(18) F-flortaucipir tau PET distinguishes established progressive supranuclear palsy from controls and Parkinson’s disease: A multicenter study.
Ann Neurol. 2017 Oct 05;:
Authors: Schonhaut DR, McMillan CT, Spina S, Dickerson BC, Siderowf A, Devous MD, Tsai R, Winer J, Russell DS, Litvan I, Roberson ED, Seeley WW, Grinberg LT, Kramer JH, Miller BL, Pressman P, Nasrallah I, Baker SL, Gomperts SN, Johnson KA, Grossman M, Jagust WJ, Boxer AL, Rabinovici GD
OBJECTIVE: (18) F-flortaucipir (formerly (18) F-AV1451 or (18) F-T807) binds to neurofibrillary tangles in Alzheimer’s disease (AD), but tissue studies assessing binding to tau aggregates in progressive supranuclear palsy (PSP) have yielded mixed results. We compared in vivo (18) F-flortaucipir uptake in patients meeting clinical research criteria for PSP (N=33) to normal controls (N=46) and patients meeting criteria for Parkinson’s disease (PD, N=26).
METHODS: Participants underwent MRI and positron emission tomography for amyloid-β ((11) C-PiB or (18) F-florbetapir) and tau ((18) F-flortaucipir). (18) F-flortaucipir Standardized Uptake Value Ratios were calculated (t=80-100 min, cerebellum gray matter reference). Voxelwise and region-of-interest group comparisons were performed in template space, with Receiver Operating Characteristic curve analyses to assess single-subject discrimination. Qualitative comparisons with postmortem tau are reported in one patient who died nine months after (18) F-flortaucipir.
RESULTS: Clinical PSP patients showed bilaterally elevated (18) F-flortaucipir uptake in globus pallidus, putamen, subthalamic nucleus, midbrain and dentate nucleus relative to controls and PD patients (voxelwise p<0.05 family-wise-error-corrected). Globus pallidus binding best distinguished PSP patients from controls and PD (Area Under the Curve (AUC)=0.872 vs. controls, AUC=0.893 vs. PD). PSP clinical severity did not correlate with (18) F-flortaucipir in any region. A patient with clinical PSP and pathological diagnosis of corticobasal degeneration had severe tau-pathology in PSP-related brain structures with good correspondence between in vivo (18) F-flortaucipir and postmortem tau neuropathology.
INTERPRETATION: (18) F-flortaucipir uptake was elevated in PSP versus controls and PD patients in a pattern consistent with the expected distribution of tau pathology. This article is protected by copyright. All rights reserved.
PMID: 28980714 [PubMed – as supplied by publisher]