Zanovello, M;
Sorarù, G;
Campi, C;
Anglani, M;
Spimpolo, A;
Berti, S;
Bussè, C;
... Cecchin, D; + view all
(2022)
Brain Stem Glucose Hypermetabolism in Amyotrophic Lateral Sclerosis/Frontotemporal Dementia and Shortened Survival: An 18F-FDG PET/MRI Study.
Journal of Nuclear Medicine
, 63
(5)
pp. 777-784.
10.2967/jnumed.121.262232.
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Abstract
A few 18F-FDG PET/CT studies have revealed the presence of brain hypermetabolism in the brain stem and cervical spinal cord of patients within the amyotrophic lateral sclerosis/frontotemporal dementia (ALS/ FTD) continuum. We aimed to investigate this finding through a hybrid PET/MRI system, allowing amore precise depiction of the spatial pattern of metabolic changes in the brain stem and cervical spinal cord. Methods: Twenty-eight patients with a diagnosis of ALS or a diagnosis of the behavioral variant of FTD plus motoneuron disease, as well as 13 control subjects, underwent 18F-FDG PET/MRI. Mean normalized 18F-FDG uptake in the midbrain/pons, medulla oblongata, and cervical spinal cord as defined on the individual's MRI scans were compared between groups. Furthermore, the associations between regional 18F-FDG uptake and clinical and demographic characteristics - including gene mutation, type of onset (bulbar, spinal, dementia), and clinical characteristics - were investigated. Results: A significant (P < 0.005) increment in glucose metabolism in the midbrain/pons and medulla oblongata was found in ALS/FTD patients (spinal-ALS and FTD-motor neuron disease subgroups) in comparison to controls. No relevant associations between clinical and metabolic features were reported, although medulla oblongata hypermetabolism was associated with shortened survival (P < 0.001). Conclusion: Increased glucose metabolism in the brain stem might be due to neuroinflammation, one of the key steps in the pathogenic cascade that leads to neurodegeneration in ALS/FTD. 18F-FDG PET/MRI could be a valuable tool to assess glial changes in the ALS/FTD spectrum and could serve as a prognostic biomarker. Large prospective initiatives would likely shed more light on the promising application of PET/MRI in this setting.
| Type: | Article |
|---|---|
| Title: | Brain Stem Glucose Hypermetabolism in Amyotrophic Lateral Sclerosis/Frontotemporal Dementia and Shortened Survival: An 18F-FDG PET/MRI Study |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.2967/jnumed.121.262232 |
| Publisher version: | https://doi.org/10.2967/jnumed.121.262232 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | FTD, PET, amyotrophic lateral sclerosis, brain stem, survival, Amyotrophic Lateral Sclerosis, Brain Stem, Fluorodeoxyglucose F18, Frontotemporal Dementia, Glucose, Humans, Magnetic Resonance Imaging, Positron Emission Tomography Computed Tomography, Prospective Studies, Tomography, X-Ray Computed |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Department of Neuromuscular Diseases |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10175398 |
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