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Case Reports
. 2015 Feb;77(2):338-42.
doi: 10.1002/ana.24321. Epub 2014 Dec 17.

Tau, amyloid, and hypometabolism in a patient with posterior cortical atrophy

Rik Ossenkoppele  1 , Daniel R Schonhaut, Suzanne L Baker, James P O'Neil, Mustafa Janabi, Pia M Ghosh, Miguel Santos, Zachary A Miller, Brianne M Bettcher, Maria L Gorno-Tempini, Bruce L Miller, William J Jagust, Gil D Rabinovici
Affiliations
Case Reports

Tau, amyloid, and hypometabolism in a patient with posterior cortical atrophy

Rik Ossenkoppele et al. Ann Neurol. 2015 Feb.

Abstract

Determining the relative contribution of amyloid plaques and neurofibrillary tangles to brain dysfunction in Alzheimer disease is critical for therapeutic approaches, but until recently could only be assessed at autopsy. We report a patient with posterior cortical atrophy (visual variant of Alzheimer disease) who was studied using the novel tau tracer [(18) F]AV-1451 in conjunction with [(11) C]Pittsburgh compound B (PIB; amyloid) and [(18) F]fluorodeoxyglucose (FDG) positron emission tomography. Whereas [(11) C]PIB bound throughout association neocortex, [(18) F]AV-1451 was selectively retained in posterior brain regions that were affected clinically and showed markedly reduced [(18) F]FDG uptake. This provides preliminary in vivo evidence that tau is more closely linked to hypometabolism and symptomatology than amyloid.

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Conflict of interest statement

Potential Conflicts of Interest: B.L.M.: Medical Director, John Douglas French Foundation; Scientific Director, Tau Consortium; Director/ Medical Advisory Board, Larry L. Hillblom Foundation; Scientific Advisory Board Member, National Institute for Health Research Cambridge Biomedical Research Centre and its subunit the Biomedical Research Unit in Dementia (UK). W.J.J.: personal fees, Genentech, Synarc, Hoffman LaRoche. G.D.R.: speaking fees, GE Healthcare, Medscape, Rockpointe.

Figures

FIGURE 1
FIGURE 1
Sagittal, axial, and coronal slices of [11C]Pittsburgh compound B (PIB), [18F]AV-1451, and [18F]fluorodeoxyglucose (FDG) positron emission tomography alongside structural magnetic resonance imaging (MRI) scan. DVR = distribution volume ratio; L = left; R = right; SUVr = standardized uptake value ratio
FIGURE 2
FIGURE 2
Pearson correlations between [18F]fluorodeoxyglucose (FDG) uptake and (A) [18F]AV-1451 retention (r = −0.60, p<0.001) and (B) [11C]Pittsburgh compound B (PIB) binding (r = 0.17, p = 0.38) across the neocortex suggest a stronger relationship with hypometabolism for tau than for amyloid pathology. See Patient and Methods section for detailed information on which brain regions were included within each cortical region of interest (ROI). DVR = distribution volume ratio; SUVr = standardized uptake value ratio
See this image and copyright information in PMC

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