Amyloid- and FDG-PET imaging in amyotrophic lateral sclerosis

• Published in: European journal of nuclear medicine and molecular imaging Vol. 43; no. 11; pp. 2050 - 2060
• Main Authors: Matías-Guiu, Jordi A., Pytel, Vanesa, Cabrera-Martín, María Nieves, Galán, Lucía, Valles-Salgado, María, Guerrero, Antonio, Moreno-Ramos, Teresa, Matías-Guiu, Jorge, Carreras, José Luis
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2016; Springer Nature B.V
• Subjects: Alzheimer's disease; Amyloid - metabolism; Amyotrophic lateral sclerosis; Amyotrophic Lateral Sclerosis - diagnostic imaging; Amyotrophic Lateral Sclerosis - metabolism; Aniline Compounds - pharmacokinetics; Brain; Brain - diagnostic imaging; Brain - metabolism; Brain Diseases, Metabolic - diagnostic imaging; Brain Diseases, Metabolic - metabolism; Cardiology; Cerebellum; Cognitive ability; Diagnostic systems; Emission analysis; Female; Fluorine isotopes; Fluorodeoxyglucose F18 - pharmacokinetics; Frontal gyrus; Humans; Hypometabolism; Imaging; Impairment; Male; Medicine; Medicine & Public Health; Metabolism; Middle Aged; Molecular chains; Molecular Imaging - methods; Neuroimaging; Nuclear Medicine; Oncology; Original Article; Orthopedics; Patients; Positron emission; Positron emission tomography; Positron-Emission Tomography - methods; Radiology; Radiopharmaceuticals - pharmacokinetics; Reproducibility of Results; Sensitivity and Specificity; Stilbenes - pharmacokinetics; Subgroups; Tomography; β-Amyloid; Amyotrophic lateral sclerosis; Amyloid; Alzheimer’s disease; Brain metabolism; Positron emission tomography; Cognitive impairment
• ISSN: 1619-7070; 1619-7089
• DOI: 10.1007/s00259-016-3434-1

Purpose We aimed to study brain metabolism and presence of beta-amyloid deposits using positron emission tomography (PET) in patients with amyotrophic lateral sclerosis (ALS). Methods 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 18 F-fluorodeoxyglucose (FDG), and amyloid-PET with 18 F-florbetaben. Results 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 18 F-florbetaben uptake compared to controls. Conclusions 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.