Sébastien Heyer, Maïa Simon, Matthieu Doyen, Ali Mortada, Véronique Roch, Elodie Jeanbert, Nathalie Thilly, Catherine Malaplate, Anna Kearney-Schwartz, Thérèse Jonveaux, Aurélie Bannay, Antoine Verger
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Here, we aimed to estimate the value of brain <sup>18</sup>F-FDG PET for predicting the risk of dementia conversion and the risk of occurrence of a neurodegenerative pathology.</p><p><strong>Methods: </strong>Longitudinal data for a cohort of patients with no diagnosis of dementia at the time of recruitment referred by a tertiary memory clinic for brain <sup>18</sup>F-FDG PET were matched with (Prince M, Wimo A, Guerchet Maëlenn, Ali G-C, Wu Y-T et al. World Alzheimer Report 2015. The Global Impact of Dementia: An analysis of prevalence, incidence, cost and trends. [Research Report] Alzheimer's Disease International. 2015. 2015.) data from the French National Health Data System (NHDS), (Jack CR, Bennett DA, Blennow K, Carrillo MC, Dunn B, Haeberlein SB, et al. NIA-AA Research Framework: Toward a biological definition of Alzheimer's disease. Alzheimers Dement. 2018;14(4):535-62.) data from the National Alzheimer Bank (NAB), and (Davis M, O`Connell T, Johnson S, Cline S, Merikle E, Martenyi F, et al. Estimating Alzheimer's Disease Progression Rates from Normal Cognition Through Mild Cognitive Impairment and Stages of Dementia. CAR. 2018;15(8):777-88.) lumbar puncture (LP) biomarker data. The criteria for dementia conversion were the designation, within the three years after the brain <sup>18</sup>F-FDG PET scan, of a long-term condition for dementia in the NHDS and a dementia stage of cognitive impairment in the NAB. The criterion for the identification of a neurodegenerative disease in the medical records was the determination of LP biomarker levels.</p><p><strong>Results: </strong>Among the 403 patients (69.9 ± 11.4 years old, 177 women) from the initial cohort with data matched with the NHDS data, 137 were matched with the NAB data, and 61 were matched with LP biomarker data. Within three years of the scan, a <sup>18</sup>F-FDG PET had negative predictive values of 85% for dementia conversion (according to the NHDS and NAB datasets) and 95% for the presence of LP neurodegeneration biomarkers.</p><p><strong>Conclusion: </strong>A normal brain <sup>18</sup>F-FDG PET scan can help rule out the risk of dementia conversion and the presence of cerebrospinal fluid (CSF) biomarker of neurodegeneration early with high certainty, allowing modifications to patient management regimens in the short term.</p><p><strong>Trial registration: </strong>Clinical Trials database (NCT04804722). March 18, 2021. Retrospectively registered.</p>","PeriodicalId":7516,"journal":{"name":"Alzheimer's Research & Therapy","volume":"16 1","pages":"182"},"PeriodicalIF":7.9000,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11320856/pdf/","citationCount":"0","resultStr":"{\"title\":\"<sup>18</sup>F-FDG PET can effectively rule out conversion to dementia and the presence of CSF biomarker of neurodegeneration: a real-world data analysis.\",\"authors\":\"Sébastien Heyer, Maïa Simon, Matthieu Doyen, Ali Mortada, Véronique Roch, Elodie Jeanbert, Nathalie Thilly, Catherine Malaplate, Anna Kearney-Schwartz, Thérèse Jonveaux, Aurélie Bannay, Antoine Verger\",\"doi\":\"10.1186/s13195-024-01535-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Precisely defining the delay in onset of dementia is a particular challenge for early diagnosis. 