Journal
DEMENTIA AND GERIATRIC COGNITIVE DISORDERS
Volume 34, Issue 2, Pages 112-120Publisher
KARGER
DOI: 10.1159/000341577
Keywords
Alzheimer's disease; Biomarkers; Cerebrospinal fluid biomarkers; FDG-PET; I-123-MIBG myocardial scintigraphy; MRI; Pittsburgh compound B; Tauopathy; Voxel-based morphometry
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Funding
- Grants-in-Aid for Scientific Research [23700817, 24590894] Funding Source: KAKEN
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Background/Aims: We previously found that some cases of clinically diagnosed Alzheimer's disease (AD) were rated as Pittsburgh compound B (PiB) negative by amyloid imaging (i.e. cases of PiB-negative dementia). The present study was designed to analyze the clinical features of PiB-negative dementia patients in detail. Methods: Of the 64 cases of clinically diagnosed AD, 14 were rated PiB negative. Eleven of these were further analyzed using CSF biomarker levels and findings from MRI, FDG-PET, I-123-MIBG myocardial scintigraphy and voxel-based morphometry (VBM). Results: When examined by I-123-MIBG myocardial scintigraphy, the heart/mediastinum ratio was significantly higher in the PiB-negative dementia group than in the dementia with Lewy bodies (DLB) group. Analyses of CSF biomarkers and MRI and FDG-PET findings suggested argyrophilic grain disease (AGD) in 3 cases, frontotemporal lobar degeneration (FTLD) in 3 cases, neurofibrillary tangle-predominant dementia (NFTD) in 1 case, and AD in 2 cases. In the VBM data analysis, the PiB-positive AD group showed significant atrophy of both hippocampi compared with the healthy control group, while the PiB-negative dementia group presented with significant atrophy of the left precuneus. Conclusion: PiB-negative dementia is unlikely to include DLB, while it most likely includes diseases of tauopathy, such as FTLD, AGD and NFTD. A better understanding of PiB-negative dementia is expected to further improve the accuracy of the clinical AD diagnosis. Copyright (C) 2012 S. Karger AG, Basel
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