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  5. Dynamic 11C-PiB PET shows cerebrospinal fluid flow alterations in Alzheimer's disease and multiple sclerosis
 
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Dynamic 11C-PiB PET shows cerebrospinal fluid flow alterations in Alzheimer's disease and multiple sclerosis
File(s)
CSFClearancePaper_MainText_JNM_May2019.pdf (2.52 MB)
Accepted version
Author(s)
Schubert, Julia J
Veronese, Mattia
Marchitelli, Livia
Bodini, Benedetta
Tonietto, Matteo
more
Type
Journal Article
Abstract
Cerebrospinal fluid (CSF) plays an important role in the clearance of solutes and maintenance of brain homeostasis. 11C-PiB PET was recently proposed as a tool for detection of CSF clearance alterations in Alzheimer's disease. The current study seeks to investigate the magnitude of 11C-PiB PET signal in the lateral ventricles of an independent group of Alzheimer's and mild cognitive impairment subjects. We have also evaluated multiple sclerosis as a model of disease with CSF clearance alterations without amyloid-beta tissue accumulation. Methods: A set of Alzheimer's and mild cognitive impairment subjects and a set of multiple sclerosis subjects with matched healthy controls underwent MRI and dynamic 11C-PiB PET. Manual lateral ventricle regions of interest were generated from MRI data. PET data was analysed using a simplified reference tissue model with cerebellum or a supervised reference region, for the Alzheimer's and multiple sclerosis datasets, respectively. Magnitude of 11C-PiB signal in the lateral ventricles was calculated as area under curve from 35 to 80 minutes and standard uptake value ratio (SUVR) from 50 to 70 minutes. Compartmental modelling analysis was performed on a separate dataset containing Alzheimer's and matched healthy control data with an arterial input function to further understand the kinetics of the lateral ventricular 11C-PiB signal. Results: Analysis of variance revealed significant group differences in lateral ventricular SUVR across the Alzheimer's, mild cognitive impairment, and healthy control groups (P = 0.004). Additional pairwise comparisons revealed significantly lower lateral ventricular SUVR in Alzheimer's compared to healthy controls (p<0.001) and mild cognitive impairment (P = 0.029). Lateral ventricular SUVR was also significantly lower in multiple sclerosis compared to healthy controls (P = 0.008). Compartmental modelling analysis revealed significantly lower uptake rates of 11C-PiB signal from blood (P = 0.005) and brain tissue (P = 0.004) to the lateral ventricles in Alzheimer's compared to healthy controls. This analysis also revealed significantly lower clearance of 11C-PiB signal out of the lateral ventricles in Alzheimer's compared to healthy controls (P = 0.002). Conclusion: Overall, these results indicate that dynamic 11C-PiB PET can be used to observe pathological changes in cerebrospinal fluid dynamics and that cerebrospinal fluid-mediated clearance is reduced in Alzheimer's disease and multiple sclerosis compared to healthy controls.
Date Issued
2019-10-01
Date Acceptance
2019-02-20
Citation
Journal of Nuclear Medicine, 2019, 60 (10), pp.1452-1460
URI
http://hdl.handle.net/10044/1/73855
DOI
https://www.dx.doi.org/10.2967/jnumed.118.223834
ISSN
1535-5667
Publisher
Society of Nuclear Medicine
Start Page
1452
End Page
1460
Journal / Book Title
Journal of Nuclear Medicine
Volume
60
Issue
10
Copyright Statement
©2019 by the Society of Nuclear Medicine and Molecular Imaging. This research was originally published in JNM.
Sponsor
Medical Research Council (MRC)
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/30850505
PII: jnumed.118.223834
Grant Number
G84/6523
Subjects
Alzheimer's disease
Molecular Imaging
Neurology
PET
PET/MRI
PiB PET
cerebrospinal fluid
glymphatic system
multiple sclerosis
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2019-03-08
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