Tau PET and multimodal brain imaging in patients at risk for chronic traumatic encephalopathy
Tau PET and multimodal brain imaging in patients at risk for chronic traumatic encephalopathy
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DOI：
10.1016/j.nicl.2019.102025
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发表时间：
2019-01-01
影响因子：
4.2
通讯作者：
Rabinovici, Gil D.
中科院分区：
文献类型：
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作者：
Lesman-Segev, Orit H.;La Joie, Renaud;Rabinovici, Gil D.
方法：对11例符合创伤性脑病综合征诊断标准(TES，中位年龄：)的男性患者进行了神经学评估、3-TESLA磁共振成像、[F-18]-氟他西平(ftp，tau-PET)和[C-11]-匹兹堡化合物B(PIB，淀粉样蛋白-PET)的正电子发射计算机断层扫描。6例患者接受了[F-18]-脱氧葡萄糖-正电子发射计算机断层扫描(FDG，葡萄糖代谢)。我们评估了个体患者水平的成像结果，并与认知正常的老年人(CN)的特定形态组进行了组级比较。TES患者的Tau-PET检查结果还与轻度认知障碍或阿尔茨海默病(AD)痴呆患者进行了比较。结果：所有TES患者在参加撞击性运动时均有反复头部损伤，其中10例在美式橄榄球比赛中。3名患者符合痴呆症的诊断标准，8名患者有轻度认知障碍。2例患者淀粉样蛋白-PET阳性，表现为最严重的MRI萎缩、FDG代谢低下和ftp-tau PET结合。在9例淀粉样蛋白阴性的患者中，tau-PET显示额颞结合轻度升高，呈“点状”模式，或无结合升高。在淀粉样蛋白阴性患者的亚组中，内侧颞叶FT值轻度升高，但显著低于AD组。Voxelise分析显示，与对照组相比，TES患者额颞区的影像异常(高FT值结合、低FDG值、低灰质体积)汇聚在一起。结论：在有CTE风险的淀粉样阴性患者中观察到轻度升高的tau-PET结合，其分布与CTE病理分期III-IV相一致。FTPPET可作为CTE中tau病理的生物标志物，但不太可能对早期疾病阶段敏感。
Objective: To characterize individual and group-level neuroimaging findings in patients at risk for Chronic Traumatic Encephalopathy (CTE).Methods: Eleven male patients meeting criteria for Traumatic Encephalopathy Syndrome (TES, median age: 64) underwent neurologic evaluation, 3-Tesla MRI, and PET with [F-18]-Flortaucipir (FTP, tau-PET) and [C-11]-Pittsburgh compound B (PIB, amyloid-PET). Six patients underwent [F-18]-Fluorodeoxyglucose-PET (FDG, glucose metabolism). We assessed imaging findings at the individual patient level, and in group-level comparisons with modality-specific groups of cognitively normal older adults (CN). Tau-PET findings in patients with TES were also compared to a matched group of patients with mild cognitive impairment or dementia due to Alzheimer's disease (AD).Results: All patients with TES sustained repetitive head injury participating in impact sports, ten in American football. Three patients ma criteria for dementia and eight had mild cognitive impairment. Two patients were amyloid-PET positive and harbored the most severe MRI atrophy, FDG hypometabolism, and FTP-tau PET binding. Among the nine amyloid-negative patients, tau-PET showed either mildly elevated frontotemporal binding, a "dot-like" pattern, or no elevated binding. Medial temporal FTP was mildly elevated in a subset of amyloid-negative patients, but values were considerably lower than in AD. Voxelwise analyses revealed a convergence of imaging abnormalities (higher FTP binding, lower FDG, lower gray matter volumes) in fronto-temporal areas in TES compared to controls.Conclusions: Mildly elevated tau-PET binding was observed in a subset of amyloid-negative patients at risk for CTE, in a distribution consistent with CTE pathology stages III-IV. FTP-PET may be useful as a biomarker of tau pathology in CTE but is unlikely to be sensitive to early disease stages.