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The Global Impact of Dementia: An analysis of prevalence, incidence, cost and trends. [Research Report] Alzheimer's Disease International. 2015. 2015.) data from the French National Health Data System (NHDS), (Jack CR, Bennett DA, Blennow K, Carrillo MC, Dunn B, Haeberlein SB, et al. NIA-AA Research Framework: Toward a biological definition of Alzheimer's disease. Alzheimers Dement. 2018;14(4):535-62.) data from the National Alzheimer Bank (NAB), and (Davis M, O`Connell T, Johnson S, Cline S, Merikle E, Martenyi F, et al. Estimating Alzheimer's Disease Progression Rates from Normal Cognition Through Mild Cognitive Impairment and Stages of Dementia. CAR. 2018;15(8):777-88.) lumbar puncture (LP) biomarker data. The criteria for dementia conversion were the designation, within the three years after the brain <sup>18</sup>F-FDG PET scan, of a long-term condition for dementia in the NHDS and a dementia stage of cognitive impairment in the NAB. The criterion for the identification of a neurodegenerative disease in the medical records was the determination of LP biomarker levels.</p><p><strong>Results: </strong>Among the 403 patients (69.9 ± 11.4 years old, 177 women) from the initial cohort with data matched with the NHDS data, 137 were matched with the NAB data, and 61 were matched with LP biomarker data. Within three years of the scan, a <sup>18</sup>F-FDG PET had negative predictive values of 85% for dementia conversion (according to the NHDS and NAB datasets) and 95% for the presence of LP neurodegeneration biomarkers.</p><p><strong>Conclusion: </strong>A normal brain <sup>18</sup>F-FDG PET scan can help rule out the risk of dementia conversion and the presence of cerebrospinal fluid (CSF) biomarker of neurodegeneration early with high certainty, allowing modifications to patient management regimens in the short term.</p><p><strong>Trial registration: </strong>Clinical Trials database (NCT04804722). March 18, 2021. 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引用次数: 0
摘要
背景：准确界定痴呆症发病的延迟时间是早期诊断的一项特殊挑战。脑[18F]氟-2-脱氧-2-D-葡萄糖（18F-FDG）正电子发射断层扫描（PET）通过测量脑葡萄糖代谢率，是早期诊断神经退行性疾病的一种特别有趣的工具。目前，还缺乏在真实条件下对足够多的患者进行纵向研究，以准确评估脑 18F-FDG PET 扫描的预测价值。在此，我们旨在估算脑 18F-FDG PET 对预测痴呆转化风险和神经退行性病变发生风险的价值：将招募时未确诊痴呆症的患者队列的纵向数据与一家三级记忆诊所转诊的脑18F-FDG PET数据进行比对（Prince M、Wimo A、Guerchet Maëlenn、Ali G-C、Wu Y-T et al.痴呆症的全球影响：对患病率、发病率、成本和趋势的分析。[研究报告] 阿尔茨海默病国际。2015.2015.) 数据来自法国国家健康数据系统 (NHDS)，（Jack CR, Bennett DA, Blennow K, Carrillo MC, Dunn B, Haeberlein SB, et al. NIA-AA Research Framework：NIA-AA Research Framework: Toward a biological definition of Alzheimer's disease.Alzheimers Dement.2018;14(4):535-62.) 数据来自国家阿尔茨海默病库（NAB），以及（Davis M, O`Connell T, Johnson S, Cline S, Merikle E, Martenyi F, et al. Estimating Alzheimer's Disease Progression Rates from Normal Cognition Through Mild Cognitive Impairment and Stages of Dementia.CAR.2018；15（8）：777-88。）腰椎穿刺（LP）生物标志物数据。痴呆转换的标准是，在脑18F-FDG PET扫描后的三年内，在NHDS中被指定为痴呆长期病症，在NAB中被指定为痴呆认知障碍阶段。病历中确定神经退行性疾病的标准是确定 LP 生物标志物水平：在与 NHDS 数据相匹配的初始队列中的 403 名患者（69.9 ± 11.4 岁，177 名女性）中，137 人与 NAB 数据相匹配，61 人与 LP 生物标记物数据相匹配。扫描后三年内，18F-FDG PET 对痴呆症转化的阴性预测值为 85%（根据 NHDS 和 NAB 数据集），对 LP 神经变性生物标记物存在的阴性预测值为 95%：结论：正常的脑18F-FDG正电子发射计算机断层扫描可帮助早期排除痴呆转化的风险和存在脑脊液（CSF）神经变性生物标志物的高度确定性，从而在短期内修改患者管理方案：临床试验数据库（NCT04804722）。2021年3月18日。回顾性注册。
18F-FDG PET can effectively rule out conversion to dementia and the presence of CSF biomarker of neurodegeneration: a real-world data analysis.
