PIB PET Scanning in Speech and Language Based Dementias

描述（由申请人提供）：言语和语言性痴呆（SLD）（通常称为原发性进行性失语症）是神经退行性疾病，其中言语和语言障碍是疾病的最显著特征，并解释日常生活活动的缺陷。这些痴呆症可能与大脑中β-淀粉样蛋白的沉积有关，也可能无关，直到最近才能在死后确定。由于新的治疗方法可能会针对潜在的异常蛋白质，因此准确预测SLD潜在的病理学至关重要。淀粉样蛋白成像化合物的最新发展现在允许在体内检测大脑中的β-淀粉样蛋白。不幸的是，淀粉样蛋白成像化合物是昂贵的，并且在美国的大多数医疗中心都无法获得。本提案中概述的研究目的是确定临床、神经心理学或非淀粉样蛋白成像生物标志物，这些生物标志物容易获得，相对便宜，并且是非侵入性的，这将允许预测SLD患者大脑中的β-淀粉样蛋白。为了实现这一目标，我们将使用淀粉样蛋白成像化合物11 C匹兹堡化合物B（Pi B）作为检测β-淀粉样蛋白的金标准。这些方法将包括详细的神经学，言语和语言以及神经心理学评估，磁共振成像，[18-F]-氟脱氧葡萄糖（FDG）和PiB PET扫描。将寻求PiB阳性扫描和这些技术之间的关联。言语和语言评估的最显著特征之一是确定言语失用症的存在和严重程度及其与β淀粉样蛋白沉积的相关性。本研究将在罗切斯特（MN）的马约诊所进行，该诊所每年对大量SLD患者进行评价。该研究还打算招募目前研究不足的具有SLD的少数群体。这些方法将由一组世界知名的科学家执行，包括痴呆症，运动障碍和语言病理学专家，放射学研究人员，核医学科学家，神经心理学家和生物统计学家。我们研究的长期目标是开发一种经济有效的算法方法来评估和诊断SLD患者。 公共卫生相关性：这项研究将确定阿尔茨海默病是否是患者进行性言语和语言问题的根本原因。此外，该研究旨在确定最具成本效益的方法，以便更多的患者，包括少数民族，可以得到准确的诊断。这笔赠款的结果将最终导致更有针对性的未来治疗与言语和语言问题的患者。

DESCRIPTION (provided by applicant): Speech and language based dementias (SLDs) (often referred to as primary progressive aphasias) are neurodegenerative diseases in which speech and language impairments are the most salient features of the disease and explain deficits in activities of daily living. These dementias may or may not be associated with the deposition of the protein beta-amyloid in the brain, which until recently could only be determined at postmortem. Since new treatments will likely target underlying abnormal proteins, accurate prediction of the pathology underlying the SLDs is critical. The recent development of amyloid imaging compounds now allows the in vivo detection of beta-amyloid in the brain. Unfortunately, amyloid imaging compounds are expensive and are not accessible to most medical centers throughout the United States. The objectives of the studies outlined in this proposal are to identify clinical, neuropsychological or non-amyloid imaging biomarkers that are readily available, relatively inexpensive, and non-invasive, that will allow the prediction of beta-amyloid in the brain in patients with SLDs. To accomplish this goal we will be using the amyloid imaging compound 11C Pittsburgh Compound B (PiB) as the gold standard for the detection of beta-amyloid. The methods will include detailed neurological, speech and language and neuropsychological assessments, magnetic resonance imaging, and [18-F]-fluoro-deoxy-glucose (FDG) and PiB PET scanning. Associations between PiB positive scanning and these techniques will be sought. One of the most salient features of the speech and language assessments will be the determination of the presence and severity of apraxia of speech and its association with beta-amyloid deposition. This study will be carried out at the Mayo Clinic in Rochester, MN, which evaluates a large number of patients with SLDs annually. The study also intends to recruit minorities with SLDs which are currently understudied. The methods will be performed by a team of world renowned scientists including dementia, movement disorders and speech pathology specialists, radiology researchers, a nuclear medicine scientist, neuropsychologists, and biostatisticians. The long term goal of our research is to develop a cost effective algorithmic approach to the evaluation and diagnosis of patients with SLDs. PUBLIC HEALTH RELEVANCE: This study will identify ways to determine whether Alzheimer's disease is the underlying cause of a patient's progressive speech and language problem. In addition, the study aims to identify the most cost effective way to do this so that more patients, including minorities, can be given an accurate diagnosis. Results from this grant will ultimately lead to better targeted future treatments for patients with problems with speech and language.