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Eur J Nucl Med Mol Imaging. 2018 Oct 21. doi: 10.1007/s00259-018-4182-1. [Epub ahead of print]

Amyloid PET as a marker of normal-appearing white matter early damage in multiple sclerosis: correlation with CSF β-amyloid levels and brain volumes.

Author information

1
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy. pb.anna@libero.it.
2
University of Milan, Milan, Italy. pb.anna@libero.it.
3
Dino Ferrari Center, Milan, Italy. pb.anna@libero.it.
4
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy.
5
University of Milan, Milan, Italy.
6
Dino Ferrari Center, Milan, Italy.
7
Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy.
8
Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy.
9
Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, UK.

Abstract

PURPOSE:

The disease course of multiple sclerosis (MS) is unpredictable, and reliable prognostic biomarkers are needed. Positron emission tomography (PET) with β-amyloid tracers is a promising tool for evaluating white matter (WM) damage and repair. Our aim was to investigate amyloid uptake in damaged (DWM) and normal-appearing WM (NAWM) of MS patients, and to evaluate possible correlations between cerebrospinal fluid (CSF) β-amyloid1-42 (Aβ) levels, amyloid tracer uptake, and brain volumes.

METHODS:

Twelve MS patients were recruited and divided according to their disease activity into active and non-active groups. All participants underwent neurological examination, neuropsychological testing, lumbar puncture, brain magnetic resonance (MRI) imaging, and 18F-florbetapir PET. Aβ levels were determined in CSF samples from all patients. MRI and PET images were co-registered, and mean standardized uptake values (SUV) were calculated for each patient in the NAWM and in the DWM. To calculate brain volumes, brain segmentation was performed using statistical parametric mapping software. Nonparametric statistical analyses for between-group comparisons and regression analyses were conducted.

RESULTS:

We found a lower SUV in DWM compared to NAWM (p < 0.001) in all patients. Decreased NAWM-SUV was observed in the active compared to non-active group (p < 0.05). Considering only active patients, NAWM volume correlated with NAWM-SUV (p = 0.01). Interestingly, CSF Aβ concentration was a predictor of both NAWM-SUV (r = 0.79; p = 0.01) and NAWM volume (r = 0.81, p = 0.01).

CONCLUSIONS:

The correlation between CSF Aβ levels and NAWM-SUV suggests that the predictive role of β-amyloid may be linked to early myelin damage and may reflect disease activity and clinical progression.

KEYWORDS:

Amyloid; Amyloid tracer; Florbetapir; Multiple sclerosis; PET; White matter

PMID:
30343433
DOI:
10.1007/s00259-018-4182-1

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