Amyloid pet in primary progressive aphasia: case series and systematic review of the literature

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• 作者：Alberto Villarejo-Galende ; Sara Llamas-Velasco ; Adolfo Gómez-Grande…
• 关键词：PET ; Amyloid ; Primary progressive aphasia ; PIB ; Florbetapir
• 刊名：Journal of Neurology
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：264
• 期：1
• 页码：121-130
• 全文大小：
• 刊物类别：Medicine
• 刊物主题：Neurology; Neurosciences; Neuroradiology;
• 出版者：Springer Berlin Heidelberg
• ISSN：1432-1459
• 卷排序：264

文摘

Primary progressive aphasia (PPA) is considered a heterogeneous syndrome, with different clinical subtypes and neuropathological causes. Novel PET biomarkers may help to predict the underlying neuropathology, but many aspects remain unclear. We studied the relationship between amyloid PET and PPA variant in a clinical series of PPA patients. A systematic review of the literature was performed. Patients with PPA were assessed over a 2-year period and classified based on language testing and the International Consensus Criteria as non-fluent/agrammatic (nfvPPA), semantic (svPPA), logopenic variant (lvPPA) or as unclassifiable (ucPPA). All patients underwent a Florbetapir (18-F) PET scan and images were analysed by two nuclear medicine physicians, using a previously validated reading method. Relevant studies published between January 2004 and January 2016 were identified by searching Medline and Web of Science databases. Twenty-four PPA patients were included (13 women, mean age 68.8, SD 8.3 years; range 54–83). Overall, 13/24 were amyloid positive: 0/2 (0%) nfvPPA, 0/4 (0%) svPPA, 10/14 (71.4%) lvPPA and 3/4 (75%) ucPPA (p = 0.028). The systematic review identified seven relevant studies, six including all PPA variants and one only lvPPA. Pooling all studies together, amyloid PET positivity was 122/224 (54.5%) for PPA, 14/52 (26.9%) for nfvPPA, 6/47 (12.8%) for svPPA, 101/119 for lvPPA (84.9%) and 12/22 (54.5%) for ucPPA. Amyloid PET may help to identify the underlying neuropathology in PPA. It could be especially useful in ucPPA, because in these cases it is more difficult to predict pathology. ucPPA is frequently associated with amyloid pathology.