Korea
  • 7Department of Biomedical Sciences and Department of Physiology, Korea University College of Medicine, Seoul 02841, Korea
  • 8Department of Neurology, Anam Hospital, Korea University College of Medicine, Seoul 02841, Korea

Abstract

Striatal changes in the pathogenesis of Alzheimer’s disease (AD) is not fully understood yet. We compared structural and functional image differences in the striatum between patients with early onset AD (EOAD) and late onset AD (LOAD) to investigate whether EOAD harbors autosomal dominant AD like imaging findings. The clinical, neuropsychological and neuroimaging biomarkers of 77 probable AD patients and 107 elderly subjects with normal cognition (NC) from the Alzheimer’s Disease Neuroimaging Initiative (ADNI)-2 dataset were analyzed. Enrolled each subject completed a 3-Tesla MRI, baseline 18F-FDG-PET, and baseline 18F-AV-45 (Florbetapir) amyloid PET studies. AD patients were divided into two groups based on the onset age of clinical symptoms (EOAD <65 yrs; LOAD ≥65 yrs). A standardized uptake value ratio of the striatum and subcortical structures was obtained from both amyloid and FDG-PET scans. Structural MR imaging analysis was conducted using a parametric boundary description protocol, SPHARM-PDM. Of the 77 AD patients, 18 were EOAD and 59 were LOAD. Except for age of symptom onset, there were no statistically significant differences between the groups in demographics and detailed neuropsychological test results. 18F-AV-45 amyloid PET showed marked β-amyloid accumulation in the bilateral caudate nucleus and left pallidum in the EOAD group. Intriguingly, the caudate nucleus and putamen showed maintained glucose metabolism in the EOAD group compared to the LOAD group. Our image findings in the striatum of EOAD patients suggest that sporadic EOAD may share some pathophysiological changes noted in autosomal dominant AD.

Keyword

Alzheimer’s disease; Striatum; Biomarkers; Amyloid PET; Early onset Alzheimer’s disease; Late onset Alzheimer’s disease
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