Background: Precisely defining the delay in onset of dementia is a particular challenge for early diagnosis. Brain [18F] fluoro-2-deoxy-2-D-glucose (18F-FDG) Positron Emission Tomography (PET) is a particularly interesting tool for the early diagnosis of neurodegenerative diseases, through the measurement of the cerebral glucose metabolic rate. There is currently a lack of longitudinal studies under real-life conditions, with sufficient patients, to accurately evaluate the predictive values of brain 18F-FDG PET scans. Here, we aimed to estimate the value of brain 18F-FDG PET for predicting the risk of dementia conversion and the risk of occurrence of a neurodegenerative pathology.
Methods: Longitudinal data for a cohort of patients with no diagnosis of dementia at the time of recruitment referred by a tertiary memory clinic for brain 18F-FDG PET were matched with (Prince M, Wimo A, Guerchet Maëlenn, Ali G-C, Wu Y-T et al. World Alzheimer Report 2015. The Global Impact of Dementia: An analysis of prevalence, incidence, cost and trends. [Research Report] Alzheimer's Disease International. 2015. 2015.) data from the French National Health Data System (NHDS), (Jack CR, Bennett DA, Blennow K, Carrillo MC, Dunn B, Haeberlein SB, et al. NIA-AA Research Framework: Toward a biological definition of Alzheimer's disease. Alzheimers Dement. 2018;14(4):535-62.) data from the National Alzheimer Bank (NAB), and (Davis M, O`Connell T, Johnson S, Cline S, Merikle E, Martenyi F, et al. Estimating Alzheimer's Disease Progression Rates from Normal Cognition Through Mild Cognitive Impairment and Stages of Dementia. CAR. 2018;15(8):777-88.) lumbar puncture (LP) biomarker data. The criteria for dementia conversion were the designation, within the three years after the brain 18F-FDG PET scan, of a long-term condition for dementia in the NHDS and a dementia stage of cognitive impairment in the NAB. The criterion for the identification of a neurodegenerative disease in the medical records was the determination of LP biomarker levels.
Results: Among the 403 patients (69.9 ± 11.4 years old, 177 women) from the initial cohort with data matched with the NHDS data, 137 were matched with the NAB data, and 61 were matched with LP biomarker data. Within three years of the scan, a 18F-FDG PET had negative predictive values of 85% for dementia conversion (according to the NHDS and NAB datasets) and 95% for the presence of LP neurodegeneration biomarkers.
Conclusion: A normal brain 18F-FDG PET scan can help rule out the risk of dementia conversion and the presence of cerebrospinal fluid (CSF) biomarker of neurodegeneration early with high certainty, allowing modifications to patient management regimens in the short term.
期刊介绍：
Alzheimer's Research & Therapy is an international peer-reviewed journal that focuses on translational research into Alzheimer's disease and other neurodegenerative diseases. It publishes open-access basic research, clinical trials, drug discovery and development studies, and epidemiologic studies. The journal also includes reviews, viewpoints, commentaries, debates, and reports. All articles published in Alzheimer's Research & Therapy are included in several reputable databases such as CAS, Current contents, DOAJ, Embase, Journal Citation Reports/Science Edition, MEDLINE, PubMed, PubMed Central, Science Citation Index Expanded (Web of Science) and Scopus.